Low- or No-Sugar Drinks Linked to 60% Higher Liver Risk; Prebiotic Sodas Supposedly Good, but Could Hurt?

What the study found

MASLD develops when excess fat accumulates in the liver for reasons other than alcohol. The condition can progress to severe scarring or end-stage liver disease, and it was previously known as nonalcoholic fatty liver disease, or NAFLD.

Over 10 years of follow-up, 949 people developed MASLD and 103 died from liver-related causes. The study associated both beverage categories with higher liver fat, reporting a 50 percent increase in risk for sugar-sweetened drinks and 60 percent for low- or non-sugar-sweetened drinks.

Uncertainty about drinks

The study authors did not identify the specific low- or no-sugar beverages participants drank, making it difficult to determine which drinks were linked to risk. The findings connect beverages other than water with MASLD, but do not establish that a particular prebiotic soda causes the condition.

Possible explanations remain tentative

Albert Matheny, a registered dietitian and co-founder of SoHo Strength Lab, said sweet-tasting drinks may prompt bodily responses similar to those triggered by sugar. He described the effect as “tricking your body,” which he said may react as though sugar were present.

Kim said some artificial sweeteners might affect glucose and insulin regulation, potentially contributing to insulin resistance and liver fat accumulation. She also said the process could influence appetite. These explanations remain speculative: the researchers did not investigate the mechanisms in depth.

Moderation is the advice

Matheny called prebiotic sodas an improvement over traditional diet sodas, while cautioning that they are not necessarily a fully healthy choice. He said having one, or an unsweetened iced tea, in moderation is probably fine.

The study’s findings do not identify which low- or no-sugar drinks were involved, and the reasons for the association have not been settled. The article offers no basis for concluding that prebiotic sodas specifically harm the liver.