Your ‘Healthy’ Soda Alternative May Not Be So Healthy for Your Liver

MASLD happens when too much fat builds up in your liver from inputs other than alcohol. It can lead to serious liver scarring or end-stage liver disease.A study found drinking nearly 9 ounces of any type of drink that was not water was associated with a significantly higher risk of developing MASLD.The risk of developing MASLD jumped 50 percent for sugar-sweetened beverages. The risk jumped to 60 percent for those who drank low- or non-sugar-sweetened beverages. WE'RE LONG PAST having to make a decision between just Coke or Pepsi. You've got a lot of options if you're bored of water—from fizzy nonalcoholic drinks to flavored seltzers. But while a lot of these drinks market themselves as healthy alternatives to sodas, research suggests they could be silently doing a number on your liver health.If you've done the work to switch to diet sodas or have learned to love prebiotic sodas like Olipop or Poppi, the news can be pretty hard to hear. So it's important to get this out of the way upfront: If you have a "healthy" soda every once in a while, the experts we spoke to say the risk of having liver problems is unlikely. The real danger to your liver is if you’re tossing these back on a daily or near-daily basis. Here's everything you need to know.What Did the Study Find?THE STUDY PRESENTED at the United European Gastroenterology (UEG) Week 2025 used data from 103,251 people who enrolled in the UK Biobank and didn’t have liver disease at the start of the study. Participants were asked to fill out questionnaires about what they ate and drank throughout the day. The researchers then paid close attention to how much sugar-sweetened and low- or non-sugar-sweetened beverages they drank.The major takeaway from the study is that it pretty much linked any drink that wasn’t water to metabolic dysfunction-associated steatotic liver disease (MASLD). You might know it by its former name, nonalcoholic fatty liver disease (NAFLD). But whatever you call it, it's no joke.MASLD happens when too much fat builds up in your liver from inputs other than alcohol. It can lead to serious liver scarring or end-stage liver disease. It can also put you at high risk for heart disease and diabetes. According to the American College of Gastroenterology, heart disease is the number one killer of people living with MASLD.What Happens to Your Liver When You Drink Low-Sugar Soda Every Day?DAILY DRINKING OF nearly 9 ounces of any type of drink that was not water was associated with a significantly higher risk of developing MASLD. That risk jumped 50 percent for sugar-sweetened beverages and was surprisingly higher—60 percent—for those who drank low- or non-sugar-sweetened beverages. (Though some of these prebiotic sodas have more sugar and less fiber than marketing claims might imply).After a 10-year follow-up, 949 people developed MASLD and 103 died from liver-related causes. Both types of beverages were significantly connected to increases in liver fat.Replacing nearly 12 ounces of sugary beverages with water lowered MASLD risk by 14.4 percent and by 13.5 percent with low- or non-sugar-sweetened drinks. But if you switched completely from a sugary beverage like soda to a low-sugar beverage like fruit juice, the authors found that this did not help lower a person's risk of developing MASLD.Exactly which beverages raised risk is hard to say because the authors did not directly state what low- or no-sugar drinks people were drinking. That said, there are lots of sodas that are marketed as being healthier alternatives that are not as good as they claim, according to Danbee Kim, MD, nutrition expert and assistant professor at Rutgers New Jersey Medical School.“Even beverages marketed as ‘natural’ or ‘health-oriented’ may still fall into this category if they rely on sweeteners instead of sugar,” Kim says. “The key commonality is that they provide sweetness without significant calories. However, they may still affect liver health.”What’s Driving the Link Between Soda Alternatives and Liver Disease?A FEW THINGS may be going on here. “Low/non-sugar sweetened beverages, although low in calories, may still affect liver health through several pathways,” says Lihe Liu, a graduate student researcher at The First Affiliated Hospital of Soochow University in China and lead study author. “They can alter the gut microbiome, interfere with feelings of fullness, increase preference for sweet foods, and in some cases stimulate insulin secretion.”When you have something that’s sweet, even if it doesn’t contain much or any sugar, it sets off a chain reaction in your body the same way as if you were to actually have sugar, says Albert Matheny, RD, CSCS, registered dietitian and co-founder of SoHo Strength Lab. “You’re basically tricking your body,” he says. “Your body still reacts as if it has sugar.”As a result, Matheny says your body produces more insulin (a hormone that helps regulate blood sugar), and encourages the liver to take in more sugar from your bloodstream. This can lead to metabolic disruption.“Some artificial sweeteners may alter how the body handles glucose and insulin, contributing to insulin resistance, which is a key driver of metabolic dysfunction and fat accumulation in the liver,” says Kim. This process may even mess with your appetite, making you think that you're hungry when you're not.Another reason has nothing to do with your gut, but with your mind. Kim says we can't discount the possibility that people who drink these low- and non-sugar-sweetened beverages may subconsciously compensate for the “saved” calories by eating more sugary or fatty foods later.Keep in mind that all this is speculation. The explanation for why and how artificially sweetened beverages are linked to MASLD is still under investigation since Liu says her team didn't look too deep into this.Should You Stop Drinking ‘Healthy’ Sodas?NOT NECESSARILY. “THEY’RE definitely an improvement over traditional diet sodas,” Matheny says. “That’s not to say that they’re a totally healthy option.”When given a choice, water reigns supreme. And even then you still don't want to go too overboard.If you still want to crack open a cranberry fizz prebiotic soda or even an unsweetened iced tea, Matheny says that’s probably fine, too. “In moderation, kind of everything is OK.”Korin Miller is a seasoned freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Everyday Health, Food & Wine, and more. She has a master’s degree from American University and lives by the beach.