Skip to main content

Advertisement

SpringerLink
Log in

Associations between intake of starchy and non-starchy vegetables and risk of hepatic steatosis and fibrosis

  • Original Article
  • Published:
Hepatology International Aims and scope Submit manuscript

Abstract

Background

Current dietary guidelines generally treat all types of vegetables the same. However, whether specific vegetables are more beneficial or deleterious for preventing chronic liver disease (CLD) remains uncertain.

Methods

We investigated the associations between starchy and non-starchy vegetables and the odds of hepatic steatosis and fibrosis in a US nationwide cross-sectional study. Diet was assessed by the 24-h dietary recalls. Hepatic steatosis and fibrosis were defined based on vibration-controlled transient elastography (TE). Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Among 4170 participants with reliable TE test, 1436 were diagnosed with steatosis, 255 with advanced fibrosis. Increased intake of total starchy vegetables was associated with higher odds of steatosis (OR per 1-SD increment 1.11, 95% CI 1.01–1.24) and advanced fibrosis (OR = 1.39, 95% CI 1.15–1.69). Similar positive associations were observed for potatoes. Conversely, intakes of total non-starchy (OR = 0.82, 95% CI 0.71–0.95) and dark-green vegetables (OR = 0.89, 95% CI 0.82–0.97) were inversely associated with steatosis prevalence. Replacing 5% of energy from starchy vegetables (OR = 0.65, 95% CI 0.44–0.97) or potatoes (OR = 0.65, 95% CI 0.43–0.97) with equivalent energy from dark-green vegetables was associated with lower odds of steatosis.

Conclusions

These findings support the recommendation to limit starchy vegetable intake and increase non-starchy vegetable intake in CLD prevention, and provide evidence for the potential health benefit from dietary substitution of non-starchy vegetables for starchy vegetables.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of data and materials

The data of this study were from public data; it will be made available to other researchers. The data were made available at https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?BeginYear=2017.

Abbreviations

BMI:

Body mass index

CAP:

Controlled attenuation parameter

CI:

Confidence interval

CLD:

Chronic liver disease

CRP:

C-reactive protein

GI:

Glycemic index

GL:

Glycemic load

HbA1c:

Hemoglobin A1c

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

hs-CRP:

High-sensitivity CRP

IL-6:

Interleukin 6

IQR:

Interquartile range

LSM:

Liver stiffness measurement

MEC:

Mobile Examination Center

METS:

Metabolic equivalent tasks

NAFLD:

Nonalcoholic fatty liver disease

NCHS:

National Centers for Health Statistics

NHANES:

National Health and Nutrition Examination Survey

OR:

Odds ratio

SD:

Standard deviation

TE:

Transient elastography

References

  1. Bertoia ML, Mukamal KJ, Cahill LE, et al. Changes in intake of fruits and vegetables and weight change in United States men and women followed for up to 24 years: analysis from three prospective cohort studies. PLoS Med. 2015;12(9): e1001878

    Article  Google Scholar 

  2. Wang DD, Li Y, Bhupathiraju SN, et al. Fruit and vegetable intake and mortality: results from 2 prospective cohort studies of US men and women and a meta-analysis of 26 cohort studies. Circulation. 2021;143(17):1642–1654

    Article  CAS  Google Scholar 

  3. Barclay AW, Petocz P, McMillan-Price J, et al. Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies. Am J Clin Nutr. 2008;87(3):627–637

    Article  CAS  Google Scholar 

  4. Murcia MA, Jimenez AM, Martinez-Tome M. Vegetables antioxidant losses during industrial processing and refrigerated storage. Food Res Int. 2009;42(8):1046–1052

    Article  CAS  Google Scholar 

  5. Tajima R, Kimura T, Enomoto A, et al. No association between fruits or vegetables and non-alcoholic fatty liver disease in middle-aged men and women. Nutrition. 2019;61:119–124

    Article  Google Scholar 

  6. Shi L, Liu ZW, Li Y, et al. The prevalence of nonalcoholic fatty liver disease and its association with lifestyle/dietary habits among university faculty and staff in Chengdu. Biomed Environ Sci. 2012;25(4):383–391

    PubMed  Google Scholar 

  7. Kim SA, Shin S. Fruit and vegetable consumption and non-alcoholic fatty liver disease among Korean adults: a prospective cohort study. J Epidemiol Community Health. 2020;74(12):1035–1042

    PubMed  Google Scholar 

  8. US Department of Agriculture and US Department of Health and Human Services. Dietary guidelines for Americans (2020–2025). 2021; https://www.dietaryguidelinesgov/resources/2020-2025-dietary-guidelines-online-materials. Accessed 18 Dec 2021

  9. Health Canada. Canada's Dietary Guidelines. 2020; https://food-guide.canada.ca/en/guidelines/appendix-b-summary-guidelines-and-considerations/. Accessed 5 Jan 2022

  10. Zhu Y, Peng Z, Lu Y, et al. Higher dietary insulinaemic potential is associated with increased risk of liver steatosis and fibrosis. Liver Int. 2022;42(1):69–79

    Article  CAS  Google Scholar 

  11. Centers for Disease Control and Prevention. Glossary—Alcohol. https://www.cdc.gov/nchs/nhis/alcohol/alcohol_glossary.htm. Accessed 19 Apr 2022

  12. Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease. Gastroenterology. 2019;156(6):1717–1730

    Article  Google Scholar 

  13. Song M, Giovannucci E. Substitution analysis in nutritional epidemiology: proceed with caution. Eur J Epidemiol. 2018;33(2):137–140

    Article  Google Scholar 

  14. Caussy C, Alquiraish MH, Nguyen P, et al. Optimal threshold of controlled attenuation parameter with MRI-PDFF as the gold standard for the detection of hepatic steatosis. Hepatology. 2018;67(4):1348–1359

    Article  CAS  Google Scholar 

  15. Petta S, Wong VW, Camma C, et al. Improved noninvasive prediction of liver fibrosis by liver stiffness measurement in patients with nonalcoholic fatty liver disease accounting for controlled attenuation parameter values. Hepatology. 2017;65(4):1145–1155

    Article  CAS  Google Scholar 

  16. Li C, Guo P, Okekunle AP, et al. Lean non-alcoholic fatty liver disease patients had comparable total caloric, carbohydrate, protein, fat, iron, sleep duration and overtime work as obese non-alcoholic fatty liver disease patients. J Gastroenterol Hepatol. 2019;34(1):256–262

    Article  CAS  Google Scholar 

  17. Li H, Wang X, Ye M, et al. Does a high intake of green leafy vegetables protect from NAFLD? Evidence from a large population study. Nutr Metab Cardiovasc Dis. 2021;31(6):1691–1701

    Article  Google Scholar 

  18. Mokhtari E, Farhadnejad H, Salehi-Sahlabadi A, et al. Spinach consumption and nonalcoholic fatty liver disease among adults: a case-control study. BMC Gastroenterol. 2021;21(1):196

    Article  Google Scholar 

  19. Cook LT, O’Reilly GA, Goran MI, Weigensberg MJ, Spruijt-Metz D, Davis JN. Vegetable consumption is linked to decreased visceral and liver fat and improved insulin resistance in overweight Latino youth. J Acad Nutr Diet. 2014;114(11):1776–1783

    Article  Google Scholar 

  20. Yu EY, Wesselius A, Mehrkanoon S, et al. Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study. BMC Med. 2021;19(1):56

    Article  CAS  Google Scholar 

  21. Valtuena S, Pellegrini N, Ardigo D, et al. Dietary glycemic index and liver steatosis. Am J Clin Nutr. 2006;84(1):136–142 (quiz 268-139)

    Article  CAS  Google Scholar 

  22. Bawden S, Stephenson M, Falcone Y, et al. Increased liver fat and glycogen stores after consumption of high versus low glycaemic index food: a randomized crossover study. Diabetes Obes Metab. 2017;19(1):70–77

    Article  CAS  Google Scholar 

  23. Bertani JPB, Alves BC, Azevedo LA, Alvares-da-Silva MR, Dall’Alba V. Is dietary glycemic load associated with liver fibrosis in hepatitis C? Nutr Hosp. 2018;35(1):140–147

    CAS  PubMed  Google Scholar 

  24. Liu Y, Croft KD, Caparros-Martin J, O’Gara F, Mori TA, Ward NC. Beneficial effects of inorganic nitrate in non-alcoholic fatty liver disease. Arch Biochem Biophys. 2021;711: 109032

    Article  CAS  Google Scholar 

  25. Camire ME, Kubow S, Donnelly DJ. Potatoes and human health. Crit Rev Food Sci Nutr. 2009;49(10):823–840

    Article  CAS  Google Scholar 

  26. Akyol H, Riciputi Y, Capanoglu E, Caboni MF, Verardo V. Phenolic compounds in the potato and Its byproducts: an overview. Int J Mol Sci. 2016;17(6):835

    Article  Google Scholar 

  27. Naruszewicz M, Zapolska-Downar D, Kosmider A, et al. Chronic intake of potato chips in humans increases the production of reactive oxygen radicals by leukocytes and increases plasma C-reactive protein: a pilot study. Am J Clin Nutr. 2009;89(3):773–777

    Article  CAS  Google Scholar 

  28. Kaspar KL, Park JS, Brown CR, Mathison BD, Navarre DA, Chew BP. Pigmented potato consumption alters oxidative stress and inflammatory damage in men. J Nutr. 2011;141(1):108–111

    Article  CAS  Google Scholar 

  29. Barbaresko J, Rienks J, Oluwagbemigun K, et al. Dietary patterns associated with inflammatory biomarkers in a Northern German population. Eur J Nutr. 2020;59(4):1433–1441

    Article  CAS  Google Scholar 

  30. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med. 2011;364(25):2392–2404

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the National Natural Science Foundation of China (82073651), Anhui Provincial Natural Science Foundation (2008085MH262 and 2108085QH357), Anhui Provincial Education Department (gxyqZD2021099), and grants from Anhui Medical University (XJ201935, 2020lcxk033, and 2021xkjT007). The funding agency had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding

This work was supported by the National Natural Science Foundation of China (82073651), Anhui Provincial Natural Science Foundation (2008085MH262 and 2108085QH357), Anhui Provincial Education Department (gxyqZD2021099), and grants from Anhui Medical University (XJ201935, 2020lcxk033, and 2021xkjT007).

Author information

Author notes

  1. Xiude Li, Tengfei Zhang and Haowei Li have contributed equally as co-first authors.

  2. Wanshui Yang and Yanan Ma have contributed equally as co-senior authors.

Authors and Affiliations

  1. Department of Nutrition, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China

    Xiude Li, Tengfei Zhang, Haowei Li, Zhihao Zhou, Meiling Li, Xueke Zeng, Hu Yang, Mingyi Zhang, Yong Huang, Yu Zhu, Zhuang Zhang & Wanshui Yang

  2. Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, Anhui, China

    Xiude Li & Wanshui Yang

  3. NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China

    Xiude Li & Wanshui Yang

  4. Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, Anhui, China

    Xiude Li & Wanshui Yang

  5. Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China

    Yanan Ma

Authors
  1. Xiude Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tengfei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haowei Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhihao Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meiling Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xueke Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mingyi Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yong Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yu Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Zhuang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yanan Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Wanshui Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

XL, TZ, and HL had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: WY and XL. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: XL and WY. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: XL, TZ, and HL. Obtained funding: WY. Administrative, technical, or material support: WY. Study supervision: WY.

Corresponding authors

Correspondence to Yanan Ma or Wanshui Yang.

Ethics declarations

Conflict of interest

Xiude Li, Tengfei Zhang, Haowei Li, Zhihao Zhou, Meiling Li, Xueke Zeng, Hu Yang, Mingyi Zhang, Yong Huang, Yu Zhu, Zhuang Zhang, Yanan Ma and Wanshui Yang declare that they have no conflict of interest.

Ethics approval

The NCHS Research Ethics Review Board approved the NHANES study protocols (Protocol #2011–17; Protocol #2018–01).

Animal research

This was not animal research.

Consent to participate

The written informed consent was obtained from all the participants.

Consent for publication

All the authors consented the publish work.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 193 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, X., Zhang, T., Li, H. et al. Associations between intake of starchy and non-starchy vegetables and risk of hepatic steatosis and fibrosis. Hepatol Int 16, 846–857 (2022). https://doi.org/10.1007/s12072-022-10368-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12072-022-10368-x

Keywords

Search

Navigation