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Zhang Y, Di H, Wu J, Wang X, Han X, Zhang B, Zeng X. Assessment of the correlation between KAP scores regarding sugar-sweetened beverage consumption and hyperuricemia amongst Chinese young adults. BMC Public Health 2024; 24:1074. [PMID: 38632558 PMCID: PMC11025163 DOI: 10.1186/s12889-024-18513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The prevalence of hyperuricemia in China has been consistently increasing, particularly among the younger generation. The excessive consumption of sugar-sweetened beverages is associated with hyperuricemia. This study examined the knowledge, attitudes, and practices (KAP) of Chinese young adults regarding sugar-sweetened beverage consumption and the correlation with hyperuricemia. METHODS This cross-sectional investigation was conducted from June 28th, 2023, to July 21st, 2023, and enrolled Chinese young adults. Demographics and KAP were evaluated using a questionnaire (Cronbach's α = 0.787). Factors influencing KAP scores were analyzed using multivariable analyses. RESULTS A total of 1288 valid questionnaires were analyzed. The median knowledge, attitude, and practice scores were 16 (12,19)/22, 22 (20,24)/30, and 27.5 (23,31.75)/40. The multivariable analysis showed that bachelor's/associate education (OR = 1.912, 95%CI: 1.128-3.239), white collar/employee (OR = 0.147, 95%CI: 0.105-0.206), educator (OR = 0.300, 95%CI: 0.174-0.518), healthcare worker (OR = 0.277, 95%CI: 0.188-0.407), not suffering from hyperuricemia (OR = 0.386, 95%CI: 0.253-0.590), and not having gout (OR = 0.456, 95%CI: 0.282-0.736) were independently associated with knowledge. Age 26-30 (OR = 1.470, 95%CI: 1.052-2.052), age 31-35 (OR = 1.489, 95%CI: 1.097-2.022), age 36-40 (OR = 0.328, 95%CI: 1.010-1.746), age 41-44 (OR = 1.548, 95%CI: 1.091-2.198), and not having hyperuricemia (OR = 0.512, 95%CI: 0.345-0.760) were independently associated with attitude. White collar/employee (OR = 0.386, 95%CI: 0.285-0.521), educator (OR = 0.534, 95%CI: 0.317-0.899), healthcare worker (OR = 0.341, 95%CI: 0.236-0.493), having siblings (OR = 0.725, 95%CI: 0.573-0.917), and not suffering from hyperuricemia (OR = 0.442, 95%CI: 0.296-0.659), were independently associated with practice. CONCLUSION Chinese young adults display moderate KAP toward sugar-sweetened beverages. Notably, an association was observed between hyperuricemia and each KAP dimension.
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Affiliation(s)
- Yun Zhang
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Hong Di
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Juan Wu
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Xiaoxue Wang
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Xinxin Han
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Bingqing Zhang
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Xuejun Zeng
- Department of Family Medicine, Division of General Internal Medicine, Department of Medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
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Genetic Risk, Adherence to a Healthy Lifestyle, and Hyperuricemia: The TCLSIH Cohort Study. Am J Med 2023; 136:476-483.e5. [PMID: 36708795 DOI: 10.1016/j.amjmed.2023.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Genetic factors have been associated with hyperuricemia in large studies, but the extent to which this can be offset by a healthy lifestyle is unknown. This study aimed to examine whether healthy lifestyle could reduce hyperuricemia risk among individuals with different genetic profiles. METHODS We defined a lifestyle score using body mass index, smoking, alcohol consumption, physical activities, and diets in 2796 unrelated individuals from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Polygenic risk scores (PRS) were constructed based on uric acid loci. Associations of combined lifestyle factors and genetic risk and incident hyperuricemia were estimated using Cox proportional hazard regression. RESULTS Of 2796 individuals, 747 participants (26.7%) developed hyperuricemia. Genetic risk and lifestyle were predictors of incident events, and they showed an interaction for the outcome. Compared with high PRS, low PRS reduced risk of incident hyperuricemia by 40%, and compared with unhealthy lifestyle, healthy lifestyle reduced risk of incident hyperuricemia by 41%. Compared with unhealthy lifestyle and high genetic risk, adherence to healthy lifestyle was associated with a 68% (95% confidence interval, 44%-81%) lower risk of hyperuricemia among those at a low genetic risk. CONCLUSIONS In this prospective cohort study, we observed an interaction between genetics and lifestyle and the risk of hyperuricemia. The public health implication is that a healthy lifestyle is important for hyperuricemia prevention, especially for individuals with high genetic risk scores.
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Feng M, Chitrakar B, Chen J, Islam MN, Wei B, Wang B, Zhou C, Ma H, Xu B. Effect of Multi-Mode Thermosonication on the Microbial Inhibition and Quality Retention of Strawberry Clear Juice during Storage at Varied Temperatures. Foods 2022; 11:foods11172593. [PMID: 36076780 PMCID: PMC9455229 DOI: 10.3390/foods11172593] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
Strawberry juice, which is rich in nutrients and charming flavor, is favored by consumers. To explore whether multi-mode thermosonication (MTS) can ensure the quality stability of strawberry clear juice (SCJ) during storage, the effects of microbial inhibition, enzyme activity, and physicochemical properties of SCJ pretreated by MTS were evaluated during storage at 4, 25, and 37 °C in comparison with thermal pretreatment (TP) at 90 °C for 1 min. The MTS, including dual-frequency energy-gathered ultrasound pretreatment (DEUP) and flat sweep-frequency dispersive ultrasound pretreatment (FSDUP), were conducted at 60 °C for 5 and 15 min, respectively. Results showed that the total phenols, flavonoids, anthocyanins, ascorbic acid, and DPPH free radical scavenging ability of SCJ decreased during the storage period. The control sample of SCJ was able to sage for only 7 days at 4 °C based on the microbiological quality, while the FSDUP and DEUP group extended the storage period up to 21 and 14 days, respectively. The polyphenol oxidase in SCJ pretreated by MTS did not reactivate during the storage period. The MTS remarkably (p < 0.05) reduced the color deterioration, browning degree, and nutrient degradation during the storage period. Moreover, the FSDUP group exhibited the maximum shelf life with a minimum loss of quality, demonstrating that it was the most suitable processing method for obtaining high-quality SCJ. It can be concluded that the MTS has the potential to inhibit enzymatic browning, inactivating microorganisms, preserve original quality attributes, and prolong the shelf life of SCJ.
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Affiliation(s)
- Min Feng
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
- Institute of Food Physical Processing, Jiangsu University, Zhenjiang 212013, China
| | - Bimal Chitrakar
- College of Food Science and Technology, Hebei Agricultural University, Baoding 071001, China
| | - Jianan Chen
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Md. Nahidul Islam
- Department of Agro-Processing, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur 1706, Bangladesh
| | - Benxi Wei
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Bo Wang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Cunshan Zhou
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Haile Ma
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
- Institute of Food Physical Processing, Jiangsu University, Zhenjiang 212013, China
| | - Baoguo Xu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
- Institute of Food Physical Processing, Jiangsu University, Zhenjiang 212013, China
- Correspondence: ; Fax: +86-(0)511-88780201
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Zhang T, Rayamajhi S, Meng G, Zhang Q, Liu L, Wu H, Gu Y, Wang Y, Zhang S, Wang X, Zhang J, Li H, Thapa A, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K. Dietary patterns and risk for hyperuricemia in the general population: Results from the TCLSIH cohort study. Nutrition 2021; 93:111501. [PMID: 34717108 DOI: 10.1016/j.nut.2021.111501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/04/2021] [Accepted: 09/19/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Prospective cohort studies linking dietary patterns and hyperuricemia (HUA) are limited, especially in Asian populations. The aim of this study was to prospectively investigate the association between various dietary patterns and risk for HUA in a general adult population. METHOD We used data from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study of 20 766 men and women who were free from HUA, cancer, and cardiovascular disease at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated 81-item food frequency questionnaire. HUA was defined as serum uric acid levels >420 μmol/L in men and >350 μmol/L in women. Cox proportional hazards regression models were used to examine the association of dietary patterns with incident HUA. RESULTS In all, 4389 first incident cases of HUA occurred during 73 822 person-years of follow-up (median follow-up of 4.2 y). Three main dietary patterns were extracted. They were the vegetable, sweet food, and animal food patterns. After adjusting for demographic characteristics, lifestyle factors, other dietary pattern scores, and inflammatory markers, comparing the highest with the lowest quartiles of dietary pattern scores, the multivariable hazard ratios (95% confidence interval) of HUA were 0.79 (0.72-0.87; Ptrend < 0.0001) for the vegetable pattern, 1.22 (1.12-1.33; Ptrend < 0.0001) for the sweet food pattern, and 1.24 (1.13-1.37; Ptrend < 0.0001) for the animal food pattern. CONCLUSIONS Dietary patterns rich in animal or sweet foods were positively associated with a higher risk for HUA, whereas the vegetable pattern was negatively associated.
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Affiliation(s)
- Tingjing Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Sabina Rayamajhi
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yawen Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Juanjuan Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Huiping Li
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Amrish Thapa
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.
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Siqueira JH, Pereira TSS, Velasquez-Melendez G, Barreto SM, Benseñor IM, Mill JG, Molina MCB. Sugar-sweetened soft drinks consumption and risk of hyperuricemia: Results of the ELSA-Brasil study. Nutr Metab Cardiovasc Dis 2021; 31:2004-2013. [PMID: 34119374 DOI: 10.1016/j.numecd.2021.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS The prospective association between sugar-sweetened beverages consumption and hyperuricemia is controversial. The aim was to investigate the association of the consumption of sugar-sweetened soft drinks and unsweetened fruit juices with the incidence of hyperuricemia and the levels of serum uric acid in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS AND RESULTS Longitudinal analysis in ELSA-Brasil participants (baseline 2008-2010 and follow-up 2012-2014). The sample consisted of 10,072 civil servants (35-74 years, both sexes). The consumption of beverages estimated by a food frequency questionnaire (baseline) was divided into five categories: nonconsumption and quartiles (≥0.1 mL/day). Hyperuricemia was defined as uric acid ≥7.0 mg/dL (men) and ≥5.7 mg/dL (women). Poisson regression with robust variance and multiple linear regression were tested. The average consumption of soft drinks was 84 ± 191 mL/day in men and 42 ± 128 mL/day in women. After 4 years of follow-up, the higher consumption of soft drinks (men: 401 ± 303 mL/day; women: 390 ± 290 mL/day) increased the relative risk of hyperuricemia by 30% (men) and 40% (women), and was associated with increased mean uric acid (men: β = 0.14 mg/dL; 95% CI 0.41-0.24; women: β = 0.11 mg/dL; 95% CI 0.00-0.21). The consumption of unsweetened juice was not associated with hyperuricemia. CONCLUSION High consumption of sugar-sweetened soft drinks is associated with an increased relative risk of hyperuricemia and elevated serum uric acid levels in Brazilian adults.
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Affiliation(s)
- Jordana H Siqueira
- Postgraduate Program in Public Health, Federal University of Espírito Santo, ES, Brazil
| | - Taísa S S Pereira
- Health Sciences Department, Universidad de las Américas Puebla, Cholula, Puebla, Mexico
| | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sandhi M Barreto
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isabela M Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - José G Mill
- Postgraduate Program in Public Health, Federal University of Espírito Santo, ES, Brazil
| | - Maria C B Molina
- Postgraduate Program in Public Health, Federal University of Espírito Santo, ES, Brazil.
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Wang YZ, Zhou C, Zhu LJ, He XLS, Li LZ, Zheng X, Xu WF, Dong YJ, Li B, Yu QX, Lv GY, Chen SH. Effects of Macroporous Resin Extract of Dendrobium officinale Leaves in Rats with Hyperuricemia Induced by Fructose and Potassium Oxonate. Comb Chem High Throughput Screen 2021; 25:1294-1303. [PMID: 34053424 DOI: 10.2174/1386207324666210528114345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/09/2021] [Accepted: 04/04/2021] [Indexed: 11/22/2022]
Abstract
AIM AND OBJECTIVE Fructose, as a ubiquitous monosaccharide, can promote ATP consumption and elevate circulating uric acid (UA) levels. Our previous studies confirmed that the macroporous resin extract of Dendrobium officinale leaves (DoMRE) could reduce the UA level of rats with hyperuricemia induced by a high-purine diet. This study aimed to investigate whether DoMRE had a UA-lowering effect on rats with hyperuricemia caused by fructose combined with potassium oxonate, so as to further clarify the UA-lowering effect of DoMRE, and to explore the UA-lowering effect of DoMRE on both UA production and excretion. MATERIALS AND METHODS Rats with hyperuricemia induced by fructose and potassium oxonate were administered with DoMRE and vehicle control, respectively, to compare the effects of the drugs. At the end of the experiment, the serum uric acid (SUA) and creatinine (Cr) levels were measured using an automatic biochemical analyzer, the activities of xanthine oxidase (XOD) were measured using an assay kit, and the protein expression of urate transporter 1 (URAT1), glucose transporter 9 (GLUT9), and ATP-binding cassette superfamily G member 2 (ABCG2) were assessed using immunohistochemical and western blot analyses. Hematoxylin and eosin staining was used to assess the histological changes in the kidney, liver, and intestine. RESULTS Rats with hyperuricemia were induced by fructose and potassiumFructose and potassium induced hyperuricemia in rats. Meanwhile, the activities of XOD were markedly augmented, the expression of URAT1 and GLUT9 was promoted, and the expression of ABCG2 was reduced, which were conducive to the elevation of UA. However, exposure to DoMRE reversed these fructose- and potassium oxonate-induced negative alternations in rats. The activities of XOD were recovered to the normal level, reducing UA formation; the expression of URAT1, ABCG2, and GLUT9 returned to the normal level, resulting in an increase in renal urate excretion. CONCLUSION DoMRE reduces UA levels in rats with hyperuricemia induced by fructose combined with potassium oxonate by inhibiting XOD activity and regulating the expression of ABCG2, URAT1, and GLUT9. DoMRE is a potential therapeutic agent for treating hyperuricemia through inhibiting UA formation and promoting UA excretion.
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Affiliation(s)
- Yu-Zhi Wang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Cong Zhou
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Li-Jie Zhu
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Xing-Li-Shang He
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Lin-Zi Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Xiang Zheng
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Wan-Feng Xu
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Ying-Jie Dong
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Bo Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
| | - Qiao-Xian Yu
- Zhejiang Senyu Co., Ltd, Yiwu, Zhejiang, 322099, China
| | - Gui-Yuan Lv
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
| | - Su-Hong Chen
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, China
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Zhang S, Gu Y, Bian S, Lu Z, Zhang Q, Liu L, Meng G, Yao Z, Wu H, Wang Y, Zhang T, Wang X, Sun S, Wang X, Zhou M, Jia Q, Song K, Qi L, Niu K. Soft drink consumption and risk of nonalcoholic fatty liver disease: results from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study. Am J Clin Nutr 2021; 113:1265-1274. [PMID: 33564868 DOI: 10.1093/ajcn/nqaa380] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Epidemiological evidence for the association of soft drink consumption with nonalcoholic fatty liver disease (NAFLD) is inconsistent, and such association has not been prospectively examined in the general adult population. OBJECTIVES We aimed to investigate the prospective association between soft drink consumption and the risk of NAFLD in a Chinese adult population. METHODS This prospective cohort study investigated 14,845 participants [mean age: 39.3 y; 6203 (41.8%) men] who were free of liver disease, cardiovascular disease, and cancer at baseline. Soft drink consumption (mainly sugar-containing carbonated beverages) was measured at baseline using a validated FFQ. NAFLD was diagnosed based on abdominal ultrasound without significant alcohol consumption and other causes of liver disease. Hepatic steatosis index (HSI) was calculated based on sex, BMI, and blood transaminase levels. Cox proportional hazards regression models were used to examine the association of soft drink consumption with incident NAFLD. RESULTS A total of 2888 first-incident cases of NAFLD occurred during 42,048 person-years of follow-up (median follow-up: 4.2 y). After adjusting for demographic characteristics, lifestyle factors, dietary intake, and inflammatory markers, the multivariable HRs (95% CIs) for incident NAFLD were 1.00 (reference) for <1 serving/wk, 1.18 (1.03, 1.34) for 1 serving/wk, 1.23 (1.08, 1.40) for 2-3 servings/wk, and 1.47 (1.25, 1.73) for ≥4 servings/wk, respectively (P for trend < 0.0001). Further sensitivity analysis showed that the corresponding multivariable HRs (95% CIs) for incident HSI-defined NAFLD were 1.00 (reference), 0.96 (0.70, 1.31), 1.16 (0.83, 1.62), and 1.59 (1.07, 2.37), respectively (P for trend < 0.0001). CONCLUSIONS The results from our prospective study indicate that soft drink consumption is associated with an increased risk of NAFLD in Chinese adults. This study was registered at UMIN Clinical Trials Registry as UMIN000027174.
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Affiliation(s)
- Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Shanshan Bian
- Department of Nutrition, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zuolin Lu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhanxin Yao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Institute of Environmental and Operational Medicine, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yawen Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tingjing Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Lu Qi
- 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
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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