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Alcohol Increases Liver Fat Just as Much as Sugar-Sweetened Beverages

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alcohol and liver

alcohol and liverSugar-sweetened beverages — including soda and energy drinks — may increase liver fat content to the same extent as alcohol in middle-aged men and women. This is according to a new study in the Journal of Nutrition.1

Study Examines Impact of Sugar and Alcohol on Liver

Research has previously reported associations between the excess intake of alcohol and liver disease; however, fewer studies have examined the association between excess sugar intake and how it compares to alcohol consumption in relation to the production of liver fat.

In a cross-sectional study from the Netherlands, researchers examined hepatic triglyceride content (HTGC; ie, liver fat) with proton magnetic resonance spectroscopy in 1966 men and women (mean ± SD age, 55 ± 6 years; body mass index, 26 ± 4 kg/m2). The mean HTGC across the cohort was 5.7% ± 7.9%.

Additionally, the investigators of this study used a validated food-frequency questionnaire to assess the consumption of alcoholic and nonalcoholic beverages and the association of that consumption with HTGC. Analyses were adjusted for age, sex, education, ethnicity, smoking status, physical activity, total energy intake, and total body fat.

Sugar and Alcohol Raises Liver Fat Equally

For each extra alcoholic beverage consumed per day, there was a 1.09-times increase in liver fat (95% CI, 1.05-1.12). Participants who reported replacing 5% of their total energy intake of alcoholic beverages with milk had 0.89-times less liver fat (95% CI, 0.81-0.98). Replacement of 5% of total energy intake of alcoholic beverages with sugar-sweetened beverages, however, was associated with a 1.00-times increase in liver fat (95% CI, 0.91-1.09).

The Detrimental Impact of Sugar on the Health

Sugar is a nutritionally devoid carbohydrate, holding little value other than providing quick energy for cells. Studies have linked fructose, a monosaccharide, to various cardiometabolic risks, including weight gain, heart disease, and type 2 diabetes.2 Other experts, however, suggest sugar is just another source of calories that does not pose a significant adverse health risk when consumed in low amounts.3 

Excess sugar in the diet can lead to the formation of advanced glycation end products, or AGEs, which do create deleterious effects on the brain, liver, as well as skeletal and cardiac muscle. In vitro observation has led some researchers to believe fructose may be the most rapid glycation agents compared to other saccharides.4

Conflicting data tend to agree that consuming sugar-sweetened beverages can also be a marker for an overall unhealthy lifestyle, with many national and international governing bodies recommending modest intake for most people. Eliminating sugar altogether and replacing them with alternatives that do not budge insulin or inflammation, such as stevia or xylitol, may be a helpful strategy for reducing the amount of calories consumed during the day and supporting overall good health.


  1. van Eekelen E, Beulens JWJ, Geelen A, et al. Consumption of Alcoholic and Sugar-Sweetened Beverages is Associated with Increased Liver Fat Content in Middle-Aged Men and WomenJ Nutr. 2019;149(4):649-658.
  2. Khan TA, Sievenpiper JL. Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetesEur J Nutr. 2016;55(Suppl 2):25-43. 
  3. Prinz P. The role of dietary sugars in health: molecular composition or just calories? Eur J Clin Nutr. 2019;73(9):1216-1223.
  4. Aragno M, Mastrocola R. Dietary Sugars and Endogenous Formation of Advanced Glycation Endproducts: Emerging Mechanisms of DiseaseNutrients. 2017;9(4).
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