Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil.
Hepatol Commun. 2023 Aug 31;7(9). doi: 10.1097/HC9.0000000000000240. eCollection 2023 Sep 1.
The effect of ultra-processed foods (UPF) on NAFLD remains unclear. Related evidence for adult NAFLD is limited and no study has yet evaluated UPF's impact on NAFLD in adolescence.
We used data from the National Health and Nutrition Examination Survey (2017-2018) with 806 adolescents and 2734 adults. UPF intake was estimated using dietary data from two 24-hour dietary recalls. NAFLD was defined by transient elastography. Logistic regression was used to estimate the multivariable OR and 95% CI for associations between UPF and NAFLD with survey weight adjustments.
The mean UPF intake was 812 g/d in adolescents and 823 g/d in adults. A total of 12.4% of the adolescents and 35.6% of the adults had NAFLD. Higher UPF intake was associated with higher odds of NAFLD in both adolescents (OR Quintile 5 vs. Quartile 1 = 2.34, 95% CI, 1.01, 5.41; ptrend = 0.15) and adults (OR Quintile 5 vs. Quintile 1 = 1.72, 95% CI, 1.01, 2.93; ptrend = 0.002). In adults, ~68% and 71% of the association between UPF intake and NAFLD was mediated by body mass index and waist circumference (all p-values < 0.001), respectively. The results were similar for adolescents but not statistically significant. A higher UPF intake was associated with lower levels of serum albumin and higher levels of C-reactive protein in adults.
Higher UPF intake was linked to higher NAFLD odds in both adolescents and adults, mainly because of elevated body fatness. If confirmed, reducing UPF intake may help prevent NAFLD in both adolescents and adults.
超加工食品（UPF）对非酒精性脂肪性肝病（NAFLD）的影响尚不清楚。成人 NAFLD 的相关证据有限，尚无研究评估 UPF 对青少年 NAFLD 的影响。
我们使用了来自全国健康和营养调查（2017-2018 年）的数据，其中包括 806 名青少年和 2734 名成年人。UPF 的摄入量是通过两次 24 小时膳食回忆中的膳食数据来估计的。NAFLD 通过瞬态弹性成像来定义。使用多变量逻辑回归来估计 UPF 与 NAFLD 之间的关联的多变量 OR 和 95%置信区间，并进行调查权重调整。
青少年的 UPF 摄入量平均为 812g/d，成年人的 UPF 摄入量平均为 823g/d。青少年中有 12.4%，成年人中有 35.6%患有 NAFLD。在青少年（UPF 摄入量最高五分位比最低五分位的比值=2.34，95%CI：1.01，5.41；趋势检验=0.15）和成年人（UPF 摄入量最高五分位比最低五分位的比值=1.72，95%CI：1.01，2.93；趋势检验=0.002）中，较高的 UPF 摄入量与 NAFLD 的几率更高相关。在成年人中，UPF 摄入量与 NAFLD 之间的关联约 68%和 71%分别通过体重指数和腰围来介导（所有 p 值均<0.001）。青少年的结果类似，但没有统计学意义。成年人中，较高的 UPF 摄入量与较低的血清白蛋白水平和较高的 C 反应蛋白水平相关。
在青少年和成年人中，较高的 UPF 摄入量与更高的 NAFLD 几率相关，主要是由于体脂肪增加。如果得到证实，减少 UPF 摄入量可能有助于预防青少年和成年人的 NAFLD。
