When Sugar Takes a Toll: How Everyday Drinks Can Strain Your Liver

Most people associate liver problems with alcohol. Yet growing research shows that another everyday habit—regular consumption of sugary drinks—can also quietly undermine liver health.

Too Much Sugar, Too Little Balance

A study in Nutrients reported that men who consumed 72 grams or more of sugar a day, and women who consumed at least 50 grams from sweetened drinks, had a 60% higher risk of developing nonalcoholic fatty liver disease (NAFLD).
 That’s roughly the amount found in a large cup of milk tea or two cans of cola.

A separate JAMA study of nearly 100,000 participants found that women who drank at least one sugary beverage a day were 68% more likely to die from chronic liver disease than those who had them only occasionally.
 These findings suggest that the liver pays a real price for daily sweetness.

“Sugar-Free” Isn’t Always Risk-Free

Many people switch to “zero-calorie” or “sugar-free” drinks, assuming they are safer. Yet these beverages often rely on artificial sweeteners, which may not be completely harmless.

The same Nutrients paper noted that frequent consumers of artificially sweetened beverages (ASBs) had a 78% higher risk of NAFLD than non-drinkers.

However, researchers urge caution:

• Most studies so far are observational, not proof of causality.
• The impact may vary depending on the type and amount of sweetener (e.g., aspartame vs. sucralose).
• Other factors like compensatory eating and individual gut microbiota differences could influence outcomes.

For now, the evidence points to moderation, not fear.

How Sweetened Drinks Affect the Liver

The health effects of sugary beverages go far beyond weight gain or tooth decay. The liver, which manages much of the body’s sugar and fat metabolism, bears a heavy part of that burden.

1. Fat Buildup
Fructose, the main sweetener in many drinks, is processed almost entirely by the liver. There it turns into triglycerides, encouraging fat deposits in liver cells.
 This process, called de novo lipogenesis (DNL), occurs more readily with fructose than glucose and is a key trigger for fatty liver disease.

2. Oxidative Stress
Processing large amounts of sugar increases reactive oxygen species (ROS) inside liver cells.
 If antioxidant defenses such as glutathione (GSH) and superoxide dismutase (SOD) cannot keep up, oxidative stress damages:

• Cell membranes
• Mitochondria
• DNA

This weakens liver function and amplifies inflammation.

3. Chronic Inflammation
Fat accumulation and oxidative stress stimulate the release of inflammatory molecules such as TNF-α and IL-6.
 Persistent low-grade inflammation gradually activates hepatic stellate cells, promoting fibrosis and, over time, cirrhosis.

4. Gut–Liver Crosstalk
A high-sugar diet can disturb the gut microbiome, reducing beneficial bacteria like Bifidobacterium and Lactobacillus while favoring endotoxin-producing strains.
 This weakens the gut barrier and allows lipopolysaccharides (LPS) to reach the liver, intensifying inflammation.

Some artificial sweeteners may also:

• Disrupt microbial metabolism
• Reduce short-chain fatty acids (SCFAs)
• Impair the liver’s energy regulation and anti-inflammatory capacity

Silybin: A Natural Support for an Overworked Liver

Cutting back on sweetened beverages is the most direct way to protect the liver.
 However, stress, poor sleep, and unbalanced diets often keep the liver under pressure.
 In these situations, natural bioactive compounds supported by research can offer additional help.

Silybin, the main active compound in silymarin, has been widely studied for its liver-supporting properties.

It works through several complementary actions:

Antioxidant Protection

Silybin helps:

• Neutralize free radicals
• Boost antioxidant systems such as SOD, GPx, and GSH
• Reduce lipid peroxidation and protect mitochondria

Anti-Inflammatory and Anti-Fibrotic Action

It also:

• Inhibits the NF-κB pathway, lowering TNF-α and IL-6
• Modulates the TGF-β pathway to prevent hepatic stellate cell activation
• Regulates AMPK and PPAR-α, helping reduce fat synthesis and increase fat oxidation

Evidence and Safe Use

A placebo-controlled trial showed that silymarin significantly reduced ALT and AST levels in NAFLD patients, indicating improved liver function.

Typical use in clinical studies:

• 150–300 mg of silybin per day, often divided into 2–3 doses
• Generally well tolerated, with occasional mild digestive discomfort

Important note:

Silybin is not a replacement for medical treatment or healthy lifestyle changes.
It should be used under professional supervision.
Pregnant or breastfeeding women and those with hormone-sensitive conditions should consult a healthcare provider before use.

Living a Little Kinder to Your Liver

We all enjoy a sweet drink sometimes. The key is balance—less sugar, more rest, and regular movement.

Giving the liver fewer reasons to struggle makes a real difference.
And when life gets demanding, nutrients like silybin can offer gentle support while you focus on what matters most: taking care of yourself.

References

1. Tseng, T.-S., Lin, W.-T., Ting, P.-S., Huang, C.-K., Chen, P.-H., Gonzalez, G. V., & Lin, H.-Y. (2023). Sugar-Sweetened Beverages and Artificially Sweetened Beverages Consumption and the Risk of Nonalcoholic Fatty Liver (NAFLD) and Nonalcoholic Steatohepatitis (NASH).Nutrients, 15(18), 3997.

2. Zhao, L., et al. (2023). Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Liver Cancer and Chronic Liver Disease Mortality.JAMA, 330(3), 213–223.

3. Stanhope, Kimber L., et al. (2009). Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans.The Journal of Clinical Investigation, 119(5), 1322–1334.

4. Mirtschink, Peter, et al. (2018). Fructose metabolism, cardiometabolic risk, and the epidemic of coronary artery disease.European Heart Journal, 79, 2497–2505.

5. Koyama, Yukihiro, and David A. Brenner. (2017). Liver Inflammation and Fibrosis.The Journal of Clinical Investigation, 127(8), 2864–2872.

6. Emamat, Hadi, et al. (2020). Artificial Sweeteners are related to Non-Alcoholic Fatty Liver Disease: Microbiota Dysbiosis as a Novel Potential Mechanism.EXCLI Journal, 19, 620–626.

Educational content only; not medical advice. Follow your product label and consult a healthcare professional as needed (especially if pregnant/nursing, managing conditions, or taking medications).