What are the risks of sugar-free drinks?

October 13, 2025 •

2 min read

According to a 2025 study, both sugary and artificially sweetened beverages are linked to an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD), challenging the notion that sugar-free options are completely harmless. For years, these drinks were promoted as a healthier alternative, yet emerging evidence reveals several potential risks of sugar-free drinks that consumers should be aware of.

Quick Summary

This article explores the potential health risks of sugar-free drinks, including negative impacts on gut microbiome, metabolic function, cardiovascular health, and more.

Key Points

Gut Microbiome Disruption: Artificial sweeteners like sucralose and saccharin can alter the balance of gut bacteria, potentially leading to digestive issues and other health problems.
Metabolic Syndrome Risk: Regular consumption of diet drinks has been correlated with a higher risk of developing metabolic syndrome, which increases the risk of heart disease and type 2 diabetes.
Increased Cardiovascular Risk: Studies have linked daily diet soda consumption to a higher incidence of heart attacks, strokes, and overall cardiovascular disease.
The Weight Management Paradox: Despite having no calories, artificial sweeteners can confuse the body's metabolic response, potentially leading to increased sugar cravings and long-term weight gain.
Organ Health Concerns: Some research indicates potential negative impacts on kidney and liver function, with artificially sweetened drinks specifically linked to a higher risk of fatty liver disease.
Dental Erosion: The acidity in many sugar-free sodas and flavored waters can erode tooth enamel over time, causing dental problems even without the presence of sugar.
Individual Sweetener Risks: Certain sweeteners, like aspartame and erythritol, carry unique risks, including potential neurological effects or increased blood clotting, respectively.

Decoding the Sweetener: How Ingredients Cause Risks

Not all sweeteners are created equal, and their impact on the body differs. Sugar-free drinks typically contain artificial sweeteners like aspartame, sucralose, and saccharin, or sugar alcohols such as erythritol and sorbitol. These compounds interact with the body in complex ways beyond simply avoiding sugar.

Gut Microbiome Disruption

A significant risk involves the gut microbiome. Studies show that artificial sweeteners can alter the balance of gut bacteria, potentially leading to dysbiosis. This imbalance may reduce beneficial bacteria and increase potentially harmful ones, possibly causing gastrointestinal issues like bloating and pain, impaired glucose tolerance, and a weakened immune system.

Metabolic and Weight Management Paradox

While used for weight management, sugar-free drinks might not always help. Some research suggests intense sweetness without calories can increase cravings for sugary foods. Chronic consumption is also linked to metabolic syndrome, a risk factor for diabetes and heart disease.

Cardiovascular and Neurological Concerns

Regular diet beverage intake is associated with increased risks of cardiovascular events like heart attack and stroke. Erythritol, a sugar alcohol, has been linked in some studies to increased blood clotting risk. Aspartame has been connected to potential mood disorders, stress, depression, and headaches.

Dental and Organ Health Risks

The acidity in many sugar-free drinks can lead to dental erosion by wearing away tooth enamel. Furthermore, studies suggest potential negative effects on kidney and liver function. A 2025 study specifically associated artificially sweetened beverages with a higher risk of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver-related mortality.

Comparison of Common Sweeteners

This table outlines some key differences and specific risks associated with common zero-calorie and low-calorie sweeteners:


Sweetener Type	Common Examples	Specific Potential Risks
Artificial	Aspartame (NutraSweet), Sucralose (Splenda), Saccharin	Headaches, mood changes, gut dysbiosis, controversial link to cancer (especially aspartame).
Sugar Alcohols	Erythritol, Sorbitol, Xylitol	Gastrointestinal upset (gas, bloating, diarrhea), high doses of erythritol potentially increase blood clotting risk.
Natural	Stevia, Monk Fruit	Generally considered safe, but potential for gut effects with high intake; crude extracts are unregulated.

The Role of Observational Data and Individual Variability

Much of the evidence linking sugar-free drinks to long-term health risks comes from observational studies, which show correlation but not necessarily causation. Individual responses to artificial sweeteners can vary due to factors like gut microbiome composition. For further research on the physiological effects, consult the National Institutes of Health.

Conclusion: Prioritizing Healthier Hydration

While calorie-free, sugar-free drinks present potential health risks, including impacts on gut health, metabolic function, and cardiovascular health. Plain water remains the best hydration choice. For flavor, consider naturally infused water or unsweetened teas. Moderation and informed choices are important, particularly for individuals with existing health conditions or long-term wellness goals.

Frequently Asked Questions

Yes, some research suggests they can, paradoxically. The intense sweetness of artificial sweeteners may increase cravings for other sweet foods and potentially lead to weight gain over time, despite the drink having zero calories.

Yes, they can be. Studies show that artificial sweeteners can disrupt the balance of your gut microbiome, potentially leading to dysbiosis, inflammation, and digestive problems like bloating and diarrhea.

Several observational studies have found an association between regular diet soda consumption and an increased risk of heart disease, stroke, and vascular events, though more research is needed to prove direct causation.

While regulated food safety agencies consider aspartame safe within the acceptable daily intake limits, it remains controversial. Some studies link it to neurological issues and a higher risk of certain cancers, particularly at high doses.

Sugar alcohols can cause digestive issues like bloating and gas in high amounts. Recently, erythritol has been linked to an increased risk of blood clotting, potentially increasing the risk of heart attack or stroke.

Yes, sugar-free drinks are often highly acidic. This acidity can erode tooth enamel over time, leading to dental erosion even without the presence of sugar.

Healthier alternatives include plain water, sparkling water infused with fruit slices (like lemon, lime, or berries), unsweetened iced tea, or water flavored with natural sweeteners like stevia.