Associations between an inflammatory diet index and severe non-alcoholic fatty liver disease: a prospective study of 171,544 UK Biobank participants

• Published in: BMC medicine 2023-04, Vol.21 (1), p.123-123, Article 123
• Main Authors: Petermann-Rocha, Fanny, Wirth, Michael D, Boonpor, Jirapitcha, Parra-Soto, Solange, Zhou, Ziyi, Mathers, John C, Livingstone, Katherine, Forrest, Ewan, Pell, Jill P, Ho, Frederick K, Hébert, James R, Celis-Morales, Carlos
• Format: Article
• Language: English
• Subjects: Biobanks; Biological Specimen Banks; Blood pressure; Care and treatment; Diabetes; Diagnosis; Diet; Diet - adverse effects; Energy; Fatty liver; Food habits; Health aspects; Health hazards; Humans; Hyperglycemia; Hypertension; Incidence; Inflammation; Inflammation - complications; Inflammation - epidemiology; Liver; Liver diseases; Metabolic disorders; Metabolic syndrome; Metabolism; Mortality; Non-alcoholic fatty liver disease; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - epidemiology; Nonlinear systems; Nonlinearity; Obesity; Patient admissions; Prospective Studies; Questionnaires; Risk; Risk Factors; Self report; Statistical models; Surveys and Questionnaires; United Kingdom - epidemiology
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-023-02793-y

Although non-alcoholic fatty liver disease (NAFLD) is linked to inflammation, whether an inflammatory diet increases the risk of NAFLD is unclear. This study aimed to examine the association between the Energy-adjusted Diet Inflammatory Index (E-DII) score and severe NAFLD using UK Biobank. This prospective cohort study included 171,544 UK Biobank participants. The E-DII score was computed using 18 food parameters. Associations between the E-DII and incident severe NAFLD (defined as hospital admission or death) were first investigated by E-DII categories (very/moderately anti-inflammatory [E-DII  1]) using Cox proportional hazard models. Nonlinear associations were investigated using penalised cubic splines fitted into the Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors. Over a median follow-up of 10.2 years, 1489 participants developed severe NAFLD. After adjusting for confounders, individuals in the very/moderately pro-inflammatory category had a higher risk (HR: 1.19 [95% CI: 1.03 to 1.38]) of incident severe NAFLD compared with those in the very/moderately anti-inflammatory category. There was some evidence of nonlinearity between the E-DII score and severe NAFLD. Pro-inflammatory diets were associated with a higher risk of severe NAFLD independent of confounders such as the components of the metabolic syndrome. Considering there is no recommended treatment for the disease, our findings suggest a potential means to lower the risk of NAFLD.