Just one can a day of an artificially sweetened drink can lead to a higher risk of liver disease than its sugary equivalent, a major new study has found.
Affecting over 30 per cent of people globally, metabolic dysfunction-associated steatotic liver disease (MASLD) is a condition where fat builds up in the liver.
The research, presented at the United European Gastroenterology Week in Berlin, examines the impact of sugary versus non-sugary beverages.
“Sugar sweetened beverages (SSBs) have long been under scrutiny, while their ‘diet’ alternatives are often seen as the healthier choice,” said lead study author Lihe Liu, a graduate student in the department of gastroenterology at the First Affiliated Hospital of Soochow University, in Suzhou, China.
However, the study refutes this notion as “even a single can per day” of artificially sweetened drinks were linked to a higher risk of liver disease, Liu said.
The study followed 123,788 participants in UK Biobank without liver disease over 10 years. Beverage consumption was assessed using repeated 24-hour dietary questionnaires at various points throughout the decade.
Researchers found that consuming sugar-sweetened beverages (SSBs) increased the risk of MASLD by 50 per cent while low or non-sugar-sweetened beverages (LNSSBs) increased the risk by 60 per cent.
“These findings challenge the common perception that these drinks are harmless and highlight the need to reconsider their role in diet and liver health, especially as MASLD emerges as a global health concern,” Liu added.
Over the 10-year follow up, 1,178 participants developed MASLD and 108 died from liver-related causes.
Consuming artificially sweetened drinks was linked to a higher risk of dying from liver disease.
In sugary drinks, the higher sugar content “can cause rapid spikes in blood glucose and insulin, promote weight gain and increase uric acid levels, all of which contribute to liver fat accumulation,” Liu said.
Artificially sweetened drinks impact the liver health by “altering the gut microbiome, disrupting the feeling of fullness, driving sweet cravings and even stimulating insulin secretion”.
According to the NHS, MASLD, also known as non-alcoholic fatty liver disease, has four stages. The first stage, which is very common, is where there is a build-up of fat but no damage to the liver.
A small number of people will progress to the later stages with more serious liver damage. However, this can be prevented with lifestyle changes.
The study’s authors emphasised that replacing SSBs and LNSSBs with water significantly reduced the risk of liver disease by more than 10 per cent.
“The safest approach is to limit both sugar-sweetened and artificially sweetened drinks,” Liu said.
“Water remains the best choice as it removes the metabolic burden and prevents fat accumulation in the liver, whilst hydrating the body.”
