SEARCHCOHORTnutrition, dietetics

cohort·nutrition, dietetics, clinical nutrition, epidemiology, gastroenterology·PMC10496397

Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease

BMC Medicine · 6 authors, 6 centres

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TL;DR

Higher healthful plant-based diet scores were associated with lower NAFLD risk, while higher unhealthful plant-based diet scores were associated with higher NAFLD risk, and these associations were generally consistent across genetic risk strata.

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MRI-PDFF data in 20,692 participants confirmed that higher overall PDI and hPDI were associated with lower liver fat content, whereas higher uPDI was associated with higher liver fat content. A significant interaction between hPDI and polygenic risk score was observed, with the lowest NAFLD risk among participants with high hPDI and low genetic risk. Associations were stronger when BMI was not adjusted for.

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cohort

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nutrition

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ORIGINAL PAPER

PMC10496397

Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease

BMC Medicine

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ABSTRACT

Abstract Background Diets rich in plant-based foods are associated with lower risks of non-alcoholic fatty liver disease (NAFLD), while the prospective evidence is limited. We aimed to examine longitudinal associations of plant-based diets and genetic susceptibility with NAFLD risk. Methods This longitudinal cohort study included 159,222 participants (58.0 ± 8.0 years old, 55.7% female) free of NAFLD in the UK Biobank. We calculated the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). New-onset NAFLD was the primary outcome. The weighted polygenic risk score was calculated based on risk variants associated with NAFLD. Hazard ratios (HR) and 95% confidential intervals (CI) were estimated by Cox proportional hazards model. Magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) measured liver fat content in a subsample of 20,692 participants (57.5 ± 7.4 years old, 52.6% female) was the secondary outcome. The associations between plant-based diet indices and MRI-PDFF were evaluated using generalized linear models. Results During a median follow-up of 9.5 years, 1541 new-onset NAFLD cases were documented. Compared to the lowest quintile, multivariable-adjusted hazard ratios (HRs) of NAFLD in the highest quintile were 0.78 (95% confidential intervals [CI], 0.66–0.93, p -trend =0.02), 0.74 (95% CI, 0.62–0.87, p -trend <0.0001), and 1.24 (95% CI, 1.05–1.46, p -trend = 0.02) for overall PDI, hPDI, and uPDI, respectively. For liver fat content, higher overall PDI and hPDI were associated with lower MRI-PDFF, while higher uPDI was associated with higher liver fat content. We observed a significant interaction between hPDI and PRS ( p -interaction =0.03), and the NAFLD risk was lowest among participants with the highest hPDI and low genetic risk. Conclusions Higher intake of plant-based diets especially healthful plant-based diets was associated with lower NAFLD risk and liver fat content regardless of genetic susceptibility, whereas an unhealthful plant-based diet was associated with higher NAFLD risk and intrahepatic steatosis. These results suggest that the quality of plant-based foods should be highlighted when adopting a plant-based diet. Supplementary Information The online version contains supplementary material available at 10.1186/s12916-023-03028-w. Keywords: Plant-based diet, NAFLD, Genetic risk, UK Biobank

CITATION EXPORT

Yanling Lv, Shuang Rong, Yan Deng et al.. Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease. BMC Medicine. (2023). https://doi.org/10.1186/s12916-023-03028-w

AUTHORS

6 · 6 CENTRES

Yanling Lv, Shuang Rong, Yan Deng, Wei Bao, Yang Xia, Liangkai Chen

1Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030 China
2Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
3Department of Preventive Medicine, School of Public Health, Wuhan University, No.115 Donghu Road, Wuhan, 430071 Hubei China
4Department of Nutrition, Hygiene and Toxicology, Academy of Nutrition and Health, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065 China
5Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China
6Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China