Soft Drinks & Your Liver: Sugar vs Sugar-Free Sweeteners

First of all, how’s your liver health? If you’re not sure, then rather than guessing, you might like to quickly check out: 12 Signs Of Liver Disease That You Can See

…to make sure that your liver isn’t about to defy its name. The liver (when healthy) is a remarkably self-regenerative organ, but the flipside of this is that this means that very often problems do not get noticed until something goes very seriously wrong.

Now, about those soft drinks…

Not so sweet after all?

Firstly, while liver failure is commonly associated with excessive drinking of alcohol (and indeed, alcohol does very much harm the liver), actually most liver disease takes the form of the awkwardly-rebranded metabolic dysfunction-associated steatotic liver disease (MASLD). If you noticed that the words do not add up to the acronym, then, so did we and we haven’t found an explanation for it either*

In any case, it’s what is formerly known as, and for now at least still better known as, non-alcoholic fatty liver disease (NAFLD).

*We delved more into this, looking and why and how the name was changed (i.e. including the voting process for the new name), within part of a previous article of ours, here: Top Diets & Fasting vs Fatty Liver: What’s Best?

MASLD, as we will now begrudgingly refer to it, is often precipitated by a diet (including drinks) high in carbs, especially sugars, without sufficient fiber. We explained why this dietary imbalance does such harm to the liver, here: From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?

So, it can safely be acknowledged that sugary beverages (including sugar-sweetened soft drinks, which we’re going to be talking about today, and also including fruit juices as these have been stripped of fiber, but not smoothies or whole fruit) are bad for the liver, by the mechanism described in the above-linked article.

But what of artificial sweeteners?

Since they do not contain sugar, or at least not sugar that is metabolized normally as such (since technically some artificial sweeteners are sugars, chemically speaking, but the body cannot metabolize them and so instead processes them as dietary fiber), they must be better for the liver, right?

New research presented at the United European Gasteroenterology week suggests otherwise.

In fact,

❝A higher intake of both low-or-no-sugar-sweetened beverages and sugar-sweetened beverages (>250g per day) was associated with a 60% (HR: 1.599) and 50% (HR: 1.469) elevated risk of developing MASLD, respectively.

Over the median 10.3-year follow-up, 1,178 participants developed MASLD and 108 died from liver-related causes.

Both beverage types were also positively associated with higher liver fat content.❞

Note: 250g is an odd way to measure drinks (usually measured in volume, not mass), but that equals 1 cup, in any case.

So, translating from sciencese:

• sugar-sweetened soft drinks increase the risk of MASLD by 50%
• diet soft drinks increase the risk of MASLD by 60%

Caveat: this was an observational study so when we say “increased the risk” really we mean “were associated with an increase in risk”, since it doesn’t strictly prove causality. However, with a sample size of 123,788 participants, the evidence does look rather damning, doesn’t it?

You can read more about the study here: Artificially-sweetened and sugary drinks linked to higher risk of non-alcoholic fatty liver disease

If, perchance, you have decided that for you, artificial sweeteners are still the “lesser evil” (and indeed there may be reasons this could be appropriate for some), then you might want to check out:

What’s The Healthiest Sweetener?

Want to do more for your liver?

Consider: N-Acetyl Cysteine For The Liver & More

Or if you prefer a purely dietary approach, then: How To Unfatty A Fatty Liver

Take care!