Research Links Sugary Beverages to Liver Disease

A daily sugar-sweetened beverage habit may increase the risk for non-alcoholic fatty liver disease (NAFLD), according to new research published in the Journal of Hepatology.

NAFLD is characterized by an accumulation of fat in the liver cells that is unrelated to alcohol consumption. NAFLD is diagnosed by ultrasounds, CT, MRI, or biopsy, and affects approximately 25 percent of Americans.

Beverages considered for the study included caffeinated- and caffeine-free colas, other carbonated beverages with sugar, fruit punches, lemonade or other non-carbonated fruit drinks.

More than 2,500 middle-aged men and women enrolled in the National Heart Lunch and Blood Institute (NHLBI) Framingham Heart Study's Offspring and Third Generation cohorts were included in the study, which was conducted by researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HRNCA) at Tufts University.

Participants self-reported dietary questionnaires, and underwent a computed tomography (CT) scan to measure the amount of fat in the liver and the authors of the current study used a previously defined cut-point to identify NAFLD. Researchers saw a higher prevalence of NAFLD among people who reported drinking more than one sugar-sweetened beverage per day compared to people who said they drank no sugar-sweetened beverages.

Interestingly, the relationships between sugar-sweetened beverages and NAFLD persisted after the authors accounted for age, sex, body mass index (BMI), and dietary and lifestyle factors such as calorie intake, alcohol, and smoking. However, after accounting for these factors the authors found no association between diet cola and NAFLD.

Importantly, the study did not determine how sugary drinks are related to increased prevalence of NAFLD.

"Future prospective studies are needed to account for the changes in beverage consumption over time as soda consumers may switch to diet soda and these changes may be related to weight status," added corresponding and senior author Nicola McKeown, Ph.D., a scientist in the Nutritional Epidemiology Program at the USDA HNRCA and an associate professor at the Friedman School.

Health concerns regarding sweeteners are just one consideration for functional beverages manufacturers. Consumers also want clean labels and natural ingredients, and are increasingly expecting nutrition-focused products to meet these demands, which has led to innovation in the sweeteners category.