The consumption of unsweetened (sugar-free) coffee has once again drawn attention in liver health. A population-based cohort study published in 2026 associated higher coffee intake with a lower risk of MASLD, the current term used for fatty liver disease linked to metabolic factors—such as excess weight, prediabetes, diabetes, high blood pressure, and cholesterol abnormalities.

What is MASLD

MASLD stands for Metabolic Dysfunction-Associated Steatotic Liver Disease. In practice, it is the accumulation of fat in the liver in individuals who also present with at least one cardiometabolic risk factor, such as abdominal obesity, elevated blood glucose, hypertension, or high triglycerides.

The condition can progress silently for years and, in some cases, lead to inflammation, fibrosis, and cirrhosis.

What the Scientific Study Showed

According to the population-based cohort study “Italian style coffee consumption and metabolically dysfunctional-associated steatotic liver disease (MASLD): a cohort population study in Southern Italy”, published in Frontiers in Nutrition, researchers evaluated 1,079 adult coffee consumers from the Nutrihep cohort in Southern Italy.

After adjusting for factors such as age, sex, BMI, blood pressure, sugar added to coffee, milk intake, smoking habits, dietary pattern, HDL levels, liver enzymes, and blood glucose, daily coffee consumption was associated with a lower likelihood of MASLD. The strongest effect was observed in those who drank 4 to 6 cups per day, with an odds ratio of 0.407 compared to drinking less than 1 cup.

Why Coffee May Protect the Liver

Coffee is not just caffeine. It contains bioactive compounds that can influence inflammation, fat metabolism, and oxidative stress—key mechanisms involved in the development of metabolic fatty liver disease:

• Chlorogenic acids: May influence glucose and fat metabolism.

• Caffeine: May modulate pathways linked to energy and liver function.

• Diterpenes: Present in higher amounts in less-filtered brews, such as espresso and moka.

• Melanoidins: Compounds formed during roasting, with potential antioxidant effects.

• Trigonelline: A substance studied for its metabolic effects.

The Detail About Unsweetened Coffee

The study adjusted its analysis for the use of added sugar in coffee, which helps isolate the effect of the beverage itself from habits that could confound the results. Still, for those at metabolic risk, sugar-free coffee tends to be a more consistent choice.

Added sugar increases calories and can hinder weight control, blood glucose management, and triglyceride levels. Therefore, when discussing coffee and liver health, the potential benefit should be viewed as part of an overall dietary pattern, rather than a license to overindulge in sweets or ultra-processed foods.

How to Consume Responsibly

While these findings are promising, they are observational. This means the study demonstrates an association rather than proving that coffee directly prevents or treats fatty liver. Additionally, the study specifically evaluated Italian-style coffee—primarily espresso and moka served in small cups of around 40 ml.

• Prefer sugar-free coffee or gradually reduce added sugar.

• Avoid pairing coffee with cakes, cookies, and sweets on a daily basis.

• Exercise caution if you experience anxiety, insomnia, gastritis, or arrhythmias.

• Pregnant women, sensitive older adults, and individuals with sleep disorders should personalize their intake.

• Do not use coffee as a replacement for weight loss, a balanced diet, and physical activity.

This content is for informational purposes only and does not substitute for evaluation, diagnosis, or treatment prescribed by a healthcare professional.

Font: TuaSaúde