Different dietary carbohydrate component intakes and long-term outcomes in patients with NAFLD: results of longitudinal analysis from the UK Biobank

• Published in: Nutrition journal 2023-12, Vol.22 (1), p.67-67, Article 67
• Main Authors: Liu, Zhening, Huang, Hangkai, Xie, Jiarong, Hou, Linxiao, Xu, Chengfu
• Format: Article
• Language: English
• Subjects: Biobanks; Biological Specimen Banks; Body mass index; Carbohydrate quality; Carbohydrates; Care and treatment; Cohort Studies; Diabetes; Diagnosis; Diet therapy; Dietary Carbohydrates; Dietary fiber; Dietary intake; End-stage liver disease; Ethnicity; Family income; Fatty liver; Food composition; Food habits; Health aspects; Health services; Hepatitis; Hospitals; Humans; Hypertension; Interactive computer systems; Liver; Liver cancer; Liver cirrhosis; Liver diseases; Low-carbohydrate diet; Metabolism; Mortality; Non-alcoholic fatty liver disease; Non-alcoholic Fatty Liver Disease - epidemiology; Patient outcomes; Population; Prospective Studies; Questionnaires; Risk Factors; Self report; Substitution; Sugar; Sugars; Triglycerides; United Kingdom
• ISSN: 1475-2891; 1475-2891
• DOI: 10.1186/s12937-023-00897-y

This study aimed to investigate the association between the intake of different dietary carbohydrate components and the long-term outcomes of non-alcoholic fatty liver disease (NAFLD). We used prospective data from 26,729 NAFLD participants from the UK Biobank cohort study. Dietary information was recorded by online 24-hour questionnaires (Oxford WebQ). Consumption of different carbohydrate components was calculated by the UK Nutrient Databank Food Composition Table. Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) and 95% confidence interval (CI). A substitution model was used to estimate the associations of hypothetical substitution for free sugars. During a median of 10.5 (IQR: 10.2-11.2) years and a total of 280,135 person-years of follow-up, 310 incident end-stage liver disease (ESLD) and 1750 deaths were recorded. Compared with the lowest quartile, the multi-adjusted HRs (95% CI) of incident ESLD in the highest quartile were 1.65 (1.14-2.39) for free sugars, 0.51 (0.35-0.74) for non-free sugars, and 0.55 (0.36-0.83) for fiber. For overall mortality, the multi-adjusted HRs (95% CI) in the highest quartile were 1.21 (1.04-1.39) for free sugars, 0.79 (0.68-0.92) for non-free sugars, and 0.79 (0.67-0.94) for fiber. Substituting free sugars with equal amounts of non-free sugars, starch or fiber was associated with a lower risk of incident ESLD and overall mortality. A lower intake of free sugars and a higher intake of fiber are associated with a lower incidence of ESLD and overall mortality in NAFLD patients. These findings support the important role of the quality of dietary carbohydrates in preventing ESLD and overall mortality in NAFLD patients.