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Sugar-sweetened beverages, low/no-calorie beverages, fruit juice and non-alcoholic fatty liver disease defined by fatty liver index: The SWEET project
Naomi,Novita D. Ngo,Joy Brouwer-Brolsma,Elske M. Buso,Marion E. C. Soedamah-Muthu,Sabita S. Pérez-Rodrigo,Carmen Harrold,Joanne A. Halford,Jason C. G. Raben,Anne Geleijnse,Johanna M.
Naomi,Novita D.
Ngo,Joy
Brouwer-Brolsma,Elske M.
Buso,Marion E. C.
Soedamah-Muthu,Sabita S.
Pérez-Rodrigo,Carmen
Harrold,Joanne A.
Halford,Jason C. G.
Raben,Anne
Geleijnse,Johanna M.
Abstract
Background 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. Methods 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. Results 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). Conclusions 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.
Description
This EU project under the acronym “SWEET” has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 774293
Date
2023
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Research Projects
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Keywords
Beverages, Energy Intake, Fruit and Vegetable Juices, Humans, Non-alcoholic Fatty Liver Disease/epidemiology, Sugar-Sweetened Beverages
Citation
Naomi, N D, Ngo, J, Brouwer-Brolsma, E M, Buso, M E C, Soedamah-Muthu, S S, Pérez-Rodrigo, C, Harrold, J A, Halford, J C G, Raben, A, Geleijnse, J M, Serra-Majem, L & Feskens, E J M 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, vol. 13, 6. https://doi.org/10.1038/s41387-023-00237-3