A major new study published during the United European Gastroenterology (UEG) Week 2025 found that both sugar-sweetened beverages (SSB) and low- or no-sugar beverages (LNSSB) were significantly associated with an increased risk of metabolic disorder-related fatty liver disease (MASLD).
This study assessed beverage intake using repeated 24-hour dietary questionnaires in 123,788 UK Biobank participants without pre-existing liver disease. This study tracked the development of MASLD, liver fat accumulation, and liver-related mortality over a mean follow-up period of 10.3 years.
Increased risk found with both beverage types
Participants consuming more than 250 g/day of LNSSB or SSB were found to have a 60% (HR: 1.599) and 50% (HR: 1.469) higher risk of developing MASLD, respectively. Among the cohort, 1,178 participants developed MASLD and 108 died from liver-related causes. SSBs were not associated with liver-related mortality, but LNSSB intake was associated with higher liver-related mortality. Both beverage types were associated with increased liver fat content.
MASLD: There is growing concern around the world.
MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD), occurs when fat builds up in the liver, potentially causing inflammation and symptoms such as pain, fatigue, and loss of appetite. The disease affects more than 30% of the world’s population and is a rapidly increasing cause of liver-related death.
Expert Insight
“SSBs have been under close scrutiny for a long time, and their ‘diet’ alternatives are often seen as healthier choices. However, both are widely consumed, and their effects on liver health are not well understood,” said Lihe Liu, senior author and a graduate student in the Department of Gastroenterology at the First Affiliated Hospital of Suzhou University.
Liu added, “Our study shows that LNSSBs are actually associated with a higher risk of MASLD, even at moderate intakes, such as one can per day. These findings challenge the common perception that these drinks are harmless and highlight the need to reconsider their role in diet and liver health.”
Prevention through beverage choices
This study highlights limiting both SSBs and LNSSBs as part of a broader strategy to prevent liver and metabolic diseases. Replacing these drinks with water significantly reduced the risk of MASLD by 12.8% for SSBs and 15.2% for LNSSBs, whereas switching between the two types of drinks did not reduce the risk.
Liu concludes, “The safest approach is to limit both sugar-sweetened and artificially sweetened beverages. Water is still the best choice as it hydrates the body while removing metabolic burden and preventing fat build-up in the liver.”
