Nut consumption and the prevalence and severity of non-alcoholic fatty liver disease

• Published in: PloS one Vol. 15; no. 12; p. e0244514
• Main Authors: Semmler, Georg, Bachmayer, Sebastian, Wernly, Sarah, Wernly, Bernhard, Niederseer, David, Huber-Schönauer, Ursula, Stickel, Felix, Aigner, Elmar, Datz, Christian
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 31.12.2020; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Alcohol; Biology and Life Sciences; Bombast von Hohenheim, Philippus Aureolus Theophrastus (Paracelsus) (1493-1541); Cardiovascular disease; Cholesterol; Colorectal cancer; Colorectal carcinoma; Consumption; Coronary vessels; Development and progression; Diabetes; Diabetes mellitus; Diagnosis; Diet; Diet Surveys - statistics & numerical data; Disease Progression; Dyslipidemia; Fasting; Fatty liver; Feeding Behavior - physiology; Female; Fibrosis; Food; Glucose; Health aspects; Hepatitis; Humans; Hypertension; Inflammation; Insulin; Insulin resistance; Internal medicine; Liver; Liver - diagnostic imaging; Liver - pathology; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - prevention & control; Liver diseases; Male; Males; Meat; Medicine; Medicine and Health Sciences; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - prevention & control; Metabolism; Middle Aged; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - pathology; Non-alcoholic Fatty Liver Disease - prevention & control; Nuts; Oxidation resistance; Oxidative stress; Patients; Prevalence; Questionnaires; Regression analysis; Risk Factors; Severity of Illness Index; Sex Factors; Subgroups; Teaching hospitals; Triglycerides; Ultrasound; Variables; Austria; United States > US; Switzerland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244514

Nut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress. However, the influence on the prevalence and severity of non-alcoholic fatty liver disease (NAFLD) has yet to be evaluated. 4655 subjects were included as part of a colorectal carcinoma screening program (SAKKOPI) between 07/2010 and 07/2019 and analyzed 2020. Patients were characterized using biochemical and metabolic parameters, as well as a detailed questionnaire on dietary habits. The diagnosis of NAFLD was established using abdominal ultrasound. Consumption of nuts was graded as: no consumption or <1 time/week, 1-6 times/week, 1 time/day and ≥2 times/day. Mean age was 58.5±9.8years with a mean BMI of 26.5±4.7kg/m2. 2058 (44.2%) patients suffered from the metabolic syndrome, 2407 (51.6%) had arterial hypertension, 2287 (49.1%) showed prediabetes/diabetes, 1854 (39.4%) had dyslipidemia and 1984 patients (43.5%) were diagnosed with NAFLD. Prevalence of metabolic syndrome (1219 [48.7%] vs. 605 [40.2%] vs. 189 [37.4%] vs. 45 [31.7%], p<0.001) and NALFD (1184 [48.1%] vs. 594 [40.7%] vs. 158 [31.7%] vs. 48 [34.0%], p<0.001). On multivariable logistic regression analysis adjusting for potential confounders and dietary patterns, nut consumption ≥1time/day was inversely associated with NAFLD in the overall cohort (adjusted Odds ratio[aOR]: 0.719 [95%CI:0.558-0.926], p = 0.011). However, following subgroup analysis, this inverse association was only confirmed in male patients (aOR: 0.589 [95%CI: 0.411-0.844], p = 0.004) but not in females (aOR: 0.886 [95%CI: 0.616-1.275], p = 0.515). Moreover, patients who consumed nuts 1-6 times/week had a significantly lower prevalence of advanced fibrosis (Fib-4 score >2.67: aOR: 0.551 [95%CI: 0.338-0.898], p = 0.017; Forns-Index >6.9: aOR: 0.585 [95%CI: 0.402-0.850], p = 0.005). Nut consumption might exert beneficial effects on the prevalence of NAFLD in males. The negative association with advanced fibrosis warrants further investigation.