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By: Andrew Carlson

For decades, millions have reached for diet sodas believing they were making the “healthier choice.” Zero calories, zero sugar — and, supposedly, zero guilt. But new research suggests that might be a dangerous illusion.

According to an alarming new study presented this week in Berlin, beverages sweetened with artificial sweeteners — the likes of Diet Coke, Coke Zero, and other “light” drinks — may carry a higher risk of liver disease than their sugary counterparts. As reported in The New York Post, the study links low- or no-sugar soft drinks to a 60% higher risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD), commonly known as fatty liver disease — compared with a 50% increased risk among those consuming regular sugary sodas.

The findings, which have already caused a stir in the scientific community, challenge one of the most pervasive assumptions in modern nutrition: that swapping sugar for artificial sweeteners is a safe way to cut calories and reduce metabolic strain.

“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,” lead study author Lihe Liu, a gastroenterology graduate student at the First Affiliated Hospital of Soochow University in China, told The New York Post.

“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.

The results were unveiled Monday during the United European Gastroenterology Week conference in Berlin, one of the world’s leading forums for digestive health research.

For years, “diet” or “zero” beverages have been marketed as a guilt-free alternative to sugary sodas. Major beverage brands have leveraged slogans like “choose lighter” and “same great taste, no sugar” to position artificial sweeteners as a solution for calorie-conscious consumers.

But the new research, presented in The New York Post report, calls attention to a growing concern among nutrition scientists: that these artificial additives might be doing harm in ways we don’t yet fully understand.

“[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.”

The study tracked 123,800 adults in the United Kingdom who had no known history of liver disease. Between 2009 and 2012, participants were asked to record their beverage consumption — specifically how many glasses, cans, or cartons (each 250 milliliters, or about 8.4 ounces) of soft drinks they consumed in a typical day.

Researchers then followed them for over a decade, monitoring for signs of MASLD, a condition marked by excessive fat accumulation in the liver. If untreated, the disease can lead to inflammation, cirrhosis, and in severe cases, liver failure or cancer.

The data were unequivocal. Even modest consumption — just one slim can per day — increased liver disease risk significantly. Those who drank artificially sweetened beverages had a 60% higher risk of MASLD, compared with a 50% higher risk among regular soda drinkers.

Both beverage types were linked to liver fat accumulation, but only the artificially sweetened drinks were tied to a greater risk of liver-related deaths.

Liu explained the potential mechanisms to The New York Post:  “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 said.

“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.”

These findings are particularly troubling given the widespread use of artificial sweeteners in the United States. The Centers for Disease Control and Prevention (CDC) estimates that nearly one-third of adults regularly consume low- or no-calorie sweetened beverages, often under the impression that they pose little or no health risk.

The new study arrives amid what The New York Post report described as “a public health storm brewing quietly in America’s livers.” Roughly 38% of U.S. adults are believed to have MASLD — a figure expected to soar past 55% by 2040 as obesity and Type 2 diabetes continue to climb.

Once referred to as non-alcoholic fatty liver disease (NAFLD), the condition was renamed in 2023 to reflect its deep metabolic roots. Unlike alcohol-related liver damage, MASLD is driven by lifestyle factors — most notably poor diet, sedentary behavior, and excessive sugar or fat consumption.

The symptoms often begin subtly: fatigue, mild nausea, or abdominal discomfort. But as fat accumulates, inflammation can progress silently for years before culminating in liver scarring or failure.

That makes prevention — and awareness — all the more critical. And, as Liu’s team found, one of the simplest preventive measures may also be the oldest: drinking more water.

When participants replaced soft drinks with water, their risk of developing MASLD dropped by 12.8% for sugary soda and 15.2% for diet soda.

“Water remains the best choice as it removes the metabolic burden and prevents fat accumulation in the liver, whilst hydrating the body,” Liu told The New York Post.

Predictably, the findings have drawn sharp criticism from the food and beverage industry. In a statement to The New York Post, Carla Saunders, president of the Calorie Control Council — an international trade association representing companies that produce low- and reduced-calorie products — dismissed the research as “alarmist and methodologically flawed.”

“While some ‘results’ are intended for alarming headlines, the public should demand science-based findings, especially those intended to inform their food and beverage choices,” Saunders said.

She pointed out that Liu’s study has not yet been peer-reviewed and relies heavily on self-reported dietary data, which can be prone to inaccuracies and bias.

“One peer-reviewed, long-term clinical trial published in the International Journal of Obesity proved that low- and no-calorie sweetened beverages are just as effective as water in terms of safety and efficacy,” Saunders added.

Still, independent researchers caution that while correlation does not equal causation, the evidence against artificial sweeteners is mounting — particularly when viewed alongside previous studies linking them to metabolic syndrome, heart disease, and gut dysbiosis (a disruption of healthy gut bacteria).

Emerging science may help explain the paradox that “zero sugar” doesn’t necessarily mean “zero harm.” Artificial sweeteners — including aspartame, sucralose, and saccharin — are metabolized differently than sugar, but they still interact with the gut microbiome, the dense ecosystem of bacteria that play a critical role in regulating metabolism, immunity, and inflammation.

Disrupting that ecosystem, researchers say, can have cascading effects — including insulin resistance, glucose intolerance, and increased fat storage in the liver.

Liu’s team plans to investigate this gut-liver connection more deeply in future studies.

“We were unable to evaluate whether particular sweeteners were more strongly associated with liver outcomes,” Liu told The New York Post. “This remains a limitation of our study. Our next phase will explore how sugar and its substitutes interact with gut bacteria and influence liver disease.”

Artificial sweeteners have been under intense scrutiny globally. In July 2023, the World Health Organization declared aspartame — the widely used sweetener found in Diet Coke and countless other products — as “possibly carcinogenic to humans,” citing limited evidence linking it to liver cancer.

Though the classification was not definitive, it underscored the growing unease surrounding products once touted as harmless.

Meanwhile, The New York Post report noted that consumer behavior may be shifting. Beverage giants like Coca-Cola and PepsiCo have begun diversifying product lines with “functional” drinks — sparkling waters, electrolyte beverages, and plant-based alternatives — aimed at health-conscious buyers wary of both sugar and synthetic additives.

Yet for now, diet sodas remain a fixture of daily life for millions — a habit that, according to the latest research, may be exacting a quiet but devastating toll.

Perhaps the most jarring aspect of Liu’s findings is what they reveal about the psychology of consumption. For many consumers, diet drinks function as moral permission — a way to indulge while maintaining the illusion of restraint. But Liu’s study, like others before it, suggests that the body does not necessarily distinguish between sugar and its imitations when it comes to metabolic risk.

Artificial sweeteners may blunt satiety signals and heighten sweet cravings, leading to overconsumption elsewhere in the diet. This “sweet deception,” as The New York Post report described it, could help explain why the obesity epidemic continues to rage despite decades of “diet” branding.

“The safest approach,” Liu concluded, “is to limit both sugar-sweetened and artificially sweetened drinks. Neither is risk-free.”

In the end, the new research doesn’t just indict artificial sweeteners — it calls for a broader reexamination of how Americans define “healthy.”

As The New York Post report observed, the study’s implications reach beyond the beverage aisle. It speaks to the false dichotomy that has shaped dietary choices for decades: sugar versus sugar-free, calories versus no calories, indulgence versus virtue.

In reality, the liver doesn’t see the labels.

Whether sweetened by cane sugar or chemicals, both forms of soda appear to carry metabolic consequences — some of them deadly.