High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance

Zelber‐Sagi, Shira; Ivancovsky‐Wajcman, Dana; Isakov, Naomi Fliss; Webb, Muriel; Orenstein, Dana; Shibolet, Oren; Kariv, Revital

doi:10.1016/j.jhep.2018.01.015

Cited by 220 publications

(232 citation statements)

References 59 publications

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“…Interestingly, a large epidemiological study showed that high red meat intake was associated with all-cause mortality and in particular with mortality from liver diseases (HR 2.30, highest vs lowest quintile) 36. In addition, a study from Israel found that high meat consumption, specifically high red and processed meat consumption were associated with NAFLD and insulin resistance, independent of saturated fat intake and BMI 37. Yet, two other studies did either not find a difference in protein consumption between patients and controls or found that controls consumed slightly more protein than patients 15 16.…”

Section: Discussionmentioning

confidence: 99%

Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: the Rotterdam Study

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Erler

et al. 2018

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ObjectiveA healthy lifestyle is the first-line treatment in non-alcoholic fatty liver disease (NAFLD), but specific dietary recommendations are lacking. Therefore, we aimed to determine whether dietary macronutrient composition is associated with NAFLD.DesignParticipants from the Rotterdam Study were assessed on (1) average intake of macronutrients (protein, carbohydrate, fat, fibre) using a Food Frequency Questionnaire and (2) NAFLD presence using ultrasonography, in absence of excessive alcohol, steatogenic drugs and viral hepatitis. Macronutrients were analysed using the nutrient density method and ranked (Q1–Q4). Logistic regression analyses were adjusted for sociodemographic, lifestyle and metabolic covariates. Moreover, analyses were adjusted for and stratified by body mass index (BMI) (25 kg/m2). Also, substitution models were built.ResultsIn total, 3882 participants were included (age 70±9, 58% female). NAFLD was present in 1337 (34%) participants of whom 132 were lean and 1205 overweight. Total protein was associated with overweight NAFLD after adjustment for sociodemographic and lifestyle covariates (ORQ4vsQ1 1.40; 95% CI 1.11 to 1.77). This association was driven by animal protein (ORQ4vsQ1 1.54; 95% CI 1.20 to 1.98). After adjustment for metabolic covariates, only animal protein remained associated with overweight NAFLD (ORQ4vsQ1 1.36; 95% CI 1.05 to 1.77). Monosaccharides and disaccharides were associated with lower overall NAFLD prevalence (ORQ4vsQ1 0.66; 95% CI 0.52 to 0.83) but this effect diminished after adjustment for metabolic covariates and BMI. No consistent associations were observed for fat subtypes or fibre. There were no substitution effects.ConclusionThis large population-based study shows that high animal protein intake is associated with NAFLD in overweight, predominantly aged Caucasians, independently of well-known risk factors. Contrary to previous literature, our results do not support a harmful association of monosaccharides and disaccharides with NAFLD.

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Section: Discussionmentioning

confidence: 99%

Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: the Rotterdam Study

Alferink

Jong

Erler

et al. 2018

Gut

105

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“…Systolic blood pressure is also associated with fatty liver, but the mechanisms that explain the association that are independent of adiposity or insulin resistance remain unknown . In addition, physical inactivity and unhealthy dietary habits, especially high consumption of red meat, have been considered behavioral risk factors of fatty liver . In this study, the highest proportions mediated of the total effect of childhood SED were observed for adulthood measures of high waist circumference (45%), BMI (40%), and systolic blood pressure (29%).…”

Section: Discussionmentioning

confidence: 67%

“…We found that adult measures of adiposity, triglycerides, insulin, systolic blood pressure, physical activity, and red meat consumption were on the pathway linking childhood SED with fatty liver. All these observed mediators have been previously associated with fatty liver . Adiposity and insulin resistance are considered key factors in the pathophysiology of fatty liver .…”

Section: Discussionmentioning

confidence: 95%

“…BMI, waist circumference, insulin, systolic blood pressure, triglycerides, physical activity, smoking, consumption of alcohol, and consumption of red meat, all previously shown as adulthood risk factors of fatty liver in this and other cohorts, were considered possible mediators between the association of childhood SED and adulthood fatty liver. Adulthood risk factors of fatty liver (possible mediators) were measured in the adulthood follow‐ups in 2001, 2007, and 2011.…”

Section: Participants and Methodsmentioning

confidence: 99%

“…In adults, obesity and metabolic disturbances, such as insulin resistance and dyslipidemia, are associated with increased risk of fatty liver . In addition, physical inactivity and unhealthy dietary habits have been considered behavioral risk factors of fatty liver . In addition, we previously identified low birth weight, high insulin, and high body mass index (BMI) in childhood as risk factors for adult fatty liver …”

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confidence: 99%

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Childhood Socioeconomic Disadvantage and Risk of Fatty Liver in Adulthood: The Cardiovascular Risk in Young Finns Study

et al. 2019

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Fatty liver is a preventable cause of liver failure, but early risk factors for adulthood fatty liver are poorly understood. We examined the association of childhood socioeconomic disadvantage with adulthood fatty liver and tested adulthood risk factors of fatty liver as possible mediators of this link. The study population comprised 2,042 participants aged 3‐18 years at baseline (1980) from the longitudinal Cardiovascular Risk in Young Finns Study. Follow‐up with repeated clinical examinations was 31 years. Childhood socioeconomic disadvantage was assessed using data from parents’ socioeconomic position and socioeconomic circumstances in participants’ residential neighborhoods, categorized as high versus low socioeconomic disadvantage. Fatty liver was determined by ultrasound during the last follow‐up (2011) at ages 34‐49 years. Childhood and adulthood risk factors, including metabolic biomarkers and lifestyle variables, were assessed in clinical examinations. A total of 18.9% of the participants had fatty liver in adulthood. High childhood socioeconomic disadvantage was associated with an increased risk of fatty liver (risk ratio [95% confidence interval], 1.42 [1.18‐1.70]; P = 0.0002). This association was robust to adjustment for age, sex, and childhood risk factors of fatty liver, including high body mass index, elevated insulin, and low birth weight (1.33 [1.09‐1.62]; P = 0.005). High childhood socioeconomic disadvantage was also associated with the development of risk factors of fatty liver in adulthood. Adulthood risk factors linking childhood socioeconomic disadvantage with fatty liver included waist circumference (proportion mediated of the total effect of childhood socioeconomic disadvantage, 45%), body mass index (40%), systolic blood pressure (29%), insulin (20%), physical activity (15%), triglycerides (14%), and red meat consumption (7%). Conclusion: Childhood socioeconomic disadvantage was associated with multiple risk factors of fatty liver and increased likelihood of fatty liver in adulthood.

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Report on the AASLD/EASL Joint Workshop on Clinical Trial Endpoints in NAFLD

et al. 2019

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Nonalcoholic fatty liver disease (NAFLD) is a global public health concern. Its natural history, the development of nonalcoholic steatohepatitis (NASH) and fibrosis, is highly variable, prone to endogenous (e.g., genetics, microbiota) and exogenous (e.g., nutrition, alcohol, physical activity) disease modifiers, and can fluctuate over time. The complexity of its pathophysiology is reflected by the multitude of pharmacological targets in development. NASH clinical trials have provided valuable insight that is applicable to future trial design. Endpoints for NASH have evolved over the past decade and will continue to be refined. Currently accepted endpoints for conditional approval include resolution of NASH without worsening of fibrosis and/or improvement in fibrosis without worsening of NASH by standardized evaluation of paired liver histology. In pediatric NASH, practical obstacles, pubertal hormonal changes, and stringent safety requirements mandate adaptations in trial design. In adult patients with NASH‐related cirrhosis, clinical events (e.g. decompensation, hepatocellular carcinoma, transplantation, death) are more prevalent and thereby are viable primary endpoints. Consideration of the natural fluctuation of disease, the clinical implication of the chosen primary endpoint, and factors that may affect placebo response will facilitate an accurate determination of efficacy of emerging therapeutics for NASH. Conclusion: The June 2018 American Association for the Study of Liver Diseases and European Association for the Study of the Liver joint workshop on NAFLD endpoints summarized important findings from ongoing and completed trials, defined the scientific evidence supporting distinct endpoints, and provided guidance for future trial design.

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High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance

Cited by 220 publications

References 59 publications

Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: the Rotterdam Study

Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: the Rotterdam Study

Childhood Socioeconomic Disadvantage and Risk of Fatty Liver in Adulthood: The Cardiovascular Risk in Young Finns Study

Report on the AASLD/EASL Joint Workshop on Clinical Trial Endpoints in NAFLD

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