Association of sugar sweetened beverages consumption with non-alcoholic fatty liver disease: a systematic review and meta-analysis

Farzaneh Asgari-Taee, Nahid Zerafati-Shoae, Mohsen Dehghani, Masoumeh Sadeghi* (Corresponding Author), Hamid R. Baradaran, Shima Jazayeri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Purpose: The relationship between consumption of sugar sweetened beverages (SSB) and NAFLD has been reported in several epidemiological studies, but the results are inconsistent. The present systematic review and meta-analysis of observational studies was carried out to assess the relationship between sugar sweetened beverages consumption and NAFLD. Methods: Online databases were searched systematically through December, 2016 for studies investigating association between SSB consumption and NAFLD but limited to observational studies in human. Pooled odds ratio (OR) and 95% confidence intervals were calculated using Der-Simonian and Laird method while random effects meta-analysis was used, taking into account conceptual heterogeneity. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. Results: Of the 1015 identified articles, 42 were reviewed in depth and six studies (four cross-sectional, one case–control, and one cohort) met the criteria for inclusion in our systematic review with 6326 participants and 1361 cases of NAFLD in both men and women. Finally, four cross-sectional studies were included in the meta-analysis. Higher intake of SSBs (highest compared to lowest categories) was significantly associated with NAFLD, with a 40% increased Odds of NAFLD after adjusting for important potential confounders (pooled odds ratio 1.40; 95% CI 1.07, 1.82). There was no evidence for significant heterogeneity across studies [P = 0.226 (Q statistics), I2 = 31.0%]. A significant positive association between SSB consumption and NAFLD was observed consistently in a sensitivity analysis [range of summary ORs 1.39–1.49]. There was no evidence of publication bias for the association between SSB and NAFLD. Conclusions: This meta-analysis supports a positive significant association between higher consumption of SSB and NAFLD in both men and women. These findings strengthen the evidence that intake of SSBs should be limited to reduce fatty liver disease.

Original languageEnglish
Pages (from-to)1759-1769
Number of pages11
JournalEuropean Journal of Nutrition
Issue number5
Early online date14 May 2018
Publication statusPublished - Aug 2019

Bibliographical note

This study was partly supported by funds from Vice-Chancellor for Research of Iran University of Medical Sciences (IUMS), Tehran, Iran (Grant no. 96-02-27-29952). The funding sources had no role in study design, data collection, analysis, interpretation, and preparation of the manuscript.


  • Meta-analysis
  • Risk factors
  • Sugar-sweetened beverage
  • RISK
  • US


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