Sugar-sweetened beverage, diet soda, and fatty liver disease

J Hepatol. 2015 Aug;63(2):462-9. doi: 10.1016/j.jhep.2015.03.032. Epub 2015 Jun 5.

Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts.

Ma J¹, Fox CS², Jacques PF¹, Speliotes EK³, Hoffmann U⁴, Smith CE¹, Saltzman E¹, McKeown NM⁵.

Author information

1

USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States.

2

NHLBI’s Framingham Heart Study, Framingham, MA, United States; Harvard Medical School, Boston, MA, United States.

3

University of Michigan Medical School, Ann Arbor, MI, United States.

4

Harvard Medical School, Boston, MA, United States; Massachusetts General Hospital, Boston, MA, United States.

5

USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States. Electronic address: nicola.mckeown@tufts.edu.

Abstract

BACKGROUND & AIMS:

Non-alcoholic fatty liver disease affects ∼30% of US adults, yet the role of sugar-sweetened beverages and diet soda on these diseases remains unknown. We examined the cross-sectional association between intake of sugar-sweetened beverages or diet soda and fatty liver disease in participants of the Framingham Offspring and Third Generation cohorts.

METHODS:

Fatty liver disease was defined using liver attenuation measurements generated from computed tomography in 2634 participants. Alanine transaminase concentration, a crude marker of fatty liver disease, was measured in 5908 participants. Sugar-sweetened beverage and diet soda intake were estimated using a food frequency questionnaire. Participants were categorized as either non-consumers or consumers (3 categories: 1 serving/month to <1 serving/week, 1 serving/week to <1 serving/day, and ⩾1 serving/day) of sugar-sweetened beverages or diet soda.

RESULTS:

After adjustment for age, sex, smoking status, Framingham cohort, energy intake, alcohol, dietary fiber, fat (% energy), protein (% energy), diet soda intake, and body mass index, the odds ratios of fatty liver disease were 1, 1.16 (0.88, 1.54), 1.32 (0.93, 1.86), and 1.61 (1.04, 2.49) across sugar-sweetened beverage consumption categories (p trend=0.04). Sugar-sweetened beverage consumption was also positively associated with alanine transaminase levels (p trend=0.007). We observed no significant association between diet soda intake and measures of fatty liver disease.

CONCLUSION:

In conclusion, we observed that regular sugar-sweetened beverage consumption was associated with greater risk of fatty liver disease, particularly in overweight and obese individuals, whereas diet soda intake was not associated with measures of fatty liver disease.

Copyright © 2015 European Association for the Study of the Liver. All rights reserved.

KEYWORDS:

Alanine transaminase; Diet soda; Fatty liver disease; Sugar-sweetened beverages

Comment in

• Sugar sweetened beverages and fatty liver disease: Rising concern and call to action. [J Hepatol. 2015]
• NAFLD: Sugary drinks and fatty liver–a bitter-sweet relationship. [Nat Rev Gastroenterol Hepatol. 2015]

PMID:

26055949

PMCID:

PMC4827616

DOI:

10.1016/j.jhep.2015.03.032

[Indexed for MEDLINE]

Free PMC Article