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

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Abstract

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.

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Acknowledgements

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.

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Authors and Affiliations

  1. Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Farzaneh Asgari-Taee & Shima Jazayeri

  2. Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Nahid Zerafati-Shoae

  3. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Mohsen Dehghani

  4. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Masoumeh Sadeghi

  5. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

    Hamid R. Baradaran

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  1. Farzaneh Asgari-Taee
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Contributions

FA conceived the idea and designed the study. MS, NZ, FA collected data, reviewed literature and extracted data. FA, MD, and MS participated in analysis of data and interpreted the results. NZ and MS conceived the study aims and design, provide the data and measures and designed the analysis. HRB and ShJ, MD reanalyzed data, made substantial contribution to interpretation of data, drafting the manuscript and revising it critically for important intellectual content and final approval of the version to be submitted and any revised version. All authors reviewed, discussed, provided critical comments, and approved the final manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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Correspondence to Masoumeh Sadeghi.

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The authors declared there were no conflicts of interest related to the study.

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Asgari-Taee, F., Zerafati-Shoae, N., Dehghani, M. et al. Association of sugar sweetened beverages consumption with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Nutr 58, 1759–1769 (2019). https://doi.org/10.1007/s00394-018-1711-4

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