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Soft drinks consumption is associated with nonalcoholic fatty liver disease independent of metabolic syndrome in Chinese population

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Abstract

Purpose

Excessive consumption of soft drinks is associated with nonalcoholic fatty liver disease (NAFLD). However, the association between soft drinks consumption and NAFLD is unclear in non-Caucasian adults with relatively low soft drinks consumption. The aim of this study was to assess the association between soft drinks consumption and NAFLD in Chinese adults.

Methods

A cross-sectional study was conducted with 26,790 adults living in Tianjin, China. NAFLD (with elevated alanine aminotransferase [ALT]) was diagnosed by the liver ultrasonography and serum ALT concentrations. Soft drinks consumption was assessed using a validated self-administered food frequency questionnaire, and it was summarized as three categories for analysis: almost never (reference), <1 cup/week, and ≥1 cups/week. Metabolic syndrome (MetS) was defined according to the criteria of the American Heart Association scientific statements of 2009. The association between soft drinks consumption and NAFLD was assessed by multiple logistic regression analysis.

Results

The prevalence of NAFLD and NAFLD with elevated ALT was 27.1 and 6.5%, respectively. After adjustment for potential confounding variables (including MetS), the odds ratios (95% confidence intervals) for NAFLD or NAFLD with elevated ALT across soft drinks consumption were 1.00 (reference) for almost never, 1.14 (1.02–1.27) or 1.16 (0.98–1.37) for <1 cup/week, and 1.26 (1.14–1.40) or 1.32 (1.13–1.53) for ≥1 cups/week (both P for trend <0.001), respectively.

Conclusions

This is the first study to demonstrate that soft drinks consumption is associated with NAFLD independent of MetS in Chinese adults with relatively low soft drinks consumption. These results suggest that reducing soft drinks consumption might be beneficial to the prevention of NAFLD.

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Acknowledgements

We gratefully acknowledge all the participants of the study and Tianjin Medical University General Hospital Health Management Center for the possibility to perform the study. This study was supported by grants from the National Natural Science Foundation of China (No. 81673166, 81372118, 81372467 and 81302422), the key technologies R&D program of Tianjin (Key Project: No. 11ZCGYSY05700, 12ZCZDSY20400, 13ZCZDSY20200, and 15YFYZSY00020), the National Science and Technology Support Program (No. 2012BAI02B02), 2012 and 2016 Chinese Nutrition Society (CNS) Nutrition Research Foundation—DSM Research Fund (No. 2014-071, 2016-046 and 2016-023), the Technologies development program of Beichen District of Tianjin (No. bcws2013-21, bcws2014-05 and 2015-SHGY-02), the technologies project of Tianjin Binhai New Area (No. 2013-02-04 and 2013-02-06), the Science Foundation of Tianjin Medical University (No. 2010KY28 and 2013KYQ24), the Key Laboratory of Public Health Safety (Fudan University), Ministry of Education (No. GW2014-5), and the National Training Programs of Innovation and Entrepreneurship for Undergraduates (No. 201510062013), China.

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Authors and Affiliations

  1. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China

    Ge Meng, Bo Zhang, Fei Yu, Chunlei Li, Li Liu, Hongmei Wu, Yang Xia, Xue Bao, Qian Su, Yeqing Gu, Liyun Fang, Huijun Yang, Bin Yu, Zhong Sun, Ming Yu & Kaijun Niu

  2. Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China

    Qing Zhang, Hongbin Shi, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Huanli Jiao, Kun Song & Kaijun Niu

  3. Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China

    Huanli Jiao & Bangmao Wang

  4. Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China

    Qi Guo

  5. Department of Epidemiology and Public Health, University College London, London, UK

    Livia A. Carvalhoa

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  1. Ge Meng
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  2. Bo Zhang
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  3. Fei Yu
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Correspondence to Ming Yu or Kaijun Niu.

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Meng, G., Zhang, B., Yu, F. et al. Soft drinks consumption is associated with nonalcoholic fatty liver disease independent of metabolic syndrome in Chinese population. Eur J Nutr 57, 2113–2121 (2018). https://doi.org/10.1007/s00394-017-1485-0

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