A large-scale investigation has found that people who regularly consume both sugar-sweetened beverages (SSBs) and low- or no-sugar-sweetened beverages (LNSSBs) face a significantly greater likelihood of developing metabolic dysfunction-associated steatotic liver disease (MASLD), previously called non-alcoholic fatty liver disease.
About the new research
The research followed 123,788 adults from the UK Biobank, an ongoing study of more than 500,000 adults across the United Kingdom, who had no signs of liver disease at the start of the study.
Participants' beverage consumption habits were recorded through repeated 24-hour dietary questionnaires, allowing researchers to explore how both SSB and LNSSB consumption related to MASLD, liver fat buildup, and deaths linked to liver disease.
The findings
Individuals who drank more than 250 grams of either type of beverage per day had notably higher risks: a 60% increased likelihood of developing MASLD for those consuming LNSSBs and a 50% increase for those drinking SSBs.
During an average follow-up of 10 years, 1,178 participants developed MASLD and 108 died from liver-related causes.
Although SSBs were not statistically significantly connected to liver-related mortality, LNSSB consumption was. Both kinds of drinks were also associated with higher levels of liver fat.
What is MASLD?
MASLD occurs when excess fat builds up in the liver. Over time, this can trigger inflammation (hepatitis) and lead to symptoms such as abdominal pain, fatigue and loss of appetite.
Now the most common chronic liver condition worldwide, MASLD affects more than 30% of people and is rapidly becoming a leading cause of liver-related deaths.
The study’s lead researcher explained, "Our study shows that LNSSBs were actually linked to a higher risk of MASLD, even at modest intake levels such as a single 355 ml 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, especially as MASLD emerges as a global health concern."
How soft drinks harm the liver
The higher sugar content in SSBs 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.
LNSSBs, on the other hand, may affect liver health by altering the gut microbiome, disrupting the feeling of fullness, driving sweet cravings and even stimulating insulin secretion.
The findings support limiting both SSBs and LNSSBs as part of a c prevention strategy, targeting not only liver disease but also cardiometabolic health.
Replacing either beverage with water significantly reduced MASLD risk -- by 12.8% for SSBs and 15.2% for LNSSBs -- while substitution between the two types of beverages offered no risk reduction.
The researchers now aim to explore causal mechanisms more deeply through long-term, randomized and genetic trials with a focus on how sugar and its substitutes interact with the gut microbiome and influence liver disease.
Source: Liu, L et al. Sugar- and low/non-sugar-sweetened beverages and risks of metabolic dysfunction-associated steatotic liver disease and liver-related mortality: A prospective analysis of the UK Biobank. Presented at UEG Week 2025; 7 October 2025; Berlin, Germany.
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