Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 16;21(1):444.
doi: 10.1186/s12916-023-03135-8.

Associations between types and sources of dietary carbohydrates and liver fat: a UK Biobank study

Josefina Orliacq  1   2 , Aurora Pérez-Cornago  2 , Siôn A Parry  3   4 , Rebecca K Kelly  2   5 , Dimitrios A Koutoukidis  6 , Jennifer L Carter  7
Affiliations

Associations between types and sources of dietary carbohydrates and liver fat: a UK Biobank study

Josefina Orliacq et al. BMC Med. .

Abstract

Background and aims: Excess energy intake can lead to metabolic dysfunction-associated steatotic liver disease (MASLD), but the relationship between dietary carbohydrate intake and liver fat content remains unclear. This study aimed to examine the associations between types and sources of dietary carbohydrates and liver fat content.

Methods: UK Biobank participants with no pre-existing diabetes, liver disease or cardiovascular disease reported dietary intake of types and sources of carbohydrates (total carbohydrates, free sugars, non-free sugars, starch from whole grains, starch from refined grains, and fibre) on at least two 24-h dietary assessments. In cross-sectional analyses, (n = 22,973), odds ratios (OR) of high liver fat content (defined as a score of ≥ 36 in the hepatic steatosis index) by quintiles of carbohydrate intakes were estimated using multivariable logistic regression models. In prospective analyses, a second sample (n = 9268) had liver proton density fat fraction (PDFF) measured by magnetic resonance imaging (2014-2020). Multivariable linear regression models estimated geometric means of PDFF (%) by quintiles of carbohydrate intakes. Models were adjusted for demographic and lifestyle confounders, including total energy intake.

Results: In the cross-sectional analyses, 6894 cases of high liver fat content were identified. Inverse associations between intakes of fibre (OR of highest vs. lowest quintile 0.46 [95% CI: 0.41-0.52]), non-free sugars (0.63 [0.57-0.70]) and starch from whole grains (0.52 [0.47-0.57]) with liver fat were observed. There were positive associations between starch from refined grains and liver fat (1.33 [1.21-1.46]), but no association with free sugars (p=0.61). In prospective analyses, inverse associations with PDFF (%) were observed for intakes of fibre (- 0.48 geometric mean difference between highest and lowest quintile of intake [- 0.60 to - 0.35]), non-free sugars (- 0.37 [- 0.49 to - 0.25]) and starch from whole grains (- 0.31 [- 0.42 to - 0.19]). Free sugars, but not starch from refined grains, were positively associated with PDFF (0.17 [0.05 to 0.28]).

Conclusion: This study suggests that different carbohydrate types and sources have varying associations with liver fat, which may be important for MASLD prevention. Non-free sugars, fibre, and starch from whole grains could be protective, while associations with free sugars and starch from refined grains are less clear.

Keywords: Carbohydrate quality; Dietary carbohydrates; Fibre intake; Hepatic steatosis; MASLD; Non-alcoholic fatty liver.

PubMed Disclaimer

Conflict of interest statement

DAK has been the chief investigator in two publicly funded (NIHR) trials where the weight loss intervention was donated by Nestle Health Sciences to the University of Oxford outside the submitted work. The other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Cross-sectional results (N = 22,973). Odds ratio of steatosis, defined as ≥36 HSI score. Results from logistic regression models, adjusted by age, sex, ethnicity, deprivation, education, smoking status, physical activity, alcohol intake, total energy intake and PUFA:SFA ratio
Fig. 2
Fig. 2
Prospective analyses (n = 9268). Geometric mean difference in liver fat between the highest (Q5) and lowest quintile (Q1) of dietary intake of carbohydrate types and sources. Results from fully adjusted linear regression models, controlling for age, sex, ethnicity, deprivation, education, region, smoking status, physical activity, alcohol intake, PUFA/SFA ratio, and body mass index
See this image and copyright information in PMC

References

    1. Younossi Z, Tacke F, Arrese M, Chander Sharma B, Mostafa I, Bugianesi E, et al. Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatology. 2019;69(6):2672–82. doi: 10.1002/hep.30251. - DOI - PubMed
    1. Paik JM, Golabi P, Younossi Y, Mishra A, Younossi ZM. Changes in the global burden of chronic liver diseases from 2012 to 2017: the growing impact of NAFLD. Hepatology. 2020;72(5):1605–16. doi: 10.1002/hep.31173. - DOI - PubMed
    1. Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: an international expert consensus statement. J Hepatol. 2020;73(1):202–9. doi: 10.1016/j.jhep.2020.03.039. - DOI - PubMed
    1. Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, et al. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. 2023. - PubMed
    1. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797–835. doi: 10.1097/HEP.0000000000000323. - DOI - PMC - PubMed

Publication types