A recent BMC Medicine study investigates the association between a plant-based food plan and genetic predisposition with the chance of non-alcoholic fatty liver disease (NAFLD).

Study: Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease. Image Credit: zarzamora / Shutterstock.com

Background

NAFLD is amongst essentially the most common chronic liver disorders, affecting around 32.4% of adults worldwide. In the UK, one in every three people is diagnosed with NAFLD.

NAFLD occurs as a consequence of an interaction between environmental and genetic aspects. The truth is, several studies have shown that food plan is a modifiable risk factor for NAFLD.

A better consumption of plant-based foods reduces the chance of NAFLD and liver fat content; nevertheless, not all plant-based foods are helpful for NAFLD. For instance, the consumption of refined grains, sugar-sweetened beverages, and fruit juices increases the chance of NAFLD.

A lot of the studies correlating these food products with NAFLD risk included a small sample size, which limits the understanding of the particular effectiveness of this food plan on NAFLD risk. Thus, there may be a necessity for extensive population-based studies to grasp what kind of plant-based food plan can reduce the chance of NAFLD.

Although multiple NAFLD-associated loci have been identified in genomic studies, no studies have assessed the interaction between genetic predisposition and food plan patterns that will influence the chance of NAFLD.

In regards to the study

The present longitudinal study investigates the connection between plant-based food plan index (PDI) and NAFLD risk and whether this association is influenced by genetic aspects.

All relevant data were obtained from the U.K. Biobank, comprising over 500,000 participants from England, Scotland, and Wales between the ages of 37 and 73. The present study included participants who underwent a minimum of one dietary assessment and excluded those diagnosed with NAFLD, cirrhosis, or other liver diseases.

Individuals diagnosed with alcohol-related problems were also excluded. Participants with incomplete genetic data or not of European descent weren’t considered on this study. 

Data related to the dietary patterns of the chosen participants from the U.K. Biobank were obtained using the Oxford WebQ, a 24-hour dietary recall questionnaire.

Different food types were categorized into seventeen groups, which were sub-classified into three larger categories, including healthy plant-based food, less healthy plant-based food, and animal-based food. Overall PDI, healthful plant-based food plan index (hPDI), and unhealthful plant-based food plan index (uPDI) were estimated using the study cohort.

Study findings

A complete of 159,222 participants were included within the NAFLD risk analyses and 20,692 in liver fat content analyses. The mean age of the participants was 58 years, and about 58% of the cohort was female.

The general PDI ranged between 25 and 74, hPDI ranged between 27 and 82, and uPDI ranged between 27 and 78. Female, educated, non-current smokers, and non-obese participants were likelier to have the next overall PDI and hPDI but lower uPDI.

Liver fat content was assessed based on magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) data. A greater consumption of PDI, particularly nPDI, was related to lower NAFLD risk and liver fat content. Comparatively, higher uPDI was linked to a greater risk of NAFLD and liver fat content.

Improved food plan quality, which a Mediterranean food plan rating could represent, influenced the genetic risk of NAFLD on the liver fat content increase. The study findings highlight that PDIs might mediate NAFLD genetic risk.

A major multiplicative interaction between PDIs and NAFLD-polygenic risk rating (PRS) was noted, which increased the chance of NAFLD in those with an hPDI in a sex-specific manner.

Consumption of nuts, tea, and occasional was related to a reduced risk of NAFLD. Consistent with previous reports, the next intake of hPDI significantly increases the ingestion of flavonoids, dietary fibers, caffeine, phytosterols, and plant proteins. This elevated amount of phytoconstituents results in improved insulin resistance, gut microbiome composition, and decreased central obesity, which significantly reduces the chance of NAFLD.

Conclusions

The present longitudinal study has some limitations, including a dietary assessment based on 24-hour recall, which is subjected to bias and misclassification. Moreover, limited data on long-term dietary habits was available. Since this study only included European participants, the generalizability of the findings was limited.

Despite these limitations, the present study reported the interplay between genetic aspects and PDIs, which influenced NAFLD risks. Higher hPDI food consumption reduced the chance of NAFLD, regardless of genetic susceptibility, which is comparable to higher uPDI, which increased the chance of NAFLD.

The study findings emphasize the importance of adhering to a healthy plant-based food plan to scale back the chance of NAFLD in your complete population, regardless of genetic susceptibilities.

Journal reference:

• Lv, Y., Rong, S., Deng, Y., et al. (2023) Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease. BMC Medicine 21(351). doi:10.1186/s12916-023-03028-w