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Maybe sugar substitutes aren’t such a Splenda-did idea.
An eye-opening new study links artificially sweetened beverages to an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD), the most common liver disease in the US. Surprisingly, these supposed guilt-free guzzlers carried a higher risk than sugary soda.
“Our study shows that [low- or non-sugar-sweetened beverages] were actually linked to a higher risk of MASLD, even at modest intake levels such as a single can per day,” said lead study author Lihe Liu, a gastroenterology grad student at the First Affiliated Hospital of Soochow University in China.
“These findings challenge the common perception that these drinks are harmless and highlight the need to reconsider their role in diet and liver health,” Liu added, “especially as MASLD emerges as a global health concern.”
Diet drinks have long been marketed as a healthier alternative to soda because they don’t have loads of sugar and calories.
But research has increasingly suggested a link between artificial sweeteners and elevated risks of metabolic syndrome, Type 2 diabetes and heart troubles. Some sugar substitutes are suspected of disrupting gut health, altering blood sugar regulation and promoting blood clots.
“[Sugar-sweetened beverages] have long been under scrutiny, while their ‘diet’ alternatives are often seen as the healthier choice,” Liu said.
“Both, however, are widely consumed and their effects on liver health have not been well understood.”
Liu’s team had nearly 123,800 UK residents without liver disease repeatedly share their hydration habits between 2009 and 2012.
Participants were asked: “How many glasses, cans or cartons containing 250 mL of soft drinks did you drink yesterday?”
Two hundred and fifty milliliters is about 8.4 fluid ounces, the equivalent of a slim can of soda.
Participants were followed for over a decade to see if they developed MASLD.
That’s when excess fat accumulates in the liver, leading to inflammation and potential damage. Fatigue, malaise and stomach pain are among the common symptoms.
Consuming more than a slim can of diet soda a day resulted in a 60% higher risk of MASLD. The same amount of regular soda carried a 50% higher risk.
Both beverage types caused fattiness in livers, while only diet drinks were tied to an elevated risk of liver-related deaths.
“The higher sugar content in [sugary beverages] 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 explained.
“[Diet drinks], 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.”
About 38% of adults have MASLD, a number that’s expected to grow to over 55% by 2040 as diabetes and obesity become more common.
The findings were presented Monday at United European Gastroenterology Week in Berlin.
Liu noted that the data didn’t include the specific beverage brands or artificial sweeteners consumed.
“We were unable to evaluate whether particular sweeteners were more strongly associated with liver outcomes,” Liu told The Post. “This remains a limitation of our study.”
The good news is that substituting water reduced MASLD risk by 12.8% for sugary sodas and 15.2% for diet sodas.
“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.”
Liu’s team plans to explore how sugar and its substitutes interact with gut bacteria and influence liver disease.
