Soda pop study with the usual self-reporting bias food questionnaires links to risk of developing fatty liver disease. Not great to drink the stuff so limiting use is a healthful choice for many reasons but study itself cannot demonstrate causality.

Medical Mythbusting Commentary for February 13, 2026

Design: Prospective cohort study of 1,759 Mexican health workers, assessing soft drink (SD) intake via food frequency questionnaire and NAFLD risk using Hepatic Steatosis Index (HSI).
Key Findings on Regular (Sugary) Sodas: Medium intake (1-<3.5 servings/week) linked to 26% higher NAFLD odds (OR 1.26, 95% CI 1.01-1.58); high intake (≥3.5/week) to 42% higher (OR 1.42, 95% CI 1.15-1.76). Stronger in men (OR up to 1.61).
No Direct Data on Diet Sodas: Study focused on sugary SDs; article extrapolates potential risks from artificial sweeteners disrupting gut microbiome, but not tested here.
Limitations: Observational (correlation, not causation); self-reported intake prone to bias; HSI as NAFLD proxy (not biopsy-confirmed); adjusted for confounders like age, BMI, diet, exercise, but residual confounding (e.g., genetics, unmeasured factors) possible; limited to Mexican health workers, reducing generalizability.

Mixed Findings: Some studies show association; e.g., exclusive artificially sweetened beverage (ASB) intake linked to 78% higher NAFLD odds (aOR 1.78, 95% CI 1.04-3.05) after BMI adjustment. Recent cohort: ASBs positively associated with liver fat content (LFC) and fibro-inflammation (HFI).
Dose-Response in Some Data: >1 diet soda/day may raise MASLD risk by 60%; substituting water reduces risk by 15%. Framingham Study: No consistent ASB-NAFLD link in younger cohort, but trends in older.
Mechanisms: Artificial sweeteners may alter gut microbiome, promote insulin resistance, inflammation, and liver fat accumulation; no calories but potential indirect effects via appetite or metabolism.
Contradictory Evidence: Systematic reviews find limited data; one meta-analysis notes no significant ASB-NAFLD risk in available studies, unlike SSBs (pooled RR 1.53 for SSBs).
Overall Limitations in Diet Soda Research: Mostly observational; confounding by obesity/diet; inconsistent definitions (e.g., ASB types); need for RCTs; some studies unpublished/unpeer-reviewed.

Regular Sodas: Consistent evidence of modest dose-dependent risk (14-53% increase); supports limiting intake for liver health, but not sole cause.
Diet Sodas: Unclear; possible 60-78% risk increase in some data, but not definitive; more research needed; safer than sugary but not risk-free alternative.
General Advice: Limit both types; prioritize water; risks amplified by obesity, poor diet, inactivity.