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Protein foods from animal sources and risk of nonalcoholic fatty liver disease in representative cohorts from North and South China.
J Intern Med. 2023 03; 293(3):340-353.JI

Abstract

BACKGROUND

Emerging evidence suggests that animal protein foods may increase the risk of nonalcoholic fatty liver disease (NAFLD). We therefore examined the NAFLD risk reduction related to substituting plant protein foods for animal protein foods.

METHODS

The cohort in North China included 14,541 participants from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) study, and the cohort in South China included 1297 participants from the Guangzhou Nutrition and Health Study (GNHS). Dietary intake was assessed using validated food frequency questionnaires. NAFLD was ascertained by abdominal ultrasound. The Cox model was used to fit the substitution analysis.

RESULTS

In the TCLSIH cohort, when replacing one type of animal protein food (eggs, processed meat, unprocessed red meat, poultry, and fish) with an equivalent serving of plant protein foods (nuts, legumes, and whole grains), the replacement of animal protein foods with whole grains showed the strongest benefit; substituting one serving per day of whole grains for an equal amount of eggs (hazard ratio [HR] = 0.89; 95% confidence interval [CI]: 0.79, 1.00), processed meat (HR = 0.76; 95% CI: 0.64, 0.91), unprocessed red meat (HR = 0.90; 95% CI: 0.81, 1.00), poultry (HR = 0.81; 95% CI: 0.72, 0.92), or fish (HR = 0.87; 95% CI: 0.78, 0.97) was associated with a lower risk of NAFLD. In both the TCLSIH and GNHS cohorts, replacing poultry with fish, nuts, legumes, or whole grains was associated with a lower risk of NAFLD. When different numbers of protein foods were simultaneously replaced, the risk reduction of NAFLD was stronger.

CONCLUSIONS

Our findings suggest that replacing animal protein foods with plant protein foods is related to a significant reduction in NAFLD risk.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Zhang S
School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China. School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China. Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Yan Y
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Meng G
School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
Zhang Q
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Liu L
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Wu H
School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
Gu Y
Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Wang X
School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
Zhang J
School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
Sun S
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Wang X
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Zhou M
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Jia Q
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Song K
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
Borné Y
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Qi L
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Chen YM
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Niu K
School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

MeSH

AnimalsDietNon-alcoholic Fatty Liver DiseaseProspective StudiesMeatPoultryPlant ProteinsRisk Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36433820

Citation

Zhang, Shunming, et al. "Protein Foods From Animal Sources and Risk of Nonalcoholic Fatty Liver Disease in Representative Cohorts From North and South China." Journal of Internal Medicine, vol. 293, no. 3, 2023, pp. 340-353.
Zhang S, Yan Y, Meng G, et al. Protein foods from animal sources and risk of nonalcoholic fatty liver disease in representative cohorts from North and South China. J Intern Med. 2023;293(3):340-353.
Zhang, S., Yan, Y., Meng, G., Zhang, Q., Liu, L., Wu, H., Gu, Y., Wang, X., Zhang, J., Sun, S., Wang, X., Zhou, M., Jia, Q., Song, K., Borné, Y., Qi, L., Chen, Y. M., & Niu, K. (2023). Protein foods from animal sources and risk of nonalcoholic fatty liver disease in representative cohorts from North and South China. Journal of Internal Medicine, 293(3), 340-353. https://doi.org/10.1111/joim.13586
Zhang S, et al. Protein Foods From Animal Sources and Risk of Nonalcoholic Fatty Liver Disease in Representative Cohorts From North and South China. J Intern Med. 2023;293(3):340-353. PubMed PMID: 36433820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protein foods from animal sources and risk of nonalcoholic fatty liver disease in representative cohorts from North and South China. AU - Zhang,Shunming, AU - Yan,Yan, AU - Meng,Ge, AU - Zhang,Qing, AU - Liu,Li, AU - Wu,Hongmei, AU - Gu,Yeqing, AU - Wang,Xuena, AU - Zhang,Juanjuan, AU - Sun,Shaomei, AU - Wang,Xing, AU - Zhou,Ming, AU - Jia,Qiyu, AU - Song,Kun, AU - Borné,Yan, AU - Qi,Lu, AU - Chen,Yu-Ming, AU - Niu,Kaijun, Y1 - 2022/11/26/ PY - 2022/11/27/pubmed PY - 2023/2/4/medline PY - 2022/11/26/entrez KW - NAFLD KW - cohort study KW - fatty liver disease KW - food KW - protein KW - substitution analysis SP - 340 EP - 353 JF - Journal of internal medicine JO - J Intern Med VL - 293 IS - 3 N2 - BACKGROUND: Emerging evidence suggests that animal protein foods may increase the risk of nonalcoholic fatty liver disease (NAFLD). We therefore examined the NAFLD risk reduction related to substituting plant protein foods for animal protein foods. METHODS: The cohort in North China included 14,541 participants from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) study, and the cohort in South China included 1297 participants from the Guangzhou Nutrition and Health Study (GNHS). Dietary intake was assessed using validated food frequency questionnaires. NAFLD was ascertained by abdominal ultrasound. The Cox model was used to fit the substitution analysis. RESULTS: In the TCLSIH cohort, when replacing one type of animal protein food (eggs, processed meat, unprocessed red meat, poultry, and fish) with an equivalent serving of plant protein foods (nuts, legumes, and whole grains), the replacement of animal protein foods with whole grains showed the strongest benefit; substituting one serving per day of whole grains for an equal amount of eggs (hazard ratio [HR] = 0.89; 95% confidence interval [CI]: 0.79, 1.00), processed meat (HR = 0.76; 95% CI: 0.64, 0.91), unprocessed red meat (HR = 0.90; 95% CI: 0.81, 1.00), poultry (HR = 0.81; 95% CI: 0.72, 0.92), or fish (HR = 0.87; 95% CI: 0.78, 0.97) was associated with a lower risk of NAFLD. In both the TCLSIH and GNHS cohorts, replacing poultry with fish, nuts, legumes, or whole grains was associated with a lower risk of NAFLD. When different numbers of protein foods were simultaneously replaced, the risk reduction of NAFLD was stronger. CONCLUSIONS: Our findings suggest that replacing animal protein foods with plant protein foods is related to a significant reduction in NAFLD risk. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/36433820/Protein_foods_from_animal_sources_and_risk_of_nonalcoholic_fatty_liver_disease_in_representative_cohorts_from_North_and_South_China_ DB - PRIME DP - Unbound Medicine ER -