A decade-long analysis of nearly 124,000 UK Biobank participants found both sugar-sweetened and artificially sweetened drinks were associated with increased risk of fatty liver disease, while replacing them with water lowered risk.
By yourNEWS Media Newsroom
Both regular and diet sodas may increase the risk of fatty liver disease, according to a 10-year study that challenges the long-held belief that artificially sweetened drinks are a safer alternative to sugary beverages.
Researchers from the First Affiliated Hospital of Soochow University analyzed data from 123,788 UK Biobank participants over a median follow-up period of 10.3 years. The findings were presented Oct. 7, 2025, at UEG Week in Berlin, Germany.
The study focused on metabolic dysfunction-associated steatotic liver disease, or MASLD, the condition previously known as non-alcoholic fatty liver disease. The disease occurs when excess fat builds up in the liver and is increasingly common worldwide.
During the study period, 1,178 participants developed MASLD, and 108 died from liver-related causes.
Researchers found that consuming more than 250 grams of sugary beverages per day, roughly the amount in a standard can, was associated with a 50% higher risk of developing fatty liver disease. Artificially sweetened beverages were linked to an even higher risk. Participants who consumed a similar daily amount of diet drinks had a 60% higher risk.
The study also found that only artificially sweetened beverages were significantly associated with liver-related deaths. Sugary drinks did not show the same mortality association in the analysis.
The relationship was dose-dependent, meaning participants who drank more sweetened beverages generally had higher risk.
Researchers said regular and diet drinks may harm the liver through different biological pathways.
Sugar-sweetened beverages can contribute to fat buildup in the liver by causing rapid increases in blood glucose and insulin, promoting weight gain and raising uric acid levels. Those effects can drive metabolic dysfunction and encourage fat accumulation in liver cells.
Diet drinks may affect the liver differently. Artificial sweeteners may alter gut bacteria, disrupt metabolism, interfere with satiety signals, increase cravings for sweet foods and potentially trigger insulin responses despite containing no sugar.
Those microbiome and metabolic effects may help explain why artificially sweetened drinks showed a stronger link to liver disease risk and were the only beverage type significantly associated with liver-related mortality.
The findings are notable because diet drinks have long been marketed as a healthier substitute for sugar-sweetened sodas. For decades, many consumers were told that replacing regular soda with diet versions could help reduce calories, manage weight and lower chronic disease risk.
The new study complicates that message, particularly for people concerned about liver health.
Researchers also examined whether switching from one type of sweetened drink to the other reduced risk. It did not. Replacing sugary drinks with artificially sweetened drinks, or diet drinks with sugary beverages, was not associated with a meaningful risk reduction.
Water was the clear exception.
Replacing sugar-sweetened beverages with water reduced MASLD risk by 12.8%. Replacing artificially sweetened beverages with water reduced risk by 15.2%.
Researchers said that finding suggests the safest approach is not to switch between regular and diet soda but to reduce both and choose water instead.
MASLD often develops silently and may not cause symptoms until significant liver damage has occurred. Many people discover the condition only after abnormal blood tests, imaging or persistent fatigue lead to further evaluation.
The condition now affects an estimated 30% of adults worldwide and is becoming a growing cause of liver-related illness and death.
The study’s lead author said the findings challenge the common assumption that diet drinks are harmless and support limiting both sugar-sweetened and artificially sweetened beverages as part of a broader prevention strategy.
For people trying to reduce soda intake, researchers pointed to water as the best replacement. Plain water avoids the sugar burden of regular soda and the potential metabolic disruption associated with artificial sweeteners.
For those who struggle with plain water, simple additions such as lemon or cucumber may provide flavor without adding the metabolic risks linked to sweetened beverages.
The study does not prove that sodas alone cause fatty liver disease, but its size, duration and dose-related findings add to growing evidence that both sugary and artificially sweetened drinks may carry health risks.
For liver health, the clearest recommendation from the research is straightforward: limit both regular and diet sodas and replace them with water whenever possible.
Source: Natural News
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