(PO22-43-22) Association of Sugar-Sweetened Beverages, Low/No-Calorie Beverages and Fruit Juice Intakes With Non-alcoholic Fatty Liver Disease: The SWEET Project

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Presenting Author(s)

Novita Naomi, M.Sc
– PhD Candidate, Division of Human Nutrition and Health, Wageningen University, Wageningen, Gelderland, Netherlands

Co-Author(s)

JN

Joy Ngo, MPH
– Nutrition Research Foundation, Barcelona, Spain
EB

Elske Brouwer-Brolsma, Ph.D.
– Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands, Wageningen, Gelderland, Netherlands
Marion Buso, M.Sc.
– PhD candidate, Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands, Wageningen, Gelderland, Netherlands
SS

Sabita Soedamah-Muthu, Ph.D
– Center of Research on Psychological and Somatic disorders (CORPS) Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands, Tilburg, Noord-Brabant, Netherlands
CP

Carmen Pérez-Rodrigo, Ph.D
– Nutrition Research Foundation, Barcelona, Spain
AR

Anne Raben, Ph.D
– professor, Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark, Frederiksberg, Hovedstaden, Denmark
JH

Jo Harrold, Ph.D
– Appetite and Obesity Research Group, Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom, Liverpool, England, United Kingdom
JH

Jason C. Halford
– University of Liverpool, Department of Psychology; University of Leeds, School of Psychology
LS

Lluis Serra-Majem, MD PhD
– Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canarias, Spain
MG

Marianne Geleijnse, PhD
– Professor, Wageningen University, Wageningen, Gelderland, Netherlands
EF

Edith Feskens, Ph.D
– Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands, Wageningen, Gelderland, Netherlands

Disclosure(s):

Novita D. Naomi, M.Sc: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Examine associations between the intake of sugar-sweetened beverages (SSB), low/no-calorie beverages (LNCB), and fruit juice (FJ) and non-alcoholic fatty liver (NAFLD) in 4 population-based studies included in the SWEET project.

Methods: Data of 42,024 participants from the Lifelines Cohort Study (LCS), NQPlus, PREDIMED-Plus and the Alpha Omega Cohort (AOC) were cross-sectionally analyzed. Dietary intake was assessed using food frequency questionnaires. NAFLD was assessed using the Fatty Liver Index (≥60). Restricted cubic spline analyses were used to visualize dose-response associations in LCS. Multivariate Cox proportional hazard regression analyses with robust variance were performed for the associations with NAFLD (prevalence ratio [PR]) in all cohorts and linear regression analyses were conducted for the associations with its markers (triglycerides, gamma-glutamyl transferase, aspartate aminotransferase and alanine aminotransferase). Models were adjusted for demographic, lifestyle, and dietary factors. Results of different cohorts were pooled using random-effects meta-analysis.

Results: NAFLD prevalence was 22% in LCS and NQplus, 60% in AOC and 78% in PREDIMED-Plus. Each additional serving/day of SSB was associated with a 7% higher NAFLD prevalence (PR 1.07, 95%CI 1.03-1.10). For LNCB, dose-response analyses showed evidence for a nonlinear association with NAFLD i.e., a sharp increase at intake ≤1 serving/day and more gradual at higher intake levels. The intake of >2 LNCB servings/week was positively associated with NAFLD (PR 1.38, 95%CI 1.15-1.60, ref: non-consumers), which disappeared after adjustment for BMI (PR 1.04, 95%CI 0.94-1.14). A J-shaped association was observed between FJ and NAFLD with an inverse association for intakes of >0-2 servings/week (PR 0.92, 95%CI: 0.88-0.96), but not for higher intakes, compared to no intake. Modest positive associations were observed between all beverages and most NAFLD clinical markers.

Conclusions: Pooling results across 4 studies showed that SSB and LNCB were associated with higher NAFLD prevalence and the majority of its markers. A J-shaped association was observed between FJ and NAFLD, suggesting lower prevalence at medium intakes.

Funding Sources: The SWEET project has received funding from the European Union’s Horizon 2020 research and innovation program.