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Sugar-sweetened beverage consumption increases NAFLD risk

In a new study published in the Journal of Hepatology, researchers found sugar-sweetened beverage consumption to be associated with an increased risk for nonalcoholic fatty liver disease.

“Our study adds to a growing body of research suggesting that sugar-sweetened beverages may be linked to NAFLD and other chronic diseases including diabetes and cardiovascular disease,” Jiantao Ma, PhD, of Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging, said in a press release. “Few observational studies, to date, have examined the relationship between sugar-sweetened beverages and NAFLD. Long-term prospective studies are needed to help ascertain the potential role of sugar-sweetened beverages in the development of NAFLD.”

Ma and colleagues analyzed data from questionnaires of 2,634 patients from the National Heart Lung and Blood Institute’s Framingham Heart Study’s Offspring (n = 1,075) and Third Generation (n = 1,559) cohorts. Computed tomography was used to measure fatty liver disease and alanine transaminase (ALT) levels were measured using the kinetic method, according to the research. Sugar-sweetened beverage and diet soda intake were estimated using a food frequency questionnaire, in which participants were categorized by sugar-sweetened beverages or diet soda intake: 1 serving per month to less than 1 serving per week; 1 serving per week to less than 1 serving per day; and more than1 serving per day.

Study results indicated a 55% increased risk of fatty liver disease in daily consumers of sugar-sweetened beverages compared with non-consumers.

Overall, NAFLD was prevalent in 17% of the studied population. Of the participants, 34% were non-consumers and 12% were daily consumers of sugar-sweetened beverages. Researchers found among those who consumed the sweetened beverages, the largest contributor was caffeinated cola (40%).

Multivariate analysis showed a dose-response relationship between sugar-sweetened beverage consumption and fatty liver disease (P = .02), with an odds ratio of 1.55 (95% CI, 1.03-2.35), according to the research.

After adjusting for numerous variables, including age, sex, diet soda intake and BMI, the ORs of fatty liver disease were 1.16 (95% CI, 0.88-1.54) for patients who had between one serving per month to less than one serving per week; 1.32 (95% CI, 0.93-1.86) in patients who consumed one serving per week to less than one serving per day; and 1.61 (95% CI, 1.04-2.49) in patients who consumed more than one serving per day.

Sugar-sweetened beverage consumption was associated with ALT levels (P = .007). However, no association between diet soda intake and measures of fatty liver disease were observed.

“The cross-sectional nature of this study prevents us from establishing causality,” study researcher Nicola McKeown, PhD, of the nutritional epidemiology program at Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging, said in the release. “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. Although there is much more research to be done, sugar-sweetened beverages are a source of empty calories, and people need to be mindful of how much they are drinking, perhaps by reserving this habit for special occasions.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.