Over time, excessive consumption can lead to insulin resistance; the body becomes less responsive to insulin, causing blood sugar levels to rise. Insulin resistance is a major risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD), which results from gradual liver damage due to high blood sugar, allowing fat to accumulate in liver tissue. This can increase hunger pangs and make you seek more sweetness from sugary foods. The risk is higher in people with obesity and worse in those who already have type 2 diabetes. Although study results vary, some have shown a clear link between insulin resistance and long-term use of artificial sweeteners like sucralose and aspartame. More research is needed. Regularly drinking diet soda can lead some people to consume more calories, whether they are aware of it or not. In this case, fat accumulates in the liver, leading to gradual scarring and liver damage. Artificial sweeteners in diet soda can sometimes cause a sudden spike in insulin levels (the hormone that regulates blood sugar). Diet sodas do not damage the liver in the same way as alcohol, viral hepatitis, or some toxic medications, but they may indirectly contribute to metabolic dysfunction-associated steatotic liver disease (MASLD) if consumed in large quantities. This is due to both biological and behavioral reasons, such as disruption of reward pathways in the brain where the sweet taste of calorie-free artificial sweeteners does not fully activate the brain's reward system, leaving the brain unsatisfied. This may be due to the artificial sweeteners in these drinks or eating patterns associated with high diet soda consumption. Artificial sweeteners like aspartame, sucralose, and saccharin can disrupt the balance of 'good' and 'bad' gut bacteria (known as dysbiosis), especially when consumed in large amounts, according to Very Well Health. With this dysbiosis, harmful bacteria can damage intestinal tissue, leading to increased intestinal permeability. These substances can cause hepatitis when they reach the liver through the portal vein. This allows inflammatory substances (such as fatty polysaccharides) to leak into the bloodstream. Chronic hepatitis is a major risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD) (formerly known as non-alcoholic fatty liver disease or 'NAFLD').
