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Added sugar intake and its forms and sources in relation to risk of non-alcoholic fatty liver disease: results from the Tianjin Chronic Low-grade Systemic Inflammation and Health cohort study

Published online by Cambridge University Press:  26 September 2022

Shunming Zhang ,
Huiping Li ,
Ge Meng ,
Qing Zhang ,
Li Liu ,
Hongmei Wu ,
Yeqing Gu ,
Tingjing Zhang ,
Xuena Wang  and
Juanjuan Zhang
...Show all authors
Shunming Zhang
Affiliation:
Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
Huiping Li
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Ge Meng
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Qing Zhang
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Li Liu
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Hongmei Wu
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Yeqing Gu
Affiliation:
Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
Tingjing Zhang
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Xuena Wang
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Juanjuan Zhang
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Jun Dong
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Xiaoxi Zheng
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Zhixia Cao
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Xu Zhang
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Xinrong Dong
Affiliation:
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China
Shaomei Sun
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Xing Wang
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Ming Zhou
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Qiyu Jia
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Kun Song
Affiliation:
Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
Yan Borné
Affiliation:
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
Emily Sonestedt
Affiliation:
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
Lu Qi*
Affiliation:
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Kaijun Niu*
Affiliation:
Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, People’s Republic of China Health Management Centre, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, People’s Republic of China Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, People’s Republic of China
*
* Corresponding authors: Lu Qi, email lqi1@tulane.edu; Kaijun Niu, email nkj0809@gmail.com
* Corresponding authors: Lu Qi, email lqi1@tulane.edu; Kaijun Niu, email nkj0809@gmail.com
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Abstract

It has been suggested that added sugar intake is associated with non-alcoholic fatty liver disease (NAFLD). However, previous studies only focused on sugar-sweetened beverages; the evidence for associations with total added sugars and their sources is scarce. This study aimed to examine the associations of total added sugars, their physical forms (liquid v. solid) and food sources with risk of NAFLD among adults in Tianjin, China. We used data from 15 538 participants, free of NAFLD, other liver diseases, CVD, cancer or diabetes at baseline (2013–2018 years). Added sugar intake was estimated from a validated 100-item FFQ. NAFLD was diagnosed by ultrasonography after exclusion of other causes of liver diseases. Multivariable Cox proportional hazards models were fitted to calculate hazard ratios (HR) and corresponding 95 % CI for NAFLD risk with added sugar intake. During a median follow-up of 4·2 years, 3476 incident NAFLD cases were documented. After adjusting for age, sex, BMI and its change from baseline to follow-up, lifestyle factors, personal and family medical history and overall diet quality, the multivariable HR of NAFLD risk were 1·18 (95 % CI 1·06, 1·32) for total added sugars, 1·20 (95 % CI 1·08, 1·33) for liquid added sugars and 0·96 (95 % CI 0·86, 1·07) for solid added sugars when comparing the highest quartiles of intake with the lowest quartiles of intake. In this prospective cohort of Chinese adults, higher intakes of total added sugars and liquid added sugars, but not solid added sugars, were associated with a higher risk of NAFLD.

Keywords

Added sugarNon-alcoholic fatty liver diseaseEpidemiologyCohort studyChina
Type
Research Article
Information
British Journal of Nutrition , Volume 129 , Issue 12 , 28 June 2023 , pp. 2094 - 2101
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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