Nuts and Non-Alcoholic Fatty Liver Disease: Are Nuts Safe for Patients with Fatty Liver Disease?

Dietary composition and its association with metabolic dysfunction-associated fatty liver disease among Chinese adults: A cross-sectional study

BACKGROUND AND STUDY AIMS

Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the most common cause of chronic liver disease worldwide. Diet plays a critical role in the prevention and treatment of MAFLD. Our hypothesis was that the intake of some macronutrients, vitamins, or mineral elements is associated with MAFLD.

PATIENTS AND METHODS

Patients with MAFLD can be diagnosed based on the evidence of hepatic steatosis and if they meet any of the three additional criteria of overweight/obesity, diabetes mellitus, or metabolic dysregulation. Diets were recorded using photographs and diaries of meals for seven consecutive days. The consumed dietary composition was compared with the recommended intake according to the China Food Composition Tables (Standard Edition) version 2019 and the Chinese Dietary Reference Intakes version 2013, and its association with MAFLD was assessed by logistical regression analyses.

RESULTS

A total of 229 MAFLD patients and 148 healthy controls were included in this study. MAFLD patients, compared with that by non-MAFLD participants, consumed more polyunsaturated fatty acids (PUFAs) (p < 0.001), vitamin E (p < 0.001), and iron (p = 0.008). The intake of PUFAs (OR = 1.070, 95 % CI: 1.017-1.127, p = 0.009) and vitamin E (OR = 1.100, 95 % CI: 1.018-1.190, p = 0.016) was positively associated with MAFLD. In addition, the percentages of individuals who consumed PUFAs (p = 0.006), vitamin E (p < 0.001), or iron (p = 0.046) above the recommended intake were higher among the individuals with MAFLD. Daily intake of PUFAs > 11 % (OR = 2.328, 95 % CI: 1.290-4.201, p = 0.005) and vitamin E > 14 mg (OR = 2.189, 95 % CI: 1.153-4.158, p = 0.017) was positively correlated with MAFLD.

CONCLUSIONS

Patients with MAFLD consumed more PUFAs, vitamin E, and iron in their daily diet. Excessive consumption of PUFAs and vitamin E might be independent risk factors for the incidence of MAFLD.

Nutrient patterns and risk of diabetes mellitus type 2: a case-control study

BACKGROUNDS

Although the significance of diet in preventing or managing diabetes complications is highlighted in current literature, there is insufficient evidence regarding the correlation between nutrient patterns and these complications. The objective of this case-control study is to investigate this relationship by analyzing the dietary intake of nutrients in participants with and without type 2 diabetes (T2D).

METHODS

A case-control study was conducted at the Tabriz Center of Metabolism and Endocrinology to investigate the relationship between nutrient patterns and type 2 diabetes (T2D). The study enrolled 225 newly diagnosed cases of T2D and 225 controls. The dietary intake of nutrients was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Principal component analysis using Varimax rotation was used to obtain nutrient patterns. Logistic regression analysis was performed to estimate the risk of T2D.

RESULTS

The participants' mean (SD) age and BMI were 39.8 (8.8) years and 27.8 (3.6) kg/m2, respectively. The results identified three major nutrient patterns. The first nutrient pattern was characterized by high consumption of sucrose, animal protein, vitamin E, vitamin B1, vitamin B12, calcium, phosphorus, zinc, and potassium. The second nutrient pattern included fiber, plant protein, vitamin D, Riboflavin, Vitamin B5, copper, and Magnesium. The third nutrient pattern was characterized by fiber, plant protein, vitamin A, riboflavin, vitamin C, calcium, and potassium. Individuals in the highest tertile of nutrient pattern 3 (NP3) had a lower risk of T2D compared to those in the lowest tertile after adjusting for confounders. The odds ratio was 0.52 with a 95% confidence interval of 0.30-0.89 and a P_trend of 0.039.

CONCLUSION

This study found that conforming to a nutrient pattern consisting of plant protein, vitamin C, vitamin A, vitamin B2, potassium, and calcium is linked to a lower likelihood of developing T2D.The initial results suggest that following a nutrient pattern that includes these nutrients may reduce the risk of T2D. However, further research is required to confirm the relationship between nutrient patterns and T2D.

Effect of Nut Consumption on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Although previous epidemiological studies have been conducted to investigate the relationship between nut consumption and the risk of nonalcoholic fatty liver disease (NAFLD), the evidence remains inconclusive and contentious. The aim of our study was to further conduct a meta-analysis of observational studies to explore the latest evidence of the influence of nut consumption on NAFLD. This meta-analysis included a comprehensive search of all articles published in the PubMed and Web of Science online databases as of April 2023. A total of 11 articles were included, comprising 2 prospective cohort studies, 3 cross-sectional studies, and 7 case-control studies, and a random effects model was used to evaluate the relationship between nuts and NAFLD. Results showed that the odds ratio (OR) of NAFLD was 0.90 (95% CI: 0.81-0.99, p < 0.001) when comparing the highest and lowest total nut intake, indicating a significant negative correlation. Furthermore, subgroup analysis revealed that the protective effect of nuts on NAFLD was more significant in females (OR = 0.88; 95% CI: 0.78-0.98, I² = 76.2%). In summary, our findings provide support for a protective relationship between nut intake and risk of NAFLD. Further exploration of the association between other dietary components and NAFLD is an important avenue for future research.

Aflatoxin B1 exposure triggers hepatic lipotoxicity via p53 and perilipin 2 interaction-mediated mitochondria-lipid droplet contacts: An in vitro and in vivo assessment

Aflatoxin B1 (AFB1) is one of the most toxic mycotoxins widely found in food contaminants, and its target organ is the liver. It poses a major food security and public health threat worldwide. However, the lipotoxicity mechanism of AFB1 exposure-induced liver injury remains unclear and requires further elucidation. Herein, we investigated the potential hepatic lipotoxicity of AFB1 exposure using in vitro and in vivo models to assess the public health hazards of high dietary AFB1 exposure. We demonstrated that low-dose of AFB1 (1.25 μM for 48 h, about one-fifth of the IC50 in HepG2 and HepaRG cells, IC50 are 5.995 μM and 5.266 μM, respectively) exposure significantly induced hepatic lipotoxicity, including abnormal lipid droplets (LDs) growth, mitochondria-LDs contacts increase, lipophagy disruption, and lipid accumulation. Mechanistically, we showed that AFB1 exposure promoted the mitochondrial p53 (mito-p53) and LDs-associated protein perilipin 2 (PLIN2) interaction-mediated mitochondria-LDs contacts, resulting in lipid accumulation in hepatocytes. Mito-p53-targeted inhibition, knockdown of PLIN2, and rapamycin application efficiently promoted the lysosome-dependent lipophagy and alleviated the hepatic lipotoxicity and liver injury induced by AFB1 exposure. Overall, our study found that mito-p53 and PLIN2 interaction mediates three organelles-mitochondria, LDs, and lysosomal networks to regulate lipid homeostasis in AFB1 exposure-induced hepatotoxicity, revealing how this unique trio of organelles works together and provides a novel insight into the targeted intervention in inter-organelle lipid sensing and trafficking for alleviating hazardous materials-induced hepatic lipotoxicity.

Nutrient patterns and non-alcoholic fatty liver disease in Iranian Adul: A case-control study

Backgrounds

The current literature boasts the importance of diet in preventing or managing liver complications. However, there is limited evidence on the association of nutrient patterns (NP) with these complications. In this case-control study, we aimed to examine the possible relationship between nutrient patterns and the risk of non-alcoholic fatty liver disease (NAFLD) amongst the adult Iranian population.

Methods

This case-control study is being conducted at the Metabolic Liver Disease Research Center at Isfahan University of Medical Sciences in 2019. The study included 225 newly diagnosed cases of NAFLD and 450 controls. A validated semi-quantitative food frequency questionnaire (FFQ) assessed dietary intake. Principal component analysis using Varimax rotation obtained nutrient patterns. Logistic regression was performed to estimate NAFLD risk.

Results

We identified four major nutrient patterns. The first nutrient pattern was high in consumption of lactose, animal protein, vitamin D, riboflavin, pantothenic acid, vitamin B12, calcium, phosphorus, zinc, and potassium. The second nutrient pattern included fiber, plant protein, vitamin A, thiamine, niacin, copper, and selenium, while the third featured plant protein, zinc, copper, magnesium, manganese, chromium, and selenium. The fourth was characterized by fructose, vitamin A, pyridoxine, vitamin C, and potassium. After adjusting for confounders, individuals in the highest tertile of NP4 had lower odds of NAFLD (OR: 0.56, 95% CI: 0.32–0.98, P_trend = 0.042); compared to those who were in the lowest tertile.

Conclusion

High compliance to a nutrient pattern characterized by fructose, vitamin C, vitamin A, pyridoxine, and potassium mainly supplied from fruits, vegetables, and nuts is inversely proportional to the odds of NAFLD. Also our findings indicate a very high fiber intake, a relatively optimal dietary fat profile, and a pretty low sugar intake for cases and controls, unseen in western countries. However, these initial findings need to be approved with further studies to confirm the relationship between nutrient patterns and NAFLD.

Therapeutic Effects of Crocin Alone or in Combination with Sorafenib against Hepatocellular Carcinoma: In Vivo & In Vitro Insights

This study investigated the therapeutic effects of the phytochemical crocin alone or in combination with sorafenib both in rats chemically induced with hepatocellular carcinoma (HCC) and in human liver cancer cell line (HepG2). Male rats were randomly divided into five groups, namely, control group, HCC induced group, and groups treated with sorafenib, crocin or both crocin and sorafenib. HCC was induced in rats with a single intraperitoneal injection of diethylnitrosamine (DEN), then 2-acetylaminofluorene (2-AAF). The HCC-induced rats showed a significant decrease in body weight compared to animals treated with either or both examined drugs. Serum inflammatory markers (C-reactive protein (CRP); interleukin-6 (IL-6); lactate dehydrogenase (LDH), and oxidative stress markers were significantly increased in the HCC group and were restored upon treatment with either or both of therapeutic molecules. Morphologically, the HCC-induced rats manifested most histopathological features of liver cancer. Treatment with either or both of crocin and sorafenib successfully restored normal liver architecture. The expression of key genes involved in carcinogenesis (TNFα, p53, VEGF and NF-κB) was highly augmented upon HCC induction and was attenuated post-treatment with either or both examined drugs. Treatment with both crocin and sorafenib improved the histopathological and inflammation parameters as compared to single treatments. The in vivo anti-cancer effects of crocin and/or sorafenib were supported by their respective cytotoxicity on HepG2 cells. Crocin and sorafenib displayed an anti-tumor synergetic effect on HepG2 cells. The present findings demonstrated that a treatment regimen with crocin and sorafenib reduced liver toxicity, impeded HCC development, and improved the liver functions.

Development of Food Group Tree-Based Analysis and Its Association with Non-Alcoholic Fatty Liver Disease (NAFLD) and Co-Morbidities in a South Indian Population: A Large Case-Control Study

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is a global problem growing in parallel to the epidemics of obesity and diabetes, with South Asians being particularly susceptible. Nutrition and behaviour are important modifiers of the disease; however, studies to date have only described dietary patterns and nutrients associated with susceptibility to NAFLD.

METHODS

This cross-sectional case-control study included 993 NAFLD patients and 973 healthy controls from Trivandrum (India). Dietary data was collected using a locally validated food frequency questionnaire. A tree-based classification categorised 2165 ingredients into three levels (food groups, sub-types, and cooking methods) and intakes were associated with clinical outcomes.

RESULTS

NAFLD patients had significantly higher consumption of refined rice, animal fat, red meat, refined sugar, and fried foods, and had lower consumption of vegetables, pulses, nuts, seeds, and milk compared to controls. The consumption of red meat, animal fat, nuts, and refined rice was positively associated with NAFLD diagnosis and the presence of fibrosis, whereas consumption of leafy vegetables, fruits, and dried pulses was negatively associated. Fried food consumption was positively associated with NAFLD, whilst boiled food consumption had a negative association. Increased consumption of animal fats was associated with diabetes, hypertension, and cardiovascular outcomes among those with NAFLD, whereas consumption of wholegrain rice was negatively associated with these clinical-related outcomes.

CONCLUSIONS

The tree-based approach provides the first comprehensive method of classifying food intakes to enable the identification of specific dietary factors associated with NAFLD and related clinical outcomes. This could inform culturally sensitive dietary guidelines to reduce risk of NAFLD development and/or its progression.

Metabolic and Microbiome Alterations Following the Enrichment of a High-Fat Diet With High Oleic Acid Peanuts Versus the Traditional Peanuts Cultivar in Mice

A new Israeli-developed peanut cultivar, “Hanoch-Oleic” (HO), uniquely contains enlarged oleic acid contents and was designed to confer additional beneficial effects over the traditional cultivar, “Hanoch” (HN). This work elucidates metabolic changes and microbiota adaptations elicited by HO addition to a high-fat diet (HFD). Male C57BL/6 mice were fed for 18 weeks with a normal diet or a HFD with/without the addition of HN (HFDh) or HO (HFDo). Body-weight did not differ between HFD-fed mice groups, while liver and adipose weight were elevated in the HFDh and HFD groups, respectively. Insulin-sensitivity (IS) was also decreased in these groups, though to a much greater extent in the traditional peanuts-fed group. Modifications in lipids metabolism were evident by the addition of peanuts to a HFD. Liver inflammation seems to return to normal only in HFDh. Peanuts promoted an increase in α-diversity, with HFDo exhibiting changes in the abundance of microbiota that is primarily associated with ameliorated gut health and barrier capacity. In conclusion, the HO cultivar appears to be metabolically superior to the traditional peanut cultivar and was associated with an improved inflammatory state and microbial profile. Nevertheless, IS-negative effects reinforced by peanuts addition, predominantly NH, need to be comprehensively defined.

The association between major dietary patterns with the risk of non-alcoholic fatty liver disease, oxidative stress and metabolic parameters: A case-control study

Purpose

Non-alcoholic fatty liver disease (NAFLD) is caused by the increase of fat in the liver. The present study aimed to study the association between different dietary patterns and NAFLD in adults.

Methods

This study included 121 adult patients with NAFLD and 119 non-NAFLD. Dietary intake was calculated by a 168-item food frequency questionnaire. Biochemical markers were measured. Dietary patterns were determined by factor analysis. The association between dietary patterns and NAFLD was evaluated using multiple logistic regression analysis.

Results

Two dietary patterns (healthy, western) were recognized in participants. Western dietary pattern was related with 72 percent increase in the odds of NAFLD (OR: 1.72; 95% CI: 1.32,2.14), after adjustment for covariates. Healthy dietary pattern was associated with 38 percent lower odds of NAFLD (OR: 0.38; 95% CI: 0.11, 0.65). Adherence to the western diet was related to 0.486 greater amounts of ALT, 3.248 mg/dl higher levels of FBS, and 3.989 mg/dl greater amounts of TG and 2.354 mg/dl greater amounts of MDA after adjusting for confounding factors (p > 0.001, p = 0.042, p > 0.001, p = 0.036 respectively). The healthy dietary pattern score was negatively associated with FBS and Cholesterol and TG levels (p = 0.035, p = 0.048, and p = 0.025), respectively. Moreover, it was associated with 3.211 mg/dl higher levels of TAC (p = 0.049).

Conclusions

There is a significant relationship between dietary patterns and non-alcoholic fatty liver disease. Adherence to a western dietary pattern is related to an increase in non-alcoholic fatty liver disease.

Weight loss interventions and nonalcoholic fatty liver disease: Optimizing liver outcomes

The growth in prevalence of obesity, type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) has become one of the most important global health challenges. The three chronic diseases are closely linked in their epidemiology and pathophysiology. Currently, weight loss is the most effective treatment for NAFLD (even in the minority of patients with NAFLD who do not have obesity) and is recommended in all national and international guidelines. Accumulating evidence has shown that weight loss, whether achieved by diet and lifestyle interventions, bariatric surgery or pharmacotherapy, can improve biomarkers of NAFLD, as well as prevent progression and, in some cases, reverse fibrosis. There is a dose dependency of weight loss with NAFLD improvement. Pharmacotherapy with antiobesity medications, alone or in combination with intensive lifestyle interventions or other weight-loss drugs, is closing the efficacy gap between diet and exercise and weight-loss surgery in efficacy at reversing obesity. Given the importance of providing effective weight-loss treatment to patients with NAFLD, weight management services need to be made increasingly available and embedded within hepatology services. This narrative review addresses the evidence that weight loss optimizes liver outcomes in people with NAFLD.

Genetics, Immunity and Nutrition Boost the Switching from NASH to HCC

Nonalcoholic fatty liver disease (NAFLD) is the leading contributor to the global burden of chronic liver diseases. The phenotypic umbrella of NAFLD spans from simple and reversible steatosis to nonalcoholic steatohepatitis (NASH), which may worsen into cirrhosis and hepatocellular carcinoma (HCC). Notwithstanding, HCC may develop also in the absence of advanced fibrosis, causing a delayed time in diagnosis as a consequence of the lack of HCC screening in these patients. The precise event cascade that may precipitate NASH into HCC is intricate and it entails diverse triggers, encompassing exaggerated immune response, endoplasmic reticulum (ER) and oxidative stress, organelle derangement and DNA aberrancies. All these events may be accelerated by both genetic and environmental factors. On one side, common and rare inherited variations that affect hepatic lipid remodeling, immune microenvironment and cell survival may boost the switching from steatohepatitis to liver cancer, on the other, diet-induced dysbiosis as well as nutritional and behavioral habits may furtherly precipitate tumor onset. Therefore, dietary and lifestyle interventions aimed to restore patients' health contribute to counteract NASH progression towards HCC. Even more, the combination of therapeutic strategies with dietary advice may maximize benefits, with the pursuit to improve liver function and prolong survival.

Nuts: Natural Pleiotropic Nutraceuticals

Common nuts (tree nuts and peanuts) are energy-dense foods that nature has gifted with a complex matrix of beneficial nutrients and bioactives, including monounsaturated and polyunsaturated fatty acids, high-quality protein, fiber, non-sodium minerals, tocopherols, phytosterols, and antioxidant phenolics. These nut components synergize to favorably influence metabolic and vascular physiology pathways, ameliorate cardiovascular risk factors and improve cardiovascular prognosis. There is increasing evidence that nuts positively impact myriad other health outcomes as well. Nut consumption is correlated with lower cancer incidence and cancer mortality, and decreased all-cause mortality. Favorable effects on cognitive function and depression have also been reported. Randomized controlled trials consistently show nuts have a cholesterol-lowering effect. Nut consumption also confers modest improvements on glycemic control, blood pressure (BP), endothelial function, and inflammation. Although nuts are energy-dense foods, they do not predispose to obesity, and in fact may even help in weight loss. Tree nuts and peanuts, but not peanut butter, generally produce similar positive effects on outcomes. First level evidence from the PREDIMED trial shows that, in the context of a Mediterranean diet, consumption of 30 g/d of nuts (walnuts, almonds, and hazelnuts) significantly lowered the risk of a composite endpoint of major adverse cardiovascular events (myocardial infarction, stroke, and death from cardiovascular disease) by ≈30% after intervention for 5 y. Impressively, the nut-supplemented diet reduced stroke risk by 45%. As they are rich in salutary bioactive compounds and beneficially impact various health outcomes, nuts can be considered natural pleiotropic nutraceuticals.

Is the Mediterranean Diet the Best Approach to NAFLD Treatment Today?

Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent diseases worldwide, involving about 20-30% of the general population [...].

Aflatoxin Detoxification Using Microorganisms and Enzymes

Mycotoxin contamination causes significant economic loss to food and feed industries and seriously threatens human health. Aflatoxins (AFs) are one of the most harmful mycotoxins, which are produced by Aspergillus flavus, Aspergillus parasiticus, and other fungi that are commonly found in the production and preservation of grain and feed. AFs can cause harm to animal and human health due to their toxic (carcinogenic, teratogenic, and mutagenic) effects. How to remove AF has become a major problem: biological methods cause no contamination, have high specificity, and work at high temperature, affording environmental protection. In the present research, microorganisms with detoxification effects researched in recent years are reviewed, the detoxification mechanism of microbes on AFs, the safety of degrading enzymes and reaction products formed in the degradation process, and the application of microorganisms as detoxification strategies for AFs were investigated. One of the main aims of the work is to provide a reliable reference strategy for biological detoxification of AFs.