Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Int J Epidemiol. 2022 Feb 18;51(1):237-249. doi: 10.1093/ije/dyab174.
Growing evidence supports a link between ultra-processed food consumption and human health outcomes. However, the association between ultra-processed food consumption and non-alcoholic fatty liver disease (NAFLD) is not known. We aimed to explore the association between ultra-processed food consumption and risk of NAFLD.
The prospective study included 16 168 participants aged 18-90 years from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Information on ultra-processed food consumption was collected at baseline using a validated food frequency questionnaire. NAFLD was defined as the presence of sonographic fatty liver in the absence of significant alcohol intake (≥210 g/week for men and ≥140 g/week for women, respectively) and other liver diseases. Multivariable Cox proportional hazards models were used to examine the association between ultra-processed food consumption and risk of NAFLD.
During 56 935 person-years of follow-up, we documented 3752 incident NAFLD cases. After adjusting for age, sex, body mass index, smoking, alcohol drinking, education, occupation, income, physical activity, total energy intake, personal and family history of disease and overall diet quality, the multivariable hazard ratios (95% confidence interval) of NAFLD across increasing quartiles of ultra-processed food consumption were 1.00 (reference), 0.99 (0.90, 1.08), 1.13 (1.03, 1.25) and 1.18 (1.07, 1.30), respectively (P for trend <0.0001). The hazard ratio (95% confidence interval) per one standard deviation increase in ultra-processed food consumption, equivalent to a 62.7 g/1000 kcal per day, was 1.06 (1.03, 1.09), P = 0.0001.
Our study indicates that higher ultra-processed food consumption is associated with a higher risk of NAFLD. This finding suggests that ultra-processed food, which is widely consumed worldwide, might be a modifiable dietary target to reduce the risk of NAFLD.
越来越多的证据表明，超加工食品的消费与人类健康结果之间存在关联。然而，超加工食品的消费与非酒精性脂肪性肝病（NAFLD）之间的关联尚不清楚。我们旨在探讨超加工食品消费与 NAFLD 风险之间的关系。
这项前瞻性研究纳入了来自天津慢性低度系统性炎症与健康（TCLSIH）队列研究的 16168 名年龄在 18-90 岁之间的参与者。基线时使用经过验证的食物频率问卷收集了超加工食品消费的信息。NAFLD 的定义为在无显著饮酒（男性分别为≥210 g/周和女性分别为≥140 g/周）和其他肝病的情况下存在超声脂肪肝。多变量 Cox 比例风险模型用于检验超加工食品消费与 NAFLD 风险之间的关系。
在 56935 人年的随访期间，我们记录了 3752 例新发 NAFLD 病例。在校正年龄、性别、体重指数、吸烟、饮酒、教育、职业、收入、体力活动、总能量摄入、个人和家族病史以及整体饮食质量后，超加工食品消费每增加一个四分位间距的多变量风险比（95%置信区间）分别为 1.00（参考）、0.99（0.90，1.08）、1.13（1.03，1.25）和 1.18（1.07，1.30）（趋势 P<0.0001）。超加工食品消费每增加一个标准差（相当于每天增加 62.7 g/1000 kcal），风险比（95%置信区间）为 1.06（1.03，1.09），P=0.0001。
我们的研究表明，较高的超加工食品消费与 NAFLD 风险增加相关。这一发现表明，在全球范围内广泛消费的超加工食品可能是一个可改变的饮食目标，以降低 NAFLD 的风险。
