Non-alcoholic fatty liver disease and dairy products consumption: Results from FASA Persian cohort study

Therapeutic potential of mesenchymal stem cell-derived extracellular vesicle in nonalcoholic fatty liver disease: a systematic review and meta-analysis of preclinical evidence

OBJECTIVE

Nonalcoholic fatty liver disease (NAFLD) is a global chronic health challenge, demanding the development of innovative therapeutic strategies. Mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) have emerged as a promising therapeutic approach for NAFLD; however, current evidence is limited to preclinical studies. This systematic review and meta-analysis assessed the therapeutic efficacy of MSC-EVs in rodent models of NAFLD and its progressive form, nonalcoholic steatohepatitis (NASH). By synthesizing preclinical data, we aim to establish a robust evidence base that can guide future clinical trials and optimize MSC-EV-based therapies.

METHODS

Comprehensive searches of the PubMed, Web of Science, Embase, CNKI, Wanfang, and VIP databases identified eligible animal studies. Methodological quality was assessed via the SYRCLE risk-of-bias tool. The meta-analyses were conducted following Cochrane Handbook guidelines via Stata 18.0.

RESULTS

MSC-EVs led to significant reductions in key metabolic parameters, including AST (SMD = -2.79, 95% CI [-3.64, -1.94], p< 0.01), ALT (SMD = -2.47, 95% CI [-3.44, -1.50], p < 0.01), TG (SMD = -1.86, 95% CI [-2.98, -0.73], P < 0.01), liver TG (SMD = -4.02, 95% CI [-5.84, -2.20], p < 0.01), TC (SMD = -2.52, 95% CI [-3.56, -1.48], p < 0.01), liver TC (SMD = -5.28, 95% CI [-7.71, -2.84], p < 0.01), NAS score(SMD = -3.56, 95% CI [-5.04, -2.09], P < 0.01), FBG SMD = -1.89, 95% CI [-2.94, -0.83], p < 0.01), and body weight (SMD = -2.34, 95% CI [-3.94, -0.74], p < 0.01). Additionally, MSC-EVs improved the level of inflammatory cytokines (TNF-α and IL-6) and oxidative stress markers (SOD and MDA). These effects surpass those reported in previous MSC-EVs studies targeting liver disease, particularly regarding unassessed lipid parameters and oxidative stress indicators.

CONCLUSION

MSC-EVs show promising potential for treating NAFLD/NASH, with substantial evidence supporting their therapeutic and reparative effects. Our findings directly inform clinical trial design by identifying optimal parameters-such as human-derived EVs, treatment durations longer than four weeks, and exosome preparations obtained via differential ultracentrifugation-to maximize therapeutic efficacy. These findings warrant further clinical investigation to facilitate the clinical translation of MSC-EVs as a therapeutic option for NAFLD/NASH.

Sex differences in the association between total energy intake and all-cause mortality among patients with metabolic dysfunction-associated steatotic liver disease

The long-term association between total energy intake and clinical outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. The present study aimed to explore the associations between total energy intake and mortality in MASLD patients and to evaluate whether the associations differ by sex. A total of 2,466 MASLD patients from the Third National Health and Nutrition Examination Survey was included. Total energy intake was assessed using 24-hour dietary recall. Mortality was ascertained by linkage to National Death Index records through 31 December 2019. Multivariable Cox proportional hazards model was used to estimate the association between total energy intake and mortality. In MASLD patients, both low and high total energy intake were significantly associated with elevated risk of all-cause mortality. Compared with moderate total energy intake (2,000-3,000 kcal/day for males and 1,600-2,400 kcal/day for females), the HRs (95% CIs) for low and high total energy intake were 1.27 (1.05-1.53; P = 0.01) and 1.40 (1.03-1.92; P = 0.03), respectively. A significant interaction was demonstrated between sex and total energy intake for all-cause mortality (P value for interaction = 0.03). In males, both low and high total energy intake were significantly associated with elevated risk of all-cause mortality. The HRs (95% CIs) for low and high total energy intake were 1.35 (1.02-1.80; P = 0.04) and 1.54 (1.05-2.28; P = 0.03), respectively. However, no significant association was observed in females. The HRs (95% CIs) for low and high total energy intake were 1.14 (0.86-1.52; P = 0.34) and 1.14 (0.81-1.61; P = 0.46), respectively. These findings provide novel evidence supporting sex-specific dietary guidelines for MASLD, with particular emphasis on maintaining moderate energy intake to mitigate mortality risk in male patients.

A cross-sectional study examining the relationship between the advanced lung cancer inflammation index and prostate cancer

BACKGROUND

Prostate cancer (PCa), a significant health concern among middle-aged and elderly men globally, has increasingly been associated with metabolic and inflammatory processes. The advanced lung cancer inflammation index (ALI), a novel marker reflecting nutritional and inflammatory status, has not yet been thoroughly investigated in the context of PCa. This study investigated the potential link between ALI and PCa.

METHODS

We first conducted a cross-sectional study utilizing data from the National Health and Nutrition Examination Survey (NHANES). The relationship between ALI and PCa was examined by NHANES-provided survey weights. Smoothed curve fitting and threshold effect analyses were conducted to evaluate possible nonlinear associations. Then we analyzed the correlation between the prognosis of PCa patients and ALI.

RESULTS

Out of 15,042 adult participants, 683 (4.54%) were diagnosed with PCa. The risk of PCa decreased across increasing quartiles of ALI. Multivariate logistic regression analysis revealed that compared to participants in the lowest ALI quartile (Q1: 2.89-41.94), those in higher quartiles (Q2: 41.94-59.08, Q3: 59.08-80.88, and Q4: ≥80.88) had progressively lower odds of developing PCa in both unadjusted and adjusted models. Smoothed curve fitting indicated a U-shaped relationship between ALI and PCa. Longitudinal follow-up data indicated that lower ALI values were positively correlated with a poor survival in cancer patients.

CONCLUSION

Our study revealed a non-linear relationship between ALI and the risk of PCa development. Specifically, there was a negative correlation between ALI and PCa risk when the ALI value was < 100. Furthermore, we found that lower ALI levels are strongly associated with a poor survival in cancer patients. Additional large-scale prospective studies are needed to confirm these findings and investigate the underlying mechanisms.

A Comparison of the Effects of Milk, Yogurt, and Cheese on Insulin Sensitivity, Hepatic Steatosis, and Gut Microbiota in Diet-Induced Obese Male Mice

The effects of low-fat dairy products on insulin resistance (IR), hepatic steatosis, and gut microbiota composition in high-fat diet (HFD)-fed obese mice were examined. C57BL/6 male mice (n = 16/group) were fed a high-fat diet (HFD, 45% fat) or HFD supplemented with either fat-free milk (MILK), fat-free yogurt (YOG), or reduced-fat (19% milk fat) cheddar cheese (CHE) at 10% of the total energy intake for 8 weeks. Body weight, fat mass, liver lipids, and metabolic enzymes were evaluated. Compared with HFD, MILK reduced homeostatic assessment of insulin resistance along with increased hepatic insulin signaling and decreased hepatic gluconeogenic enzymes. YOG and MILK decreased hepatic triacylglycerol content and lipid droplet size, while CHE had no effect. In the liver, MILK and YOG downregulated de novo lipogenesis enzymes. In MILK, fat oxidation capacity was elevated. Compared with HFD, liver lipidomic analysis in MILK and YOG revealed unique profiles of decreased proinflammatory lipid species, including ceramides. Dairy feeding elicited an increase in beneficial bacteria, such as Streptococcus in YOG and Anaero-tignum in MILK, as shown by 16S rRNA sequencing of gut microbiota. In conclusion, the ability of milk and yogurt to reduce hepatic steatosis in HFD mice may be explained, at least in part, by the regulation of the gut microbiome and liver lipidome.

Unraveling the Association Between Cheese Consumption and Non-Alcoholic Fatty Liver Disease: Insights From a Two-Sample Mendelian Randomization Analysis

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally, and diet plays a crucial role in its progression. While dietary fats impact NAFLD, the specific effect of cheese consumption remains unclear. This study employs a two-sample Mendelian randomization (MR) approach to explore the causal relationship between cheese intake and NAFLD, liver fat content, and liver fat proportion. Using summary-level data from large genome-wide association studies, we applied a two-sample MR approach. Genetic variants linked to cheese consumption served as instrumental variables, selected under strict criteria, including genome-wide significance and exclusion of pleiotropy. Robustness was ensured through various MR methods, including Inverse Variance Weighted (IVW) and MR-Egger. MR analysis indicated that increased cheese consumption is negatively associated with NAFLD risk (OR = 0.589, 95% CI: 0.387-0.896, p = 0.014). This inverse relationship also extended to liver fat content (OR = 0.814, 95% CI: 0.689-0.960, p = 0.015) and liver fat proportion (OR = 0.830, 95% CI: 0.695-0.992, p = 0.04). No significant link was found between cheese intake and liver volume (OR = 0.976, 95% CI: 0.846-1.126, p = 0.737). Cheese intake may have a protective effect against NAFLD, potentially informing dietary management strategies. Further research is needed to confirm these findings across diverse populations.

Association between non-skimmed milk consumption and metabolic dysfunction-associated fatty liver disease in US adults: insights from NHANES data

PURPOSE

Previous studies on the association between non-skimmed milk consumption and non-alcoholic fatty liver disease (NAFLD) have reported inconsistent findings, with some suggesting an increased risk and others indicating a protective effect. Moreover, as the research focus has shifted globally from NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD), there remains limited evidence on the relationship between non-skimmed milk consumption and MAFLD. The objective of this cross-sectional study was to investigate this association using data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

In this U.S. population-based study, adults with complete information on non-skimmed milk consumption and MAFLD diagnosis from the 2017-March 2020 Pre-Pandemic NHANES were included. MAFLD was defined using the controlled attenuation parameter (CAP). The association between non-skimmed milk consumption and MAFLD was assessed using weighted multivariable logistic regression, adjusting for potential confounders. Subgroup and sensitivity analyses were conducted to evaluate effect modifications and robustness.

RESULTS

The study involved 3,758 participants in total, 1,423 (37.87%) of whom had MAFLD according to the diagnosis. Frequent non-skimmed milk consumption was independently associated with higher MAFLD risk. Compared to the "Rarely" group (< 1 time/week), the "Sometimes" group (≥ 1 time/week but < 1 time/day) had an odds ratio (OR) of 1.67 (95% CI: 1.32-2.12, P = 0.004), and the "Often" group (≥ 1 time/day) had an OR of 1.36 (95% CI: 1.06-1.75, P = 0.046). Stratified analysis revealed that the association was significantly modified by education level (P for interaction = 0.010), with a stronger association observed among participants with higher education levels. Sensitivity analysis yielded consistent results, further supporting the robustness of the association.

CONCLUSION

Our findings suggest a significant association between frequent non-skimmed milk consumption and risk of MAFLD, particularly in highly educated individuals. These results highlight the importance of dietary modifications, specifically reducing non-skimmed milk intake, as a potential preventive strategy for MAFLD, especially in high-risk populations.

Association between body roundness index and constipation using data from NHANES 2005-2010

Obesity, particularly visceral fat, is a well-established risk factor for various gastrointestinal disorders, including constipation, possibly due to its metabolic and hormonal effects on bowel motility, though the mechanisms remain unclear. The Body Roundness Index (BRI), a novel and reliable anthropometric measure, has been validated as a precise indicator of visceral fat. However, its relationship with constipation remains uncertain. This population-based, cross-sectional study analyzed data from 6,898 participants in the National Health and Nutrition Examination Survey (NHANES, 2005-2010) to assess this association. Binary logistic regression analyses, adjusted for multiple covariates, revealed that higher BRI levels were significantly associated with a lower likelihood of constipation. Participants in the highest quartile had 32% lower odds of constipation than those in the lowest quartile (adjusted OR: 0.68; 95% CI: 0.54-0.86; P: 0.0013). As this was a cross-sectional study, the findings indicate an association between BRI levels and constipation rather than causality. These results suggest that BRI could be a practical and accessible marker for identifying individuals with different susceptibility to constipation, potentially aiding clinical assessment and guiding preventive strategies.

Efficacy of different nutrition interventions on sarcopenia in patients with cirrhosis: a systematic review and network meta-analysis

BACKGROUND & AIMS

Sarcopenia, characterized by the loss of muscle mass and strength, is a significant concern in cirrhotic patients. Nutritional interventions have been explored for its management, but the comparative efficacy of these interventions remains unclear. This study synthesizes current evidence to evaluate the effectiveness of nutritional interventions for sarcopenia in cirrhosis.

METHODS

Data sources included Scopus, PubMed, Web of Science Core Collection, and Cochrane Library up to Dec 2024. Eligible trials compared different nutritional interventions against control diets, placebos, or each other. A Bayesian network meta-analysis was performed to combine direct and indirect evidence. Effect sizes were calculated as mean differences (MD) with 95% confidence intervals (CIs). Intervention rankings were assessed using P-score, and evidence quality was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

RESULTS

A total of 14 randomized controlled trials (RCTs) involving 1,437 patients met the inclusion criteria. For improving muscle mass (MAMC), post-paracentesis intravenous nutritional support combined with an oral nutritional protocol (Treat A) showed the greatest effect compared to high-calorie, high-protein diets (HCHP) (MD: 2.78 cm, 95% CI: 1.15 to 4.40, low certainty), and oral nutritional protocol (Treat B) (MD of 3.41 cm, 95% CI: 2.12, 4.69). For muscle strength, the HINT diet (MD: 8.01 kg, 95% CI: 7.64 to 8.37, low certainty) and the HCHP (MD: 5 kg, 95% CI: 3.90 to 6.10, low certainty) were more effective than control diets. HCHP also demonstrated greater handgrip improvement than the HINT diet (MD: 3.00 kg, 95% CI: 1.84, 4.16; low certainty evidence). BCAA combined with vitamin D (2000 IU once a day) significantly improved skeletal muscle index (SMI) compared to both BCAA (MD: 0.72 kg/m2, 95% CI: 0.11 to 1.34; low certainty evidence) and placebo (MD: 0.25 kg/m2, 95% CI: -0.05 to 0.05; very low certainty evidence). BCAA supplementation effectively improved handgrip strength compared to placebo (MD: 2.36 kg, 95% CI: 1.85, 2.88; low certainty evidence).

CONCLUSIONS

Post-paracentesis intravenous nutritional support combined with an oral nutritional protocol effectively improves muscle mass, while high-calorie, high-protein diets enhance handgrip strength. BCAA supplementation alone or with vitamin D has been shown to effectively enhance muscle strength and muscle mass. However, these findings should be interpreted cautiously due to low evidence certainty.

Which dietary patterns fend off nonalcoholic fatty liver disease? A systematic review of observational and interventional studies

BACKGROUND

The global burden of non-alcoholic fatty liver disease (NAFLD) has significantly risen over the past decade. Dietary intake strongly influences its development and should be a component of any prevention and treatment plan strategy. Dietary pattern analysis enables the investigation of the overall diet and permits the consideration of interactions and cumulative effects of dietary components. The current study aimed to systematically review observational studies and intervention trials to determine the associations between various dietary patterns and NAFLD.

METHODS

The protocol was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and the Cochrane Library. We included studies that reported a priori dietary pattern (i.e., diet quality scores) or a posteriori method, which identified existing eating patterns (i.e., principal component analysis) in adult participants. Two investigators conducted independent screening, extraction, and quality assessment using the Newcastle‒Ottawa or Jadad scale. A third reviewer resolved conflicts.

RESULTS

We identified 27 relevant observational and 16 interventional studies from 16 countries. A Mediterranean or DASH diet might prevent and improve NAFLD, whereas dietary patterns such as Western dietary patterns characterized by high consumption of sweets and animal foods such as red meat and fast food are positively associated with NAFLD. A low-carbohydrate diet effectively prevents and treats NAFLD; however, we need more research on the effects of a low-fat diet and the type of fats.

CONCLUSION

Healthy dietary patterns, mainly plant-based or adjusted macronutrient distributions, such as the adoption of a low-carbohydrate diet, are linked to a reduced risk of NAFLD and could halt its progression. We proposed recommendations for future studies to fill the gap in knowledge regarding the management of NAFLD via dietary modifications.

Differential effects of low or high-fat dairy and fat derived from dairy products on MASLD

Background & Aims

Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly related to nutrition. However, only a few human and animal studies have tested the association between MASLD and dairy consumption and the effect of milk fat on liver damage. Therefore, we aimed at testing the association between consumption of dairy product and the incidence of MASLD and fibrosis markers in humans, and the effect of milk fat vs. other fats on MASLD in animal studies.

Methods

A prospective 7-year follow-up cohort study was performed including baseline and follow-up fasting blood tests, liver evaluation and a face-to-face interview on health status and behaviour using structured questionnaires. MASLD was determined by ultrasonography or by controlled attenuation parameter (CAP), and liver fibrosis by FibroTest™ or FibroScan®. An animal study was performed in which 6-week-old C57BL/6j male mice were fed a high-fat diet (HFD) consisting of lard, soybean oil, and milk fat for 12 weeks. Metabolic impairment was assessed during the animal experiment, and serum advanced glycation end-products (AGEs) and liver damage were evaluated.

Results

A total of 316 patients were included in the prospective cohort. In multivariable analysis, high consumption of low-medium fat low-sugar dairy products (g/day above the baseline sex-specific median) was associated with a lower risk for MASLD incidence (OR 0.42, 95% CI 0.18-0.95, p = 0.037) or incidence/persistence at follow-up (OR 0.58, 0.34-0.97, p = 0.039). Constantly high consumption of high-fat low-sugar dairy products was associated with greater odds for new onset/persistence of MASLD. Neither low-medium nor high-fat dairy consumption was related to fibrosis markers. In mice, all HFDs induced similar weight gain and steatosis and did not affect liver enzymes. Milk fat increases serum cholesterol and AGEs levels more than lard or soybean oil.

Conclusions

Low-medium fat low-sugar dairy products may be protective and should be preferred over high-fat dairy to prevent MASLD. HFDs from different fat sources with a wide spectrum of fatty acid saturation content are equally deleterious.

Impact and implications

MASLD is related to nutrition, but evidence of an association between high-fat and low-fat dairy products is lacking, therefore, we evaluated this association by performing experimental studies in mice and an observational human study. For MASLD prevention, a differential effect based on the type of dairy products should be considered: low-medium fat low-sugar dairy products were found to be protective, in contrast high-fat dairy and generally high-fat diets may be harmful. It would be advisable to prefer low-fat low-sugar dairy products and minimise intake of high-fat dairy products; however, additional evidence is needed to allow generalisability of our findings.

Comparison of nutritional value of the wild and cultivated spiny loaches at three growth stages

Environmental pollution and overfishing of wild spiny loach have led to the increased demand for breeding the fish. However, the nutritional value between the wild and cultivated spiny loaches was unknown. Therefore, this study aimed to evaluate the nutritional components among the wild and cultivated spiny loaches at different growth stages by analyzing and comparing the proximate compositions, fatty acids, amino acids and volatile compounds. Results showed that the cultivated ones had significantly higher energy and fat contents than the wild. Particularly, the cultivated second-age spiny loach contained the highest contents of polyunsaturated fatty acids (4.83 ± 0.01%) and EPA + DHA (0.85 ± 0.02%). Besides, the total essential amino acid content of cultivated second-age spiny loach was 2201.28, exceeding that recommended in the FAO/WTO scoring pattern (2,190). And it had the highest flavor amino acid (6.24 ± 0.04 g/100 g), essential amino acid index value (71.82) and higher contents of volatile compounds. Overall, the cultivated spiny loach, especially that at the second growth stage, displayed the highest nutritional value. The findings of this study would help farmers to harvest the suitable breeding stage of spiny loaches from the perspective of nutritional value, which is beneficial to the sustainable fish farming.

The association between dietary carbohydrate intake and the risk of hyperlipidemia among reproductive-aged women in the US: A cross-sectional study

BACKGROUND

The association between dietary carbohydrate intake and hyperlipidemia remained incompletely understood. This study aimed to explore the association between dietary carbohydrate intake and the risk of hyperlipidemia among reproductive-aged women in the US.

METHODS

The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted from 2005 to 2020. Dietary intake information was assessed via interviews using 24-hour dietary recall interviews, and hyperlipidemia diagnosis adhered to the National Cholesterol Education Program guidelines. Univariate and multivariate logistic regression analyses, along with restricted cubic splines (RCS) and stratified analyses, were conducted to investigate the association between dietary carbohydrate intake and the risk of hyperlipidemia.

RESULTS

A total of 6,791 women of reproductive age, with a mean age of 34.87 (±8.57) years, were included in the final analysis. In the multivariate logistic regression model adjusting for covariates, a higher percentage of energy from carbohydrate was positively correlated with the risk of hyperlipidemia (adjusted odds ratio (AOR): 1.014, 95% CI: 1.004-1.024). Analyzing the percentage of energy from carbohydrate as a categorical variable, compared to the lowest quartile, the third quartile (AOR: 1.263, 95% CI: 1.031-1.546) and the highest quartile (AOR: 1.411, 95% CI: 1.083-1.839) were associated with increased hyperlipidemia risk. Additionally, a linear relationship (P for nonlinearity = 0.088) existed between the percentage of energy from carbohydrate and the risk of hyperlipidemia, with an inflection point identified at 49.64.

CONCLUSIONS

This study found that elevated dietary carbohydrate intake was associated with an increased the risk of hyperlipidemia in reproductive-aged women. These findings implied that reproductive-aged women should pay closer attention to reducing their carbohydrate intake.

Association between dairy-rich dietary pattern and metabolic dysfunction-associated steatotic liver disease: Findings from the Korean Genome and Epidemiology Study

BACKGROUNDS

Dietary components and the development of metabolic dysfunction-associated liver disease (MASLD) are closely linked, but large-scale studies on dietary patterns and MASLD are scarce, most previous studies having focused on individual nutrients or foods rather than overall dietary patterns. Therefore, we aimed to investigate the association between dietary patterns and MASLD in Koreans.

METHODS

A total of 6,052 participants from the Korean Genome and Epidemiology Study. Dietary intake was assessed using a validated Korean semiquantitative food frequency questionnaire comprising 106 food items. Principal component analysis was used to determine the major dietary patterns. Cox proportional hazard regression analysis was performed to assess the association between the incidence of MASLD and dietary patterns.

RESULTS

Four major dietary patterns, namely carnivore, plant-based, dairy-rich, and starch-rich diet patterns, were identified. The carnivore, plant-based, and starch-rich diet patterns showed no significant association with incident MASLD, while the dairy-rich diet pattern was associated with a lower risk of MASLD, also showing significantly lower cumulative incidence of MASLD in the higher adherence to dairy-rich diet pattern.

CONCLUSION

The dairy-rich diet pattern was significantly associated with a lower risk of MASLD in Koreans. Appropriate dietary guidance based on dietary patterns is crucial for preventing MASLD.

Intake of the different types of dairy products, genetic predisposition, and the risks of nonalcoholic fatty liver disease and cirrhosis: a prospective cohort study

Background: The association of dairy product consumption with nonalcoholic fatty liver disease (NAFLD) and cirrhosis remains controversial. This study aimed to prospectively investigate the associations between the consumption of the different types of dairy products, genetic predisposition, and the risks of NAFLD and cirrhosis. Methods: This cohort study included 190 145 participants from the UK Biobank Study. The consumption of the different types of dairy products was assessed based on the Oxford WebQ at baseline and defined as the sum of milk, yogurt, and cheese. NAFLD and cirrhosis were evaluated using hospital inpatient records and death data in the UK Biobank. The weighted genetic risk score (GRS) for NAFLD and cirrhosis was constructed using 5 and 6 single-nucleotide variants (SNVs), respectively. Cox proportional hazards regression models were utilized to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between genetic factors and different types of dairy products with the incidence of NAFLD and cirrhosis. Results: During a median follow-up of 11.6 years, 1512 NAFLD and 556 cirrhosis cases were ascertained. After adjusting for several potential confounders, the HRs (95% CIs) (Q4 vs. Q1) of NAFLD were 0.86 (0.74, 0.995) for total dairy products, 0.96 (0.84, 1.09) for high-fat dairy products, 0.78 (0.67, 0.92) for low-fat dairy products, 0.86 (0.74, 0.99) for unfermented dairy products, and 0.79 (0.68, 0.91) for fermented dairy products. The multivariable-adjusted HRs (95% CIs) (Q4 vs. Q1) of cirrhosis were 0.75 (0.59, 0.96) for total dairy products, 0.97 (0.78, 1.19) for high-fat dairy products, 0.67 (0.51, 0.89) for low-fat dairy products, 0.75 (0.59, 0.96) for unfermented dairy products, and 0.71 (0.56, 0.90) for fermented dairy products. The associations of high-fat dairy products and fermented dairy products with NAFLD and cirrhosis were found to be nonlinear (P for nonlinear <0.05). No interaction was observed between dairy product consumption and NAFLD or cirrhosis genetic susceptibility. Conclusions: Higher consumption of dairy products, except for high-fat dairy, was correlated with lower risks of NAFLD and cirrhosis, regardless of their differences in genetic susceptibility.

Dietary pattern associated with non-alcoholic fatty liver disease (NAFLD) in non-diabetic adult patients: A case control study

BACKGROUND

Dietary intake is an important factor in the development and management of non-alcoholic fatty liver disease (NAFLD) however, optimal food group composition remains unclear. Data on detailed food group intake of NAFLD patients from India is scarce.

METHODS & MATERIALS

In this study with 320 participants (160 NAFLD cases and 160 controls), dietary habits were assessed using a 24-h dietary recall for two days and a validated 142-item food frequency questionnaire over the past year. Principal component analysis identified dietary patterns associated with NAFLD among the participants.

RESULTS

Cases were having a significantly higher intake of edible oils and fats along with nuts and oilseeds as compared to controls (p < 0.05). There was a positive and significant association with edible oils and fats with NAFLD [OR (95 % CI):1.7 (1.11-2.49) p = 0.013). In dietary pattern analysis western dietary pattern was found to be a risk for NAFLD whereas protective dietary pattern was associated with the decreased risk of NAFLD.

CONCLUSION

The overall food groups intake in NAFLD cases and controls was low suggesting lower diet quality. Protective dietary pattern found to be beneficial for NAFLD. High intake of sugars and edible oils associated with western dietary pattern increases the risk of NAFLD.

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

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.

Polyphenol consumption and Nonalcoholic fatty liver disease risk in adults

In this cross-sectional investigation, the primary objective was to explore the correlation between the consumption of polyphenols and the likelihood of non-alcoholic fatty liver disease (NAFLD) in the adult population participating in the Hoveyzeh cohort. Data from the Hoveyzeh cohort study, part of the Persian Cohort Study, involving 10,009 adults aged 35-70, were analyzed. Exclusions were made for missing data, extreme energy intake, and liver cancer patients. Dietary habits were assessed using a food frequency questionnaire, and polyphenol intake was calculated using the Phenol Explorer database. Logistic regression analyses, adjusted for confounders, were performed to assess the relationship between polyphenol subclasses (total polyphenols, total flavonoids, phenolic acid, and lignin) and NAFLD. Among 9894 participants, those in the highest quintile of total polyphenol (OR 0.65, CI 0.5-0.84; P = 0.007), phenolic acid (OR 0.67, CI 0.52-0.86; P < 0.001), and lignin intake (OR 0.69, CI 0.52-0.87; P = 0.001) demonstrated lower odds of NAFLD compared to the lowest quintile, even after adjusting for confounding factors. However, no significant association was found between total flavonoid intake and NAFLD (OR 1.26, CI 0.96-1.67; P = 0.47). Subgroup analysis indicated a significant inverse association between total polyphenols and NAFLD in women (OR 0.64, CI 0.42-0.93; P = 0.001). Higher intake of total polyphenols, phenolic acid, and lignin was associated with reduced odds of NAFLD among adults in the Hoveyzeh cohort. This suggests that dietary patterns rich in these polyphenols may play a role in mitigating the risk of NAFLD. Further interventional and longitudinal studies are needed to validate these findings and explore potential preventive strategies involving polyphenol-rich diets.

Liver triacylglycerol accumulation but not postprandial lipemia is reduced by a skim milk powder diet in male rats

Increases in postprandial lipids are linked to the development of cardiometabolic and fatty liver disease. Prior work has suggested that dairy possesses beneficial cardiometabolic effects and thus the aim of the current investigation was to test the hypotheses that the habitual consumption of dairy, in the form of skim milk powder (SMP), would protect against increases in circulating lipids and liver lipid accumulation following an oral fat challenge in rats. Male rats were fed either a semipurified low-fat control diet with casein or a diet with an equivalent amount of protein (∼13% kcal) provided through skim milk powder (SMP) for 6 weeks (n = 40/group). Rats were then given an oral gavage of palm oil (5 mL/kg body weight) or an equivalent volume of water, and serum and liver were harvested 90 minutes or 4 hours after. Rats fed the SMP diet gained less weight than controls but there were no differences in glucose tolerance between groups. The fat gavage increased serum lipids in both diet groups, whereas there was a main effect of the fat challenge to increase, and the SMP diet, to decrease liver triacylglycerol accumulation. The percentage of saturated and monounsaturated fatty acids and the protein content/activity of lipogenic enzymes were reduced in livers from SMP-fed rats, whereas the percentage of polyunsaturated fatty acids was increased. In summary, we provide evidence that SMP consumption, although not protecting against postprandial lipemia, markedly attenuates triacylglycerol accumulation and the relative amount of saturated and monounsaturated fatty acids in the liver.

Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease without pharmacological treatment yet. There is also a lack of specific dietary recommendations and strategies to treat the negative health impacts derived from NAFLD.

OBJECTIVE

This scoping review aimed to compile dietary patterns, foods, and nutrients to ameliorate NAFLD.

METHODS

A literature search was performed through MEDLINE, Scopus, Web of Science, and Google Scholar.

RESULTS

Several guidelines are available through the literature. Hypocaloric Mediterranean diet is the most accepted dietary pattern to tackle NAFLD. Coffee consumption (sugar free) may have a protective effect for NAFLD. Microbiota also plays a role in NAFLD; hence, fibre intake should be guaranteed.

CONCLUSIONS

A high-quality diet could improve liver steatosis. Weight loss through hypocaloric diet together with physical activity and limited sugar intake are good strategies for managing NAFLD. Specific dietary recommendations and a Mediterranean plate have been proposed to ameliorate NAFLD.

Dairy product consumption was associated with a lower likelihood of non-alcoholic fatty liver disease: A systematic review and meta-analysis

Background and aims

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. Several epidemiological studies attempted to assess the association between dairy product and the likelihood of NAFLD, but the contribution of dairy consumption to NAFLD remains controversial. We conducted a meta-analysis to investigate the association between dairy product consumption and NAFLD.

Methods

We conducted a literature search using the PubMed, Web of Science and Scopus databases, we conducted a thorough search of the literature published before January 5, 2023. Combined odds ratios (ORs) and 95% confidence intervals (CIs) of NAFLD in relation to dairy product intake were estimated using random-effects models. Subgroup analysis and meta-regression were performed according to the study design, region, sex, body mass index (BMI), type of exposure, NAFLD diagnostic criteria, and exposure assessment tools.

Results

We initially identified 4,634 relevant studies, of which 25 complied with the inclusion criteria, including seven cross-sectional studies, six case-control studies and one cohort study. A total of 51,476 participants (14,546 patients with NAFLD) were included in the meta-analysis. There was an inverse association between dairy product consumption and NAFLD (OR = 0.97, 95% CI = 0.94-0.99). Subgroup analysis demonstrated that lower likelihood of NAFLD was associated with dairy product consumption in subgroups of Asian populations, women, patients diagnosed using NAFLD-related scores, patients with a BMI of 18.5-24.9 kg/m2, dairy intake assessed using a food frequency questionnaire, milk consumption, and yogurt consumption. No noteworthy connection was observed in the other subgroups.

Conclusion

Our meta-analysis findings revealed that dairy product consumption is inversely associated with NAFLD. Consumption of dairy products could help prevent the development of non-alcoholic fatty liver disease.