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Published in: Hepatology International 2/2024

26-02-2024 | Fatty Liver | Original Article

Dairy products intake and prevalence, incidence, and recovery of non-alcoholic fatty liver disease in Chinese population

Authors: Yurou Xu, Youyi Wang, Qi Zhao, Bo Chen, Na Wang, Tiejun Zhang, Yonggen Jiang, Yiling Wu, Na He, Genming Zhao, Xing Liu

Published in: Hepatology International | Issue 2/2024

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Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) is a growing public health concern. Modifiable factors such as diet and lifestyle are of research interest in preventing or reversing the disease. The relationship between dairy products and NAFLD remains unclear.

Methods

In this cohort study, 36,122 participants aged 20–74 were enrolled by multi-stage, stratified, randomized cluster sampling from 2016 to 2017. A total of 25,085 participants finished at least one follow-up visit from 2019 to 2023. Dairy intake was collected by food frequency questionnaire at baseline. NAFLD was defined as fatty liver diagnosed by ultrasonography with excessive alcohol drink excluded. Logistic regression and Cox proportional hazard models were used to analyze the association between dairy intake and NAFLD.

Results

A total of 34,040 participants were included in the baseline analysis. The prevalence of NAFLD was inversely associated with dairy intake (OR>7vs 0 servings/week = 0.91, 95% CI 0.84–0.98; ORper serving/day increase = 0.95, 95% CI 0.92–0.99). 20,460 participants entered the follow-up analysis. Among 12,204 without NAFLD at baseline, 4,470 developed NAFLD after a median time of 4.3 years. The incidence of NAFLD was inversely associated with dairy intake (HR>7 vs 0 servings/week = 0.89, 95% CI 0.81–0.98; HRper serving/day increase = 0.94, 95% CI 0.89–0.99). Among 8256 with NAFLD at baseline, 3,885 recovered after 4.2-year follow-up. Total dairy intake did not show significant associations with recovery of NAFLD, and the HRs (95% CI) were 0.96 (0.87–1.06) for > 7 servings/week and 0.98 (0.93–1.03) for per serving/day increase.

Conclusion

Dairy product intake of more than one serving per day was associated with a lower prevalence and incidence of NAFLD in Chinese population. However, total dairy intake did not show significant association in NAFLD reversal.
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Literature
1.
go back to reference Cheemerla S, Balakrishnan M. Global epidemiology of chronic liver disease. Clin Liver Dis. 2021;17:365–370CrossRef Cheemerla S, Balakrishnan M. Global epidemiology of chronic liver disease. Clin Liver Dis. 2021;17:365–370CrossRef
2.
go back to reference Li J, Zou B, Yeo YH, Feng Y, Xie X, Lee DH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019;4:389–398CrossRefPubMed Li J, Zou B, Yeo YH, Feng Y, Xie X, Lee DH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019;4:389–398CrossRefPubMed
3.
go back to reference Estes C, Anstee QM, Arias-Loste MT, Bantel H, Bellentani S, Caballeria J, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol. 2018;69:896–904CrossRefPubMed Estes C, Anstee QM, Arias-Loste MT, Bantel H, Bellentani S, Caballeria J, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol. 2018;69:896–904CrossRefPubMed
4.
go back to reference Huang TD, Behary J, Zekry A. Non-alcoholic fatty liver disease: a review of epidemiology, risk factors, diagnosis and management. Intern Med J. 2020;50:1038–1047CrossRefPubMed Huang TD, Behary J, Zekry A. Non-alcoholic fatty liver disease: a review of epidemiology, risk factors, diagnosis and management. Intern Med J. 2020;50:1038–1047CrossRefPubMed
5.
go back to reference Leoni S, Tovoli F, Napoli L, Serio I, Ferri S, Bolondi L. Current guidelines for the management of non-alcoholic fatty liver disease: a systematic review with comparative analysis. World J Gastroenterol. 2018;24:3361–3373CrossRefPubMedPubMedCentral Leoni S, Tovoli F, Napoli L, Serio I, Ferri S, Bolondi L. Current guidelines for the management of non-alcoholic fatty liver disease: a systematic review with comparative analysis. World J Gastroenterol. 2018;24:3361–3373CrossRefPubMedPubMedCentral
6.
go back to reference Zelber-Sagi S, Salomone F, Mlynarsky L. The Mediterranean dietary pattern as the diet of choice for non-alcoholic fatty liver disease: evidence and plausible mechanisms. Liver Int. 2017;37:936–949CrossRefPubMed Zelber-Sagi S, Salomone F, Mlynarsky L. The Mediterranean dietary pattern as the diet of choice for non-alcoholic fatty liver disease: evidence and plausible mechanisms. Liver Int. 2017;37:936–949CrossRefPubMed
7.
go back to reference Cheng R, Wang Q, Wei L. Income growth, employment structure transition and the rise of modern markets: the impact of urbanization on residents’ consumption of dairy products in China. PLoS ONE. 2022;17: e0267006CrossRefPubMedPubMedCentral Cheng R, Wang Q, Wei L. Income growth, employment structure transition and the rise of modern markets: the impact of urbanization on residents’ consumption of dairy products in China. PLoS ONE. 2022;17: e0267006CrossRefPubMedPubMedCentral
8.
go back to reference Society CN. Dietary guidelines for Chinese residents (2022). Beijing: People’s Health Press; 2022 Society CN. Dietary guidelines for Chinese residents (2022). Beijing: People’s Health Press; 2022
9.
go back to reference Belobrajdic DP, McIntosh GH, Owens JA. A high-whey-protein diet reduces body weight gain and alters insulin sensitivity relative to red meat in Wistar rats. J Nutr. 2004;134:1454–1458CrossRefPubMed Belobrajdic DP, McIntosh GH, Owens JA. A high-whey-protein diet reduces body weight gain and alters insulin sensitivity relative to red meat in Wistar rats. J Nutr. 2004;134:1454–1458CrossRefPubMed
10.
go back to reference Arias N, Arboleya S, Allison J, Kaliszewska A, Higarza SG, Gueimonde M, et al. The relationship between choline bioavailability from diet, intestinal microbiota composition, and its modulation of human diseases. Nutrients. 2020;12:2340CrossRefPubMedPubMedCentral Arias N, Arboleya S, Allison J, Kaliszewska A, Higarza SG, Gueimonde M, et al. The relationship between choline bioavailability from diet, intestinal microbiota composition, and its modulation of human diseases. Nutrients. 2020;12:2340CrossRefPubMedPubMedCentral
11.
go back to reference Lee JH, Lee HS, Ahn SB, Kwon YJ. Dairy protein intake is inversely related to development of non-alcoholic fatty liver disease. Clin Nutr. 2021;40:5252–5260CrossRefPubMed Lee JH, Lee HS, Ahn SB, Kwon YJ. Dairy protein intake is inversely related to development of non-alcoholic fatty liver disease. Clin Nutr. 2021;40:5252–5260CrossRefPubMed
12.
go back to reference Lang S, Martin A, Farowski F, Wisplinghoff H, Vehreschild M, Liu J, et al. High protein intake is associated with histological disease activity in patients with NAFLD. Hepatol Commun. 2020;4:681–695CrossRefPubMedPubMedCentral Lang S, Martin A, Farowski F, Wisplinghoff H, Vehreschild M, Liu J, et al. High protein intake is associated with histological disease activity in patients with NAFLD. Hepatol Commun. 2020;4:681–695CrossRefPubMedPubMedCentral
13.
go back to reference Trottier SK, MacPherson REK, Knuth CM, Townsend LK, Peppler WT, Mikhaeil JS, et al. Dairy attenuates weight gain to a similar extent as exercise in rats fed a high-fat high-sugar diet. Obesity (Silver Spring). 2017;25:1707–1715CrossRefPubMed Trottier SK, MacPherson REK, Knuth CM, Townsend LK, Peppler WT, Mikhaeil JS, et al. Dairy attenuates weight gain to a similar extent as exercise in rats fed a high-fat high-sugar diet. Obesity (Silver Spring). 2017;25:1707–1715CrossRefPubMed
14.
go back to reference Hirahatake KM, Bruno RS, Bolling BW, Blesso C, Alexander LM, Adams SH. Dairy foods and dairy fats: new perspectives on pathways implicated in cardiometabolic health. Adv Nutr. 2020;11:266–279CrossRefPubMed Hirahatake KM, Bruno RS, Bolling BW, Blesso C, Alexander LM, Adams SH. Dairy foods and dairy fats: new perspectives on pathways implicated in cardiometabolic health. Adv Nutr. 2020;11:266–279CrossRefPubMed
15.
go back to reference Zhao Q, Chen B, Wang R, Zhu M, Shao Y, Wang N, et al. Cohort profile: protocol and baseline survey for the Shanghai Suburban Adult Cohort and Biobank (SSACB) study. BMJ Open. 2020;10: e035430CrossRefPubMedPubMedCentral Zhao Q, Chen B, Wang R, Zhu M, Shao Y, Wang N, et al. Cohort profile: protocol and baseline survey for the Shanghai Suburban Adult Cohort and Biobank (SSACB) study. BMJ Open. 2020;10: e035430CrossRefPubMedPubMedCentral
16.
go back to reference Wang Y, Huang Y, Wu H, He G, Li S, Chen B. Association between dietary patterns and frailty prevalence in shanghai suburban elders: a cross-sectional study. Int J Environ Res Public Health. 2021;18: 10852CrossRefPubMedPubMedCentral Wang Y, Huang Y, Wu H, He G, Li S, Chen B. Association between dietary patterns and frailty prevalence in shanghai suburban elders: a cross-sectional study. Int J Environ Res Public Health. 2021;18: 10852CrossRefPubMedPubMedCentral
17.
go back to reference Fan JG, Wei L, Zhuang H, National Workshop on Fatty L, Alcoholic Liver Disease CSoHCMA, Fatty Liver Disease Expert Committee CMDA. Guidelines of prevention and treatment of nonalcoholic fatty liver disease (2018, China). J Dig Dis. 2018;2019(20):163–173 Fan JG, Wei L, Zhuang H, National Workshop on Fatty L, Alcoholic Liver Disease CSoHCMA, Fatty Liver Disease Expert Committee CMDA. Guidelines of prevention and treatment of nonalcoholic fatty liver disease (2018, China). J Dig Dis. 2018;2019(20):163–173
18.
go back to reference Sun Y, Chen S, Zhao X, Wang Y, Lan Y, Jiang X, et al. Adherence to the dietary approaches to stop hypertension diet and non-alcoholic fatty liver disease. Liver Int. 2022;42:809–819CrossRefPubMed Sun Y, Chen S, Zhao X, Wang Y, Lan Y, Jiang X, et al. Adherence to the dietary approaches to stop hypertension diet and non-alcoholic fatty liver disease. Liver Int. 2022;42:809–819CrossRefPubMed
19.
go back to reference Charatcharoenwitthaya P, Tansakul E, Chaiyasoot K, Bandidniyamanon W, Charatcharoenwitthaya N. Dietary composition and its association with newly diagnosed nonalcoholic fatty liver disease and insulin resistance. Nutrients. 2021;13:4438CrossRefPubMedPubMedCentral Charatcharoenwitthaya P, Tansakul E, Chaiyasoot K, Bandidniyamanon W, Charatcharoenwitthaya N. Dietary composition and its association with newly diagnosed nonalcoholic fatty liver disease and insulin resistance. Nutrients. 2021;13:4438CrossRefPubMedPubMedCentral
20.
go back to reference Zhang S, Fu J, Zhang Q, Liu L, Lu M, Meng G, et al. Association between habitual yogurt consumption and newly diagnosed non-alcoholic fatty liver disease. Eur J Clin Nutr. 2020;74:491–499CrossRefPubMed Zhang S, Fu J, Zhang Q, Liu L, Lu M, Meng G, et al. Association between habitual yogurt consumption and newly diagnosed non-alcoholic fatty liver disease. Eur J Clin Nutr. 2020;74:491–499CrossRefPubMed
21.
go back to reference Keshavarz Z, Rahimlou M, Farjam M, Homayounfar R, Khodadost M, Abdollahi A, et al. Non-alcoholic fatty liver disease and dairy products consumption: results from FASA Persian cohort study. Front Nutr. 2022;9: 962834CrossRefPubMedPubMedCentral Keshavarz Z, Rahimlou M, Farjam M, Homayounfar R, Khodadost M, Abdollahi A, et al. Non-alcoholic fatty liver disease and dairy products consumption: results from FASA Persian cohort study. Front Nutr. 2022;9: 962834CrossRefPubMedPubMedCentral
22.
go back to reference Razavi Zade M, Telkabadi MH, Bahmani F, Salehi B, Farshbaf S, Asemi Z. The effects of DASH diet on weight loss and metabolic status in adults with non-alcoholic fatty liver disease: a randomized clinical trial. Liver Int. 2016;36:563–571CrossRefPubMed Razavi Zade M, Telkabadi MH, Bahmani F, Salehi B, Farshbaf S, Asemi Z. The effects of DASH diet on weight loss and metabolic status in adults with non-alcoholic fatty liver disease: a randomized clinical trial. Liver Int. 2016;36:563–571CrossRefPubMed
23.
go back to reference Dai W, Liu H, Zhang T, Chang Q, Zhao Y, Guo C, et al. Dairy product consumption was associated with a lower likelihood of non-alcoholic fatty liver disease: a systematic review and meta-analysis. Front Nutr. 2023;10:1119118CrossRefPubMedPubMedCentral Dai W, Liu H, Zhang T, Chang Q, Zhao Y, Guo C, et al. Dairy product consumption was associated with a lower likelihood of non-alcoholic fatty liver disease: a systematic review and meta-analysis. Front Nutr. 2023;10:1119118CrossRefPubMedPubMedCentral
24.
go back to reference Lonardo A, Nascimbeni F, Ballestri S, Fairweather D, Win S, Than TA, et al. Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps. Hepatology. 2019;70:1457–1469CrossRefPubMed Lonardo A, Nascimbeni F, Ballestri S, Fairweather D, Win S, Than TA, et al. Sex differences in nonalcoholic fatty liver disease: state of the art and identification of research gaps. Hepatology. 2019;70:1457–1469CrossRefPubMed
25.
go back to reference Hannah WN Jr, Harrison SA. Lifestyle and dietary interventions in the management of nonalcoholic fatty liver disease. Dig Dis Sci. 2016;61:1365–1374CrossRefPubMed Hannah WN Jr, Harrison SA. Lifestyle and dietary interventions in the management of nonalcoholic fatty liver disease. Dig Dis Sci. 2016;61:1365–1374CrossRefPubMed
26.
go back to reference Farzanegi P, Dana A, Ebrahimpoor Z, Asadi M, Azarbayjani MA. Mechanisms of beneficial effects of exercise training on non-alcoholic fatty liver disease (NAFLD): roles of oxidative stress and inflammation. Eur J Sport Sci. 2019;19:994–1003CrossRefPubMed Farzanegi P, Dana A, Ebrahimpoor Z, Asadi M, Azarbayjani MA. Mechanisms of beneficial effects of exercise training on non-alcoholic fatty liver disease (NAFLD): roles of oxidative stress and inflammation. Eur J Sport Sci. 2019;19:994–1003CrossRefPubMed
27.
go back to reference Companys J, Pla-Paga L, Calderon-Perez L, Llaurado E, Sola R, Pedret A, et al. Fermented dairy products, probiotic supplementation, and cardiometabolic diseases: a systematic review and meta-analysis. Adv Nutr. 2020;11:834–863CrossRefPubMedPubMedCentral Companys J, Pla-Paga L, Calderon-Perez L, Llaurado E, Sola R, Pedret A, et al. Fermented dairy products, probiotic supplementation, and cardiometabolic diseases: a systematic review and meta-analysis. Adv Nutr. 2020;11:834–863CrossRefPubMedPubMedCentral
28.
go back to reference Davoodi SH, Shahbazi R, Esmaeili S, Sohrabvandi S, Mortazavian A, Jazayeri S, et al. Health-related aspects of milk proteins. Iran J Pharm Res. 2016;15:573–591PubMedPubMedCentral Davoodi SH, Shahbazi R, Esmaeili S, Sohrabvandi S, Mortazavian A, Jazayeri S, et al. Health-related aspects of milk proteins. Iran J Pharm Res. 2016;15:573–591PubMedPubMedCentral
29.
go back to reference Sohouli MH, Sayyari AA, Lari A, Nameni G, Lotfi M, Fatahi S, et al. Association of dietary insulinaemic potential and odds of non-alcoholic fatty liver disease among adults: a case-control study. J Hum Nutr Diet. 2021;34:901–909CrossRefPubMed Sohouli MH, Sayyari AA, Lari A, Nameni G, Lotfi M, Fatahi S, et al. Association of dietary insulinaemic potential and odds of non-alcoholic fatty liver disease among adults: a case-control study. J Hum Nutr Diet. 2021;34:901–909CrossRefPubMed
30.
go back to reference Volokh O, Klimenko N, Berezhnaya Y, Tyakht A, Nesterova P, Popenko A, et al. Human gut microbiome response induced by fermented dairy product intake in healthy volunteers. Nutrients. 2019;11:547CrossRefPubMedPubMedCentral Volokh O, Klimenko N, Berezhnaya Y, Tyakht A, Nesterova P, Popenko A, et al. Human gut microbiome response induced by fermented dairy product intake in healthy volunteers. Nutrients. 2019;11:547CrossRefPubMedPubMedCentral
31.
go back to reference Xue L, He J, Gao N, Lu X, Li M, Wu X, et al. Probiotics may delay the progression of nonalcoholic fatty liver disease by restoring the gut microbiota structure and improving intestinal endotoxemia. Sci Rep. 2017;7:45176CrossRefPubMedPubMedCentral Xue L, He J, Gao N, Lu X, Li M, Wu X, et al. Probiotics may delay the progression of nonalcoholic fatty liver disease by restoring the gut microbiota structure and improving intestinal endotoxemia. Sci Rep. 2017;7:45176CrossRefPubMedPubMedCentral
32.
go back to reference Doustmohammadian A, Clark CCT, Maadi M, Motamed N, Sobhrakhshankhah E, Ajdarkosh H, et al. Favorable association between Mediterranean diet (MeD) and DASH with NAFLD among Iranian adults of the Amol Cohort Study (AmolCS). Sci Rep. 2022;12:2131CrossRefPubMedPubMedCentral Doustmohammadian A, Clark CCT, Maadi M, Motamed N, Sobhrakhshankhah E, Ajdarkosh H, et al. Favorable association between Mediterranean diet (MeD) and DASH with NAFLD among Iranian adults of the Amol Cohort Study (AmolCS). Sci Rep. 2022;12:2131CrossRefPubMedPubMedCentral
33.
go back to reference Cui Q, Xia Y, Wu Q, Chang Q, Niu K, Zhao Y. Validity of the food frequency questionnaire for adults in nutritional epidemiological studies: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2023;63:1670–1688CrossRefPubMed Cui Q, Xia Y, Wu Q, Chang Q, Niu K, Zhao Y. Validity of the food frequency questionnaire for adults in nutritional epidemiological studies: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2023;63:1670–1688CrossRefPubMed
Metadata
Title
Dairy products intake and prevalence, incidence, and recovery of non-alcoholic fatty liver disease in Chinese population
Authors
Yurou Xu
Youyi Wang
Qi Zhao
Bo Chen
Na Wang
Tiejun Zhang
Yonggen Jiang
Yiling Wu
Na He
Genming Zhao
Xing Liu
Publication date
26-02-2024
Publisher
Springer India
Keyword
Fatty Liver
Published in
Hepatology International / Issue 2/2024
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-024-10638-w

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