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Epidemiology

Dietary patterns are associated with prevalence of fatty liver disease in adults

European Journal of Clinical Nutrition volume 69, pages 914–921 (2015)Cite this article

Subjects

Abstract

Background/objectives:

Previous studies have indicated that higher levels of food consumption are associated with fatty liver disease (FLD), but few studies have investigated the relationship between this disease and different dietary patterns. The aim of this cross-sectional study was to examine the association between dietary patterns and FLD in adults.

Subjects/methods:

Dietary intakes of participants in the Tianjin were assessed via questionnaire. Factor analysis was used to identify dietary patterns, and FLD was defined as having a FLD diagnosis using liver ultrasonography. Relationships between dietary patterns and FLD were assessed using multiple logistic regression analysis.

Results:

Female participants in the highest quartile of high-carbohydrate/sweet pattern scores had a 2.19-fold greater risk (95% confidence interval (CI), 1.40–3.46) of developing non-alcoholic FLD (NAFLD) than those in the lowest quartile after adjusting for confounding factors. No significant differences were found between any dietary pattern and NAFLD in males. In males, a significantly increasing trend of alcoholic FLD (AFLD) prevalence was associated with increasing high-protein/cholesterol pattern scores (P for trend=0.03; odds ratio (OR), 2.08; 95% CI, 1.15–3.81) while an increased high-carbohydrate/sweet pattern score appeared protective against AFLD (P for trend=0.02; OR, 0.55; 95% CI, 0.29–1.00).

Conclusions:

Our study demonstrates that high-protein/cholesterol pattern scores are associated with higher prevalence of AFLD in males. We also show high-carbohydrate/sweet pattern scores are associated with higher prevalence of NAFLD in females; but, interestingly, this pattern shows a favorable effect on AFLD in males.

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References

  1. Angulo P .. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther 2007; 25: 883–889.

    Article  CAS  Google Scholar 

  2. Jaurigue MM, Cappell MS . Therapy for alcoholic liver disease. World J Gastroenterol 2014; 20: 2143–2158.

    Article  CAS  Google Scholar 

  3. Fan JG . Epidemiology of alcoholic and nonalcoholic fatty liver disease in China. J Gastroenterol Hepatol 2013; 28 (Suppl 1), 11–17.

    Article  Google Scholar 

  4. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C . Prevalence of fatty liver in children and adolescents. Pediatrics 2006; 118: 1388–1393.

    Article  Google Scholar 

  5. Cheung O, Sanyal AJ . Recent advances in nonalcoholic fatty liver disease. Curr Opin Gastroenterol 2009; 25: 230–237.

    Article  Google Scholar 

  6. Bellentani S, Dalle Grave R, Suppini A, Marchesini G, Fatty Liver Italian N . Behavior therapy for nonalcoholic fatty liver disease: the need for a multidisciplinary approach. Hepatology 2008; 47: 746–754.

    Article  Google Scholar 

  7. Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R, Webb M, Blendis L, Halpern Z et al. Long term nutritional intake and the risk for non-alcoholic fatty liver disease (NAFLD): a population based study. J Hepatol 2007; 47: 711–717.

    Article  CAS  Google Scholar 

  8. Di Minno MN, Russolillo A, Lupoli R, Ambrosino P, Di Minno A, Tarantino G . Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease. World J Gastroenterol 2012; 18: 5839–5847.

    Article  CAS  Google Scholar 

  9. Petit JM, Guiu B, Duvillard L, Jooste V, Brindisi MC, Athias A et al. Increased erythrocytes n-3 and n-6 polyunsaturated fatty acids is significantly associated with a lower prevalence of steatosis in patients with type 2 diabetes. Clin Nutr 2012; 31: 520–525.

    Article  CAS  Google Scholar 

  10. Hu FB . Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13: 3–9.

    Article  CAS  Google Scholar 

  11. Oddy WH, Herbison CE, Jacoby P, Ambrosini GL, O'Sullivan TA, Ayonrinde OT et al. The Western dietary pattern is prospectively associated with nonalcoholic fatty liver disease in adolescence. Am J Gastroenterol 2013; 108: 778–785.

    Article  CAS  Google Scholar 

  12. Sun S, Wu H, Zhang Q, Wang C, Guo Y, Du H et al. Subnormal peripheral blood leukocyte counts are related to the lowest prevalence and incidence of metabolic syndrome: Tianjin chronic low-grade systemic inflammation and health cohort study. Mediators Inflamm 2014; 2014: 412386.

    PubMed  PubMed Central  Google Scholar 

  13. Song K, Du H, Zhang Q, Wang C, Guo Y, Wu H et al. Serum immunoglobulin M concentration is positively related to metabolic syndrome in an adult population: Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) Cohort Study. PLoS One 2014; 9: e88701.

    Article  Google Scholar 

  14. Zeng MD, Fan JG, Lu LG, Li YM, Chen CW, Wang BY et al. Guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases. J Digest Dis 2008; 9: 108–112.

    Article  Google Scholar 

  15. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC . Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women. Am J Clin Nutr 2007; 85: 910–918.

    Article  CAS  Google Scholar 

  16. Toshimitsu K, Matsuura B, Ohkubo I, Niiya T, Furukawa S, Hiasa Y et al. Dietary habits and nutrient intake in non-alcoholic steatohepatitis. Nutrition 2007; 23: 46–52.

    Article  Google Scholar 

  17. Assy N, Nasser G, Kamayse I, Nseir W, Beniashvili Z, Djibre A et al. Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Can J Gastroenterol 2008; 22: 811–816.

    Article  Google Scholar 

  18. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004; 292: 927–934.

    Article  CAS  Google Scholar 

  19. Abid A, Taha O, Nseir W, Farah R, Grosovski M, Assy N . Soft drink consumption is associated with fatty liver disease independent of metabolic syndrome. J Hepatol 2009; 51: 918–924.

    Article  CAS  Google Scholar 

  20. Miele L, Dall'armi V, Cefalo C, Nedovic B, Arzani D, Amore R et al. A case-control study on the effect of metabolic gene polymorphisms, nutrition, and their interaction on the risk of non-alcoholic fatty liver disease. Genes Nutr 2014; 9: 383.

    Article  Google Scholar 

  21. Lim JS, Mietus-Snyder M, Valente A, Schwarz JM, Lustig RH . The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome. Nature reviews. Gastroenterol Hepatol 2010; 7: 251–264.

    CAS  Google Scholar 

  22. Shi L, Liu ZW, Li Y, Gong C, Zhang H, Song LJ et al. The prevalence of nonalcoholic fatty liver disease and its association with lifestyle/dietary habits among university faculty and staff in Chengdu. Biomed Environ Sci 2012; 25: 383–391.

    PubMed  Google Scholar 

  23. Dunn W, Sanyal AJ, Brunt EM, Unalp-Arida A, Donohue M, McCullough AJ et al. Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease (NAFLD). J Hepatol 2012; 57: 384–391.

    Article  CAS  Google Scholar 

  24. Davies MJ, Baer DJ, Judd JT, Brown ED, Campbell WS, Taylor PR . Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: a randomized controlled trial. JAMA 2002; 287: 2559–2562.

    Article  CAS  Google Scholar 

  25. Howard AA, Arnsten JH, Gourevitch MN . Effect of alcohol consumption on diabetes mellitus: a systematic review. Ann Int Med 2004; 140: 211–219.

    Article  Google Scholar 

  26. Day CP . Genes or environment to determine alcoholic liver disease and non-alcoholic fatty liver disease. Liver Int 2006; 26: 1021–1028.

    Article  CAS  Google Scholar 

  27. Rotily M, Durbec JP, Berthezene P, Sarles H . Diet and alcohol in liver cirrhosis: a case-control study. Eur J Clin Nutr 1990; 44: 595–603.

    CAS  PubMed  Google Scholar 

  28. Naveau S, Dobrin AS, Balian A, Njike-Nakseu M, Nohra P, Asnacios A et al. Body fat distribution and risk factors for fibrosis in patients with alcoholic liver disease. Alcohol Clin Exp Res 2013; 37: 332–338.

    Article  CAS  Google Scholar 

  29. Sid B, Verrax J, Calderon PB . Role of oxidative stress in the pathogenesis of alcohol-induced liver disease. Free Radic Res 2013; 47: 894–904.

    Article  CAS  Google Scholar 

  30. Sid B, Verrax J, Calderon PB . Role of AMPK activation in oxidative cell damage: implications for alcohol-induced liver disease. Biochem Pharmacol 2013; 86: 200–209.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge all of the men and women who participated in the study and Tianjin Medical University General Hospital-Health Management Center for the opportunity to perform the study. This study was supported by grants from the key technologies R&D program of Tianjin (Key Project: No. 11ZCGYSY05700, 12ZCZDSY20400, and 13ZCZDSY20200), the Technologies development program of Beichen District of Tianjin (No. bcws2013-21 and bc2014-05), the technologies project of Tianjin Binhai New Area (No. 2013-02-04 and 2013-02-06), and the Science Foundation of Tianjin Medical University (No. 2010KY28), China.

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Author notes

  1. Q Jia and Y Xia: These two authors are co-first authors with equal contribution.

Authors and Affiliations

  1. Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China

    Q Jia, Q Zhang, L Liu, C Wang, H Shi, S Sun, X Wang, H Zhao, K Song & K Niu

  2. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China

    Y Xia, H Wu, H Du, X Guo, X Liu, C Li, G Huang, Y Wu & K Niu

  3. Department of Surgery, Tianjin Nankai Hospital, Tianjin, China

    N Cui

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Corresponding authors

Correspondence to Y Wu or K Niu.

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Cite this article

Jia, Q., Xia, Y., Zhang, Q. et al. Dietary patterns are associated with prevalence of fatty liver disease in adults. Eur J Clin Nutr 69, 914–921 (2015). https://doi.org/10.1038/ejcn.2014.297

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  • DOI: https://doi.org/10.1038/ejcn.2014.297

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