Chen · International journal of environmental research and public health 2019 · systematic review and dose-response meta-analysis · n=12 studies (35,705 participants)

Consumption of Sugar-Sweetened Beverages Has a Dose-Dependent Effect on the Risk of Non-Alcoholic Fatty Liver Disease: An Updated Systematic Review and Dose-Response Meta-Analysis.

Cited 114 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational studies

PubMed 31234281 · doi:10.3390/ijerph16122192 · record verified 2026-08-27

What was done

A systematic review and dose-response meta-analysis was conducted according to PRISMA guidelines using Review Manager 5.3 and Stata 14.0. Researchers evaluated the dose-response relationship between sugar-sweetened beverage (SSB) consumption and non-alcoholic fatty liver disease (NAFLD) using non-linear trend regression across 12 included studies comprising 35,705 participants.

What was found

SSB consumption was associated with increased odds of NAFLD (OR 1.39, 95% CI: 1.29 to 1.50, p < 0.00001). Risk rose in a dose-dependent manner: - Low dose (<1 cup/week): 14% increase in relative risk (p = 0.01) - Middle dose (1–6 cups/week): 26% increase in relative risk (p < 0.00001) - High dose (≥7 cups/week): 53% increase in relative risk (p = 0.03)

Why it matters

This review establishes a quantitative dose-response relationship between sugary beverage intake and NAFLD, supporting dietary guidance to limit SSBs for primary liver disease prevention.

Limits

The abstract does not specify the study designs of included trials (e.g., cross-sectional vs. cohort), the methods used to diagnose NAFLD, or how studies adjusted for key confounders such as total caloric intake, baseline adiposity, or physical activity. Observational designs cannot definitively prove causality.

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