Background & Aims
Non-alcoholic fatty liver disease affects ∼30% of US adults, yet the role of sugar-sweetened
beverages and diet soda on these diseases remains unknown. We examined the cross-sectional
association between intake of sugar-sweetened beverages or diet soda and fatty liver
disease in participants of the Framingham Offspring and Third Generation cohorts.
Methods
Fatty liver disease was defined using liver attenuation measurements generated from
computed tomography in 2634 participants. Alanine transaminase concentration, a crude
marker of fatty liver disease, was measured in 5908 participants. Sugar-sweetened
beverage and diet soda intake were estimated using a food frequency questionnaire.
Participants were categorized as either non-consumers or consumers (3 categories:
1 serving/month to <1 serving/week, 1 serving/week to <1 serving/day, and ⩾1 serving/day)
of sugar-sweetened beverages or diet soda.
Results
After adjustment for age, sex, smoking status, Framingham cohort, energy intake, alcohol,
dietary fiber, fat (% energy), protein (% energy), diet soda intake, and body mass
index, the odds ratios of fatty liver disease were 1, 1.16 (0.88, 1.54), 1.32 (0.93,
1.86), and 1.61 (1.04, 2.49) across sugar-sweetened beverage consumption categories
(p trend = 0.04). Sugar-sweetened beverage consumption was also positively associated with alanine
transaminase levels (p trend = 0.007). We observed no significant association between diet soda intake and measures
of fatty liver disease.
Conclusion
In conclusion, we observed that regular sugar-sweetened beverage consumption was associated
with greater risk of fatty liver disease, particularly in overweight and obese individuals,
whereas diet soda intake was not associated with measures of fatty liver disease.
Abbreviations:
ALT (alanine transaminase), FFQ (food frequency questionnaire), LPR (liver to phantom ratio), MDCT (multidetector computed tomography), NAFLD (nonalcoholic fatty liver disease), SAT (abdominal subcutaneous adipose tissue), SSB (sugar-sweetened beverage), VAT (visceral adipose tissue)Keywords
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Article info
Publication history
Published online: June 05, 2015
Accepted:
March 27,
2015
Received in revised form:
March 1,
2015
Received:
November 9,
2014
See Editorial, pages 306–308Identification
Copyright
© 2015 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
