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Nutrition and Health (including climate and ecological aspects)

Higher plain water intake is related to lower newly diagnosed nonalcoholic fatty liver disease risk: a population-based study

Abstract

Background/objectives

High plain water intake (PWI) lowered body weight, reduced total energy intake, and increased fat oxidation and energy consumption. Because such factors are closely linked to metabolic disorders, which are the main risk factors for nonalcoholic fatty liver disease (NAFLD) onset, it was speculated that higher PWI was associated with a lower risk of NAFLD. However, no prior human studies have examined such relationship. Therefore, the purpose of this study was to evaluate the relationship between PWI and newly diagnosed NAFLD in a large-scale adult population.

Subjects/methods

A total of 16,434 participants from 2010 to 2019 in Tianjin, China, were included in this cross-sectional study. PWI was assessed by using a validated self-administered food frequency questionnaire, and it was categorized into three subgroups for analysis: ≤3 cups/day, 4–7 cups/day, and >7 cups/day. NAFLD was diagnosed by abdominal ultrasound. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the relationship between PWI and NAFLD.

Results

Among 16,434 participants, 20.5% (3,364) had newly diagnosed NAFLD. After controlling for demographic characteristics, lifestyle risk factors, and dietary intake, the adjusted ORs (95% CIs) for having NAFLD across PWI categories were 1.00 (reference) for ≤3 cups/day, 0.84 (0.72, 0.97) for 4–7 cups/day, and 0.77 (0.63, 0.94) for >7 cups/day in males and 1.00 (reference) for ≤3 cups/day, 1.02 (0.81, 1.27) for 4–7 cups/day, and 1.08 (0.78, 1.49) for >7 cups/day in females, respectively.

Conclusions

This study is the first to show that higher PWI is independently related to lower newly diagnosed NAFLD among males, but not females. Further studies are needed to explore the causal relationship.

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Acknowledgements

This study was supported by grants from the National Natural Science Foundation of China (nos 81941024, 81872611, 91746205, and 81673166).

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Xing Wang, SL, and YG drafted the manuscript. SG, YY, QZ, LL, GM, ZY, DZ, HW, and SZ interpreted the results and contributed to the discussions. YWang, TZ, SS, QJ, KS, Xiao-Hui Wu, QJ, and YWu contributed to collect the data. KN and QZ designed the study, analyzed the data, reviewed and edited the manuscript, and had full access to all the data and took responsibility for the integrity of the data. All authors approved the final version.

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Correspondence to Qing Zhang or Kaijun Niu.

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Wang, X., Lin, S., Gan, S. et al. Higher plain water intake is related to lower newly diagnosed nonalcoholic fatty liver disease risk: a population-based study. Eur J Clin Nutr 75, 1801–1808 (2021). https://doi.org/10.1038/s41430-021-00891-9

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