Naomi, Novita D, Ngo, Joy, Brouwer-Brolsma, Elske M, Buso, Marion EC, Soedamah-Muthu, Sabita S, Perez-Rodrigo, Carmen, Harrold, Joanne A 
ORCID: 0000-0002-0899-4586, Halford, Jason CG ORCID: 0000-0003-1629-3189, Raben, Anne, Geleijnse, Johanna M et al (show 2 more authors)
(2023)
Sugar-sweetened beverages, low/no-calorie beverages, fruit juice and non-alcoholic fatty liver disease defined by fatty liver index: the SWEET project.
NUTRITION & DIABETES, 13 (1).
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Abstract
<h4>Background</h4>Sweetened beverage intake may play a role in non-alcoholic fatty liver disease (NAFLD) development, but scientific evidence on their role is limited. This study examined associations between sugar-sweetened beverages (SSB), low/no-calorie beverages (LNCB) and fruit juice (FJ) intakes and NAFLD in four European studies.<h4>Methods</h4>Data for 42,024 participants of Lifelines Cohort, NQPlus, PREDIMED-Plus and Alpha Omega Cohort were cross-sectionally analysed. NAFLD was assessed using Fatty Liver Index (FLI) (≥60). Restricted cubic spline analyses were used to visualize dose-response associations in Lifelines Cohort. Cox proportional hazard regression analyses with robust variance were performed for associations in individual cohorts; data were pooled using random effects meta-analysis. Models were adjusted for demographic, lifestyle, and other dietary factors.<h4>Results</h4>Each additional serving of SSB per day was associated with a 7% higher FLI-defined NAFLD prevalence (95%CI 1.03-1.11). For LNCB, restricted cubic spline analysis showed a nonlinear association with FLI-defined NAFLD, with the association getting stronger when consuming ≤1 serving/day and levelling off at higher intake levels. Pooled Cox analysis showed that intake of >2 LNCB servings/week was positively associated with FLI-defined NAFLD (PR 1.38, 95% CI 1.15-1.61; reference: non-consumers). An inverse association was observed for FJ intake of ≤2 servings/week (PR 0.92, 95% CI: 0.88-0.97; reference: non-consumers), but not at higher intake levels. Theoretical replacement of SSB with FJ showed no significant association with FLI-defined NAFLD prevalence (PR 0.97, 95% CI 0.95-1.00), whereas an adverse association was observed when SSB was replaced with LNCB (PR 1.12, 95% CI 1.03-1.21).<h4>Conclusions</h4>Pooling results of this study showed that SSB and LNCB were positively associated with FLI-defined NAFLD prevalence. Theoretical replacement of SSB with LNCB was associated with higher FLI-defined NAFLD prevalence. An inverse association was observed between moderate intake of FJ and FLI-defined NAFLD. Our results should be interpreted with caution as reverse causality cannot be ruled out.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Energy Intake, Beverages, Non-alcoholic Fatty Liver Disease, Fruit and Vegetable Juices, Sugar-Sweetened Beverages |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 11 Jul 2023 12:37 |
| Last Modified: | 11 Jul 2023 12:37 |
| DOI: | 10.1038/s41387-023-00237-3 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3171618 |
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