Zhang Shunming, Yan Yan, Zeng Xu-Fen, Gu Yeqing, Wu Hongmei, Zhang Qing, Liu Li, Huo Zhenyu, Luo Xiaoqin, Zhang Rui, Sonestedt Emily, Borné Yan, Qi Lu, Huang Tao, Zheng Ming-Hua, Chen Yu-Ming, Niu Kaijun, Ma Le
School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Hepatology. 2025 May 1;81(5):1583-1594. doi: 10.1097/HEP.0000000000001039. Epub 2024 Aug 2.
The EAT-Lancet Commission devised a globally sustainable dietary pattern to jointly promote human health and sustainability. However, the extent to which this diet supports metabolic dysfunction-associated steatotic liver disease (MASLD) has not yet been assessed. This study aimed to investigate the association between the EAT-Lancet diet and the risk of MASLD and its severity.
This prospective multicohort study included 15,263 adults from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort, 1137 adults from the Guangzhou Nutrition and Health Study (GNHS) cohort, and 175,078 adults from the UK Biobank. In addition, 228 Chinese adults from the Prospective Epidemic Research Specifically of Non-alcoholic Steatohepatitis (PERSONS) with biopsy-proven MASLD were included. An EAT-Lancet diet index was created to reflect adherence to the EAT-Lancet reference diet. The TCLSIH cohort recorded 3010 MASLD cases during 53,575 person-years of follow-up, the GNHS cohort documented 624 MASLD cases during 6454 person-years of follow-up, and the UK Biobank developed 1350 MASLD cases during 1,745,432 person-years of follow-up. In multivariable models, participants in the highest tertiles of the EAT-Lancet diet index had a lower risk of MASLD compared with those in the lowest tertiles (TCLSIH: HR = 0.87, 95% CI: 0.78, 0.96; GNHS: HR = 0.79, 95% CI: 0.64, 0.98; UK Biobank: HR = 0.73, 95% CI: 0.63, 0.85). Moreover, liver-controlled attenuation parameter decreased with increasing the diet index in individuals with biopsy-proven MASLD (β = -5.895; 95% CI: -10.014, -1.775).
Adherence to the EAT-Lancet reference diet was inversely associated with the risk of MASLD as well as its severity.
《柳叶刀 - 饮食委员会》设计了一种全球可持续的饮食模式，以共同促进人类健康与可持续发展。然而，这种饮食对代谢功能障碍相关脂肪性肝病（MASLD）的支持程度尚未得到评估。本研究旨在调查《柳叶刀 - 饮食委员会》饮食与MASLD风险及其严重程度之间的关联。
这项前瞻性多队列研究纳入了来自天津慢性低度全身炎症与健康（TCLSIH）队列的15263名成年人、来自广州营养与健康研究（GNHS）队列的1137名成年人以及来自英国生物银行的175078名成年人。此外，还纳入了228名来自非酒精性脂肪性肝炎前瞻性流行病研究（PERSONS）且经活检证实患有MASLD的中国成年人。创建了一个《柳叶刀 - 饮食委员会》饮食指数，以反映对《柳叶刀 - 饮食委员会》参考饮食的依从性。TCLSIH队列在53575人年的随访期间记录了3010例MASLD病例，GNHS队列在6454人年的随访期间记录了624例MASLD病例，英国生物银行在1745432人年的随访期间出现了1350例MASLD病例。在多变量模型中，与处于《柳叶刀 - 饮食委员会》饮食指数最低三分位数的参与者相比，处于最高三分位数的参与者患MASLD的风险更低（TCLSIH：HR = 0.87，95%CI：0.78，0.96；GNHS：HR = 0.79，95%CI：0.64，0.98；英国生物银行：HR = 0.73，95%CI：0.63，0.85）。此外，在经活检证实患有MASLD的个体中，肝脏控制衰减参数随着饮食指数的增加而降低（β = -5.895；95%CI：-10.014，-1.775）。
坚持《柳叶刀 - 饮食委员会》参考饮食与MASLD风险及其严重程度呈负相关。
