Daily imbibing linked to fatty liver disease.

• Position: Beverage Sugar

A daily sugar-sweetened beverage habit may increase the risk for nonalcoholic fatty liver disease (NAFLD), report researchers from the USDA Human Nutrition Research Center on Aging at Tufts University, Boston. The researchers analyzed self-reported dietary questionnaires from mostly middle-aged Caucasian men and women enrolled in the National Heart Lung and Blood Institute Framingham Heart Study.

Sugar-sweetened beverages are a major dietary source of fructose, the sugar that is suspected of increasing risk of NAFLD because of how our bodies process it.

NAFLD is characterized by an accumulation of fat in the liver cells that is unrelated to alcohol consumption. NAFLD is diagnosed by ultrasounds, CT, MRI, or biopsy, and many of the approximately 25% of Americans with the disease do not experience any symptoms. Being obese or overweight increases the risk for NAFLD and people with it are at greater risk of developing cardiovascular disease and type 2 diabetes.

The sugar-sweetened beverages on the questionnaires included caffeinated and caffeine-free colas, other carbonated beverages with sugar, fruit punches, lemonade, or other noncarbonated fruit drinks. The participants underwent a computed tomography (CT) scan to measure the amount of fat in the liver and the authors of the current study used a previously defined cut-point to identify NAFLD. They saw a higher prevalence of NAFLD among people who reported drinking more than one sugar-sweetened beverage per day compared to people who said they drank no sugar-sweetened beverages.

The relationships between sugar-sweetened beverages and NAFLD persisted after the authors accounted for age, sex, body mass index, and dietary and lifestyle factors such as calorie intake, alcohol, and smoking. In contrast, after accounting for these factors, the authors found no association between diet cola and NAFLD.

"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...