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Association between ultra-processed foods consumption and risk of non-alcoholic fatty liver disease: a population-based analysis of NHANES 2011–2018

Published online by Cambridge University Press:  16 December 2022

Zhening Liu Open the ORCID record for Zhening Liu [Opens in a new window] ,
Hangkai Huang ,
Yan Zeng ,
Yishu Chen  and
Chengfu Xu
Zhening Liu
Affiliation:
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, People’s Republic of China
Hangkai Huang
Affiliation:
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, People’s Republic of China
Yan Zeng
Affiliation:
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, People’s Republic of China
Yishu Chen
Affiliation:
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, People’s Republic of China
Chengfu Xu*
Affiliation:
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, People’s Republic of China
*
*Corresponding author: Chengfu Xu, email xiaofu@zju.edu.cn
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Abstract

An increasing number of studies have evaluated the association between ultra-processed foods (UPF) consumption and metabolic disorders. However, the association between UPF intake and non-alcoholic fatty liver disease (NAFLD) remains unclear. In this study, we analysed data from 6545 participants who were recruited in National Health and Nutrition Examination Surveys 2011–2018. UPF were defined in light of the NOVA food classification system and divided into quartiles based on its proportion of total weight intake. Complex logistic regression models were used to assess the association between UPF and NAFLD. Mediation analyses were conducted to reveal underlying mediators. We found that NAFLD patients consumed more UPF than controls (925·92 ± 18·08 v. 812·70 ± 14·32 g/d, P < 0·001). Dietary intake of UPF (% weight) was negatively related to the Healthy Eating Index-2015 score (Spearman r = −0·32, P < 0·001). In the multivariable model, the highest quartile compared with the lowest, the OR (95 % CI) were 1·83 (1·33, 2·53) for NAFLD (OR per 10 % increment: 1·15; 95 % CI: 1·09, 1·22; P for trend < 0·001) and 1·52 (1·12, 2·07) for insulin resistance (OR per 10 % increment: 1·11; 95 % CI: 1·05, 1·18; P for trend = 0·002). Mediation analyses revealed that poor diet quality, high saturated fat and refined grain intake partly mediated the association between UPF and NAFLD. In conclusion, high UPF intake was associated with an increased risk of NAFLD in US adults. Further prospective studies are needed to verify these findings.

Keywords

Ultra-processed foodsFatty liver diseaseInsulin resistanceDietary pattern
Type
Research Article
Information
British Journal of Nutrition , Volume 130 , Issue 6 , 28 September 2023 , pp. 996 - 1004
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Copyright
© Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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