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Nutrition and Health (including climate and ecological aspects)

Inflammatory potential of diet and risk of nonalcoholic fatty liver disease: a prospective cohort study

European Journal of Clinical Nutrition volume 76, pages 1125–1132 (2022)Cite this article

Subjects

Abstract

Background/objectives

Diet is an important factor that can exacerbate or ameliorate chronic inflammation, which has been implicated in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). However, no prospective study has yet investigated the relation between the inflammatory potential of diet and NAFLD. The aim of this study was to investigate the association between the inflammatory potential of the diet and the risk of NAFLD.

Subject/methods

The study included 12,877 participants aged over 18 years (mean [standard deviation]: 39.4 [11.5] years). Dietary intake was assessed at baseline through food frequency questionnaires. Using white blood cell count as the inflammatory marker, we newly created a dietary inflammatory potential score by reduced rank regression and stepwise linear regression. NAFLD was identified by abdominal ultrasound during yearly health checkups. Cox proportional hazards regression models were used to estimate the association between the dietary inflammatory potential score and the risk of NAFLD.

Results

During a median follow-up period of 4.2 years, 2744 first incident cases of NAFLD occurred. After adjustment for potential confounders, the multivariable hazards ratios (95% confidence intervals) for NAFLD across increasing quartiles of the dietary inflammatory potential score were 1.00 (reference), 1.01 (0.90, 1.13), 1.15 (1.03, 1.29), and 1.26 (1.13, 1.41), with P for trend <0.0001. This positive association appeared greater in men than in women (P for interaction = 0.02).

Conclusions

Our results indicate that a dietary pattern with high inflammatory potential is associated with a higher risk of NAFLD. Such findings provide the support that inflammation may be a potential mechanism linking diet to the risk of NAFLD.

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Acknowledgements

We are grateful to all the people that have made this study.

Funding

This study was supported by grants from the National Natural Science Foundation of China (Nos. 81941024 and 81872611), 2014 and 2016 Chinese Nutrition Society (CNS) Nutrition Research Foundation—DSM Research Fund (Nos. 2016-046, 2014-071 and 2016–023), Study of Diet and Nutrition Assessment and Intervention Technology (No. 2020YFC2006300) from Active Health and Aging Technologic Solutions Major Project of National Key R&D Program——Development and application of key technologies for nutrition and health food at specific physiological stages (Nos. 2020YFC2006304, 2020YFC2006302, and 2020YFC2006305), National Health Commission of China (No. SPSYYC 2020015) and SZ is a recipient of a scholarship under the China Scholarship Council to pursue his study in Sweden (No. 202006940030).

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Authors and Affiliations

  1. Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China

    Shunming Zhang, Yeqing Gu & Kaijun Niu

  2. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China

    Shunming Zhang, Ge Meng, Hongmei Wu, Yawen Wang, Tingjing Zhang, Xuena Wang, Juanjuan Zhang, Yaogang Wang & Kaijun Niu

  3. Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden

    Shunming Zhang

  4. Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China

    Ge Meng

  5. Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China

    Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song & Kaijun Niu

  6. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA

    Lu Qi

  7. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Lu Qi

  8. Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China

    Kaijun Niu

  9. Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China

    Kaijun Niu

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  1. Shunming Zhang
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Contributions

SZ analyzed the data and wrote the paper. SZ, GM, QZ, LL, HW, YG, YW, TZ, XW, JZ, SS, XW, MZ, QJ, KS, and YW conducted research. LQ and KN designed the research and had primary responsibility for the final content. All authors had full access to all the data in the study and read and approved the final manuscript.

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Correspondence to Lu Qi or Kaijun Niu.

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Zhang, S., Meng, G., Zhang, Q. et al. Inflammatory potential of diet and risk of nonalcoholic fatty liver disease: a prospective cohort study. Eur J Clin Nutr 76, 1125–1132 (2022). https://doi.org/10.1038/s41430-022-01069-7

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