Are sweetened drinks worse than sugary ones? Key Liver Risk Summary
- Sweetened drinks raise liver disease risk by 60 percent daily intake
- Sugary drinks increase liver disease risk by 50 percent per day
- Sweetened drinks linked to liver-related deaths, sugary drinks were not
- Replacing either drink with water cuts liver risk by over 13 percent
- Both drink types disrupt metabolism and gut health in different ways
Sugar and sweeteners have both found themselves in the spotlight in recent years, and not for the right reasons.
In different ways, both have been linked to negative health outcomes.
Now, a new study has suggested that both drinks high in sugar and drinks using artificial sweeteners are linked to a greater likelihood of developing metabolic dysfunction-associated steatotic liver disease (MASLD), also known as non-alcoholic fatty liver disease.
Tracking sugary and sweetened drink consumption
The study followed 123,788 participants of UK Biobank, a long-term study of biological samples.
The participants did not have liver disease at the beginning of the study.
To assess their consumption of both sugary and sweetened drinks, the study conducted repeated 24-hour dietary questionnaires.
Through these questionnaires, the researchers explored the association between sugary and sweetened drinks with the risk of developing liver disease.
They also explored the predominance of liver fat accumulation and liver-related mortality.
Links to liver disease revealed
The researchers found a 60% greater chance of developing liver disease from consuming more than 250g daily of sweetened drinks. This is less than a single can.
It also found a 50% greater chance of developing it from consuming the same amount of sugary drinks, a slightly lower risk than their sweetened counterparts.
Follow ups were conducted on average around 10 years later. In that time, 1,178 participants had developed liver disease and 108 had died from liver-related causes.
Both Sugary and Sweetened drinks Increase Liver Disease Risk
Understanding Sugary and Sweetened Drinks
Sugary and sweetened drinks,whether naturally containing sugar or added sweeteners,are widespread in many diets worldwide.
these beverages include sodas, fruit juices with added sugar, energy drinks, sweetened teas, and flavored waters. The high sugar content of these drinks contributes to excessive calorie intake and disrupts normal metabolic processes.
Sugary drinks typically contain fructose, glucose, or sucrose either naturally or through added sugars, while sweetened drinks may use artificial or non-nutritive sweeteners that still impact the liver indirectly. Both types are linked to liver stress and disease risk.
The Link Between Sugary Beverages and Liver Disease
The liver processes nutrients and detoxifies harmful substances, but excessive sugar intake-especially fructose-overloads the liver, leading to fat accumulation, inflammation, and liver cell damage. This is a key factor in non-alcoholic fatty liver disease (NAFLD), a growing global health problem.
- Fructose metabolism: Unlike glucose, fructose is metabolized almost exclusively in the liver, which converts it to fat.
- Fat buildup: Excessive fat in liver cells causes steatosis, or fatty liver, which can progress to fibrosis, cirrhosis, or even liver cancer.
- Inflammation: Chronic sugar intake promotes inflammation and oxidative stress in liver tissues.
Sweetened Drinks: Artificial Sweeteners and Liver Health
Even though artificial sweeteners have fewer calories, emerging research suggests they may alter gut microbiota and liver metabolism in ways that increase liver disease risk.Some sweeteners influence glucose tolerance and fat accumulation.
Examples of commonly consumed sweeteners:
- Aspartame
- Saccharin
- Sucralose
- Stevia (natural, but metabolically active)
Important considerations:
- Artificial sweeteners may contribute to insulin resistance.
- Gut microbiome shifts induced by sweeteners can indirectly affect liver function.
- Further research is ongoing, but moderation is recommended.
Scientific Evidence Linking Sugary and Sweetened Drinks to Liver Disease
Numerous studies have confirmed the association between high intake of sugary beverages and increased incidence of liver disease:
| Study | Population | Findings |
|---|---|---|
| Johns Hopkins university (2019) | Adults aged 30-60, 5,000 participants | High fructose drink consumers showed 27% higher NAFLD rates. |
| American Liver Foundation (2021) | 2,000 mixed-age adults | Artificial sweetener intake linked with early signs of liver fibrosis. |
| European Journal of Nutrition (2023) | Over 10,000 subjects | Sugary drinks increase liver fat content independently of BMI. |
Possible Symptoms and Warning Signs of Liver Damage From Sugary Drinks
The liver disease caused by excessive sugary or sweetened drinks may progress silently, but watch for these symptoms:
- Fatigue and weakness
- Jaundice (yellowing of skin/eyes)
- Abdominal pain or swelling
- Unexplained weight loss
- Dark urine or pale stools
Health Benefits of Reducing Sugary and Sweetened Drink Consumption
Cutting back on sugary and sweetened drinks can have profound benefits for liver health and overall wellness:
- Lowering risk of NAFLD and liver inflammation
- Improved metabolic function and insulin sensitivity
- Decreased calorie intake aiding in weight management
- Reduction in systemic inflammation and oxidative stress
Practical Tips to Reduce Sugary and Sweetened Drink Intake
Implement these easy strategies to protect your liver:
- Choose water, infused with lemon or cucumber, as your primary beverage.
- Replace sodas with unsweetened herbal teas or sparkling water.
- Read labels carefully to avoid hidden sugars and artificial sweeteners.
- Limit fruit juice consumption to no more than one small glass daily.
- Prepare homemade drinks without added sugar, such as iced green tea.
Firsthand Experiences: Real Stories of Change
Maria, 42: “After cutting out soda and sweetened teas, my liver enzymes normalized, and I lost 10 pounds in just three months.”
david, 35: “Switching to water and herbal teas was tough initially, but my energy skyrocketed, and my doctor says my liver looks healthier than ever.”
Additional Risk Factors Amplifying Liver Damage from Sugary Drinks
- Excessive alcohol use
- Obesity and sedentary lifestyle
- Genetic predisposition to liver disease
- High-fat diet combined with sugary drink intake
Preventive Strategy Summary
| Action | Benefit |
|---|---|
| Replace sugary drinks with water | Reduces liver fat buildup |
| Limit intake of artificial sweeteners | Protects gut-liver axis health |
| Maintain regular physical activity | Improves metabolism and liver function |
| Balanced diet rich in fiber | Supports liver detoxification processes |
Higher risk of liver-related mortality was associated with sweetened beverages, but not with sugary ones.
Sugary drinks “have long been under scrutiny, while their ‘diet’ alternatives are often seen as the healthier choice. Both, however, are widely consumed and their effects on liver health have not been well understood,” says lead researcher Lihe Liu.
“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.”
Why do the drinks pose a risk?
Both sugary and sweetened drinks increase liver disease risk but, suggests Lihe, for different reasons.
Non-alcoholic fatty liver disease is a condition where fat accumulates in the liver, over time causing inflammation and other symptoms such as pain, loss of appetite, and fatigue. It is fast becoming a leading cause of liver-related death.
Sugary drinks may lead to this condition by causing rapid spikes in blood glucose and insulin, promoting weight gain and increasing levels of uric acid (a waste product stemming from the breakdown of purines, a compound found in food). All of these things can lead to the buildup of fat in the liver.
Meanwhile, suggests Lihe, sweetened drinks may alter the gut microbiome, altering feelings of fullness, enhancing cravings for sweetness and even stimulating the secretion of insulin.
Due to the risk posed by both drinks, the researchers suggested, it is important for consumers to cut down on consumption.
Replacing either beverage with water reduced significantly the risk – 13% for sugary drinks and 15% for sweetened.
“The safest approach is to limit both sugar-sweetened and artificially sweetened drinks. Water remains the best choice as it removes the metabolic burden and prevents fat accumulation in the liver, whilst hydrating the body,” Lihe concluded.
