Excessive consumption of diet soda could raise the risk of metabolic dysfunction-associated steatotic liver disease (MASLD), the most common form of chronic liver disease, a new study has revealed.

A previous study has found a connection between the mother's consumption of aspartame, an artificial sweetener used in diet soda, during pregnancy or breastfeeding, and autism risk in their kids.

In the latest study, published in the journal BMC Public Health, researchers established an association between heavy intake of diet soda and MASLD risk.

MASLD, previously known as NAFLD (non-alcoholic fatty liver disease), is a progressive condition caused by a build-up of fat in the liver. It is the leading cause of liver-related mortality and affects around 38% of the global population.

"To the best of our knowledge, this is the first study to explore the association between diet soft drink consumption and MASLD in a nationally representative sample, and our findings can provide valuable dietary recommendations for the prevention and treatment of MASLD," the researchers wrote.

The team used data from the National Health and Nutrition Examination Survey (NHANES). They evaluated the diet soda consumption pattern of 2,378 participants using questionnaires.

There were 1,089 participants with MASLD, of which 54.6% were males. The results were then adjusted for factors such as age, gender, ethnicity, hypertension and diabetes.

"By analyzing nationally representative data, we found that excessive diet soft drink consumption was associated with the occurrence of MASLD. Additionally, BMI may play a mediating role in the association between diet soft drink consumption and MASLD. Our findings can provide valuable dietary recommendations for the prevention and treatment of MASLD," the researchers added.

The study has certain limitations. Since it is a cross-sectional research, there is a possibility of reverse causality, meaning participants diagnosed with MASLD may be more inclined to consume diet sodas. The diagnosis of MASLD was not based on any imaging method commonly used in clinical practice. It used FLI (fatty liver index), an algorithmic tool to predict MASLD by assessing factors such as body mass index (BMI), waist circumference, gamma-glutamyl transferase and triglyceride levels. The results were also not adjusted for factors such as genetics and sleep patterns, which are risk factors for MASLD.

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