Association between nut intake and non-alcoholic fatty liver disease risk: a retrospective case-control study in a sample of Chinese Han adults

Abstract

ObjectivesNut consumption has been associated with a lower risk of type 2 diabetes, metabolic syndrome and insulin resistance. However, its effect on the risk of non-alcoholic fatty liver disease (NAFLD) is unknown. Therefore, we investigated the relationship between nut consumption and NAFLD risk.Setting and participantsWe conducted a retrospective case-control study including 534 patients diagnosed with NAFLD and 534 controls matched by sex and age (±5 years) from the Affiliated Nanping First Hospital of Fujian Medical University in China.Main outcome measuresInformation on dietary intake was collected using a semiquantitative food frequency questionnaire and nut consumption was calculated. Nut consumption was categorised using quartiles based on the distribution of daily nut intake of the controls. Binary logistic regression models were used to estimate ORs and the 95% CIs for the association between nut consumption and NAFLD risk.ResultsAfter adjusting for potential confounding variables, nut consumption was not associated with NAFLD risk in the overall sample. When the fully adjusted model was stratified by sex, a significant inverse association was found between high nut consumption and NAFLD only among the men in the highest quartile (OR=0.43; 95% CI 0.26 to 0.71;Ptrend =0.01). The inverse association of nut consumption with NAFLD risk in men remained significant after controlling for other known or suspected risk factors for NAFLD.ConclusionsDiets with a higher intake of nuts may be associated with a decreased risk of NAFLD, particularly in men.

The Association between Nuts Intake and Non-Alcoholic Fatty Liver Disease (NAFLD) Risk: a Case-Control Study

“…The association disappeared after adjusting for age, sex, waist circumference, homeostatic model assessment for insulin resistance, adiponectin, and tumor necrosis factor-α [38]. However, our findings are consistent with the results of a study by Chen et al [29], which failed to find a significant inverse relationship between high nut consumption and NAFLD risk among the overall samples. Interestingly, the current study indicated that compared to the first decile, higher consumption of nuts (in the deciles 9 and 10) was significantly associated with a higher risk of NAFLD.…”

“…The median intake of the highest frequency of nut consumption class in the Zhang et al study was 21.88 g/day [28]. Also, in Chen et al' study [29] the median of nut intake was 3.15 g/day in cases and 2.86 g/day in control group. Though most case-control studies showed protective effects on nut consumption on risk of NAFLD, high intake of nuts should be able to increase the prevalence of NFLD in other ways.…”

“…According to our literature review, only 2 studies have been conducted regarding to the association between nuts intake and NAFLD risk in China. Zhang et al [28] have shown an inverse association between them and Chen et al [29] concluded that nut consumption was not associated with NAFLD risk in the overall sample.…”

Food groups and the likelihood of non-alcoholic fatty liver disease: a systematic review and meta-analysis

“…Among them, forty-seven articles were excluded because seven were review articles, eight were about adolescents, twenty-four were without the relevant exposure/outcomes and eight did not conform to the relevant study design. Finally, twenty-four articles were identified and included in this systematic review and meta-analysis (12)(13)(14)(15)18,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) . The study selection process is described in Fig.…”

“…A total of five studies assessed the effect of nut consumption on the likelihood of NAFLD, which include two cross-sectional studies (with 4737 cases) and three case-control studies (with 768 cases) (15,34,35,39,51) . A negative association of nut intake with the possibility of NAFLD was observed among the cross-sectional studies (I 2 = 0 (Fig.…”