Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Sugar-Sweetened Beverages and Artificially Sweetened Beverage Consumption and the Risk of Nonalcoholic Fatty Liver (NAFLD) and Nonalcoholic Steatohepatitis (NASH)

Tung-Sung Tseng
* ORCID logo ,
Wei-Ting Lin
ORCID logo ,
Peng-Sheng Ting
ORCID logo ,
Chiung-Kuei Huang
,
Po-Hung Chen
,
Gabrielle V. Gonzalez
,
Hui-Yi Lin
ORCID logo
Version 1 : Received: 4 August 2023 / Approved: 7 August 2023 / Online: 8 August 2023 (13:59:04 CEST)

A peer-reviewed article of this Preprint also exists.

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

Abstract

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are fast becoming the most common chronic liver disease and are often preventable with healthy dietary habits and weight management. Sugar-sweetened beverage (SSB) consumption is associated with obesity and NAFLD. However, the impact of different types of SSB, including artificially sweetened beverages (ASB), is not clear after controlling for total sugar intake and total caloric intake. In this study, we examined the association between different SSB consumption and the risk of NAFLD and NASH. A total of 3,739 US adults aged ≥20 years old who had completed 24-hour dietary recall interviews and measurements, including dietary, SSB, smoking, physical activity, and liver stiffness measurement, using the National Health and Nutrition Examination Survey 2017-2020 surveys were included in this study. Chi-square tests, t-tests, and weighted logistic regression models were utilized for analyses. The prevalence of NASH was 20.5%, and NAFLD (defined without NASH) was 32.7% of .S.U.S. adults. We observed a higher prevalence of NASH/NAFLD in men, Mexican-Americans, sugar intake from SSB, light-moderate alcohol use, individuals with lower physical activity levels, higher energy intake, obesity, and medical comorbidities. Heavy sugar consumption through SSB was significantly associated with NAFLD (aOR=1.60, 95% CI=1.05-2.45). In addition, intake of ASB only (compared to non-SSB category) was significantly associated with NAFLD (aOR=1.78, 95% CI=1.04-3.05), after adjusting for demographic, risk behaviors, and body mass index. Higher sugar intake from SSB and exclusive ASB intake are both associated with the risk of NAFLD.

Keywords

Sugar-sweetened beverage (SSB); artificially sweetened beverages (ASB); nonalcoholic fatty liver disease (NAFLD); nonalcoholic steatohepatitis (NASH); NHANES

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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