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Dietary flavonoid intakes are associated with lower risk of NAFLD: a UK biobank study

Published online by Cambridge University Press:  16 December 2024

W. Bell ,
A. Jennings ,
A.S. Thompson ,
N.P. Bondonno ,
A. Tresserra-Rimbau ,
T. Kühn  and
A. Cassidy
W. Bell
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
A. Jennings
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
A.S. Thompson
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
N.P. Bondonno
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK Danish Cancer Institute, Copenhagen, Denmark Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
A. Tresserra-Rimbau
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK Department of Nutrition, Food Science and Gastronomy, XIA, School of Pharmacy and Food Sciences, INSA, University of Barcelona, 08921 Barcelona, Spain Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
T. Kühn
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK Department of Nutritional Sciences, University of Vienna, Vienna, Austria Center for Public Health, Medical University of Vienna, Vienna, Austria
A. Cassidy
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
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Abstract

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Mechanistic studies and short-term randomised trials suggest that higher intakes of dietary flavonoids may protect against non-alcoholic fatty liver disease (NAFLD)(1–3). However, little research has been conducted at a population level, and to date no long term prospective study has assessed the associations between flavonoid intakes and NAFLD risk(4). We aim to perform the first population-based study with long-term follow-up on flavonoid consumption and NAFLD incidence.

In a prospective study, we assessed the associations between flavonoid intakes based on ≥2 24hour dietary assessments and NAFLD risk among 121,563 adults aged 40 to 69 years by multivariable regression analyses. Flavonoid intakes were assessed on three levels: a novel flavodiet score (FDS), flavonoid rich foods, and flavonoid subclasses. Cox proportional hazard models were used to assess NAFLD risk, and linear trend tests were used to test for significance. Additional sensitivity analysis was conducted using both a FDS excluding red wine, and non flavonoid containing equivalent foods as negative controls.

Over 10 years of follow-up, 1090 cases of NAFLD were observed. When compared to the lowest Quartile, the highest quartile (Q4) of the Flavodiet Score (FDS) was associated with a 20% lower risk of NAFLD (HR (95%CI): 0.80 (0.66−0.96), P trend=0.02). Additionally, higher apple intake was associated with a 22% lower risk of NAFLD (HR (95%CI): 0.78 (0.66 - 0.92), P trend=<0.01), while higher tea consumption was associated with a 13% lower risk of NAFLD (HR (95%CI): 0.87 (0.73 -1.03), P trend=0.046). Of the flavonoid subclasses, we observed that higher intakes of proanthocyanidins, theaflavins and thearubigins, flavonols and flavan-3-ols were also associated with lower risk.

In a large UK cohort, we demonstrate for the first time that flavonoid-rich diets, containing approximately 6-servings of flavonoid rich food per day, are associated with lower risk of NAFLD. As such, the consumption of flavonoid-rich foods may reduce the risk of NAFLD and its sequalae among middle-aged adults.

Type
Abstract
Information
Proceedings of the Nutrition Society , Volume 83 , Issue OCE4: Nutrition Society Congress 2024, 2–5 July 2024 , November 2024 , E418
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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