Association of alcohol consumption with prevalence of fatty liver after adjustment for dietary patterns: Cross-sectional analysis of Japanese middle-aged adults.

BACKGROUND & AIMS: Moderate alcohol intake is associated with reduced prevalence or incidence of fatty liver. However, whether or not the association is independent of dietary patterns remains unclear. We aimed to evaluate the cross-sectional association of alcohol intake with fatty liver after accounting for dietary patterns and obesity. METHODS: We assessed 4579 adults aged 30-79 years who participated in routine clinical examinations in St. Luke's International Hospital, Japan (January to March, 2015). We assessed their habitual diet using diet-history questionnaire, estimated alcohol intake, and derived dietary pattern variables using factor analysis. Fatty liver was ascertained using ultrasonography. Linear and U-shaped associations of alcohol intake with fatty liver were evaluated using Poisson regression, and a post hoc analysis was conducted after detecting potential outliers for alcohol intake and excluding them using sex-specific statistics (median plus 2 × interquartile range). RESULTS: Fatty liver was ascertained in 1120 participants (24.5%). Whereas no significant association of alcohol intake with fatty liver was observed when potential outliers of alcohol intake were included (p = 0.25), a significant U-shaped association was observed after excluding the outliers with and without adjustment for dietary patterns (p = 0.003 and 0.02, respectively). The lowest prevalence was estimated when alcohol consumption was approximately 7% of energy, with a prevalence ratio of 0.72 (95% confidence interval = 0.59-0.86) compared to non-drinkers. The association became imprecise and attenuated toward the null after further adjustment for body mass index (p = 0.06). CONCLUSIONS: Alcohol intake showed a U-shaped association with fatty liver prevalence. This association was independent of underlying dietary patterns, while it was sensitive to excessive alcohol intake and obesity status, providing clinical implications for the prevention of fatty liver.This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant numbers 14J11939 and 23240104). JSPS had no role in the design, analysis, or writing of this article

Association of alcohol consumption with prevalence of fatty liver after adjustment for dietary patterns: Cross-sectional analysis of Japanese middle-aged adults.

BACKGROUND & AIMS: Moderate alcohol intake is associated with reduced prevalence or incidence of fatty liver. However, whether or not the association is independent of dietary patterns remains unclear. We aimed to evaluate the cross-sectional association of alcohol intake with fatty liver after accounting for dietary patterns and obesity. METHODS: We assessed 4579 adults aged 30-79 years who participated in routine clinical examinations in St. Luke's International Hospital, Japan (January to March, 2015). We assessed their habitual diet using diet-history questionnaire, estimated alcohol intake, and derived dietary pattern variables using factor analysis. Fatty liver was ascertained using ultrasonography. Linear and U-shaped associations of alcohol intake with fatty liver were evaluated using Poisson regression, and a post hoc analysis was conducted after detecting potential outliers for alcohol intake and excluding them using sex-specific statistics (median plus 2 × interquartile range). RESULTS: Fatty liver was ascertained in 1120 participants (24.5%). Whereas no significant association of alcohol intake with fatty liver was observed when potential outliers of alcohol intake were included (p = 0.25), a significant U-shaped association was observed after excluding the outliers with and without adjustment for dietary patterns (p = 0.003 and 0.02, respectively). The lowest prevalence was estimated when alcohol consumption was approximately 7% of energy, with a prevalence ratio of 0.72 (95% confidence interval = 0.59-0.86) compared to non-drinkers. The association became imprecise and attenuated toward the null after further adjustment for body mass index (p = 0.06). CONCLUSIONS: Alcohol intake showed a U-shaped association with fatty liver prevalence. This association was independent of underlying dietary patterns, while it was sensitive to excessive alcohol intake and obesity status, providing clinical implications for the prevention of fatty liver.This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant numbers 14J11939 and 23240104). JSPS had no role in the design, analysis, or writing of this article

Terminalia bellirica (Gaertn.) Roxb. Extract and Gallic Acid Attenuate LPS-Induced Inflammation and Oxidative Stress via MAPK/NF-κB and Akt/AMPK/Nrf2 Pathways

Excessive oxidative stress plays a critical role in the progression of various diseases. Recently, we showed that Terminalia bellirica (Gaertn.) Roxb. extract (TBE) inhibits inflammatory response and reactive oxygen species (ROS) production in THP-1 macrophages. However, molecular mechanisms underlying anti-inflammatory and antioxidant activities of TBE and its major polyphenolic compounds gallic acid (GA) and ellagic acid (EA) remain unclear. We found that TBE and GA attenuated LPS-induced inflammatory mediator expression, ROS production, and activation of mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) in RAW 264 macrophages. Furthermore, TBE and GA increased antioxidant enzyme expression along with upstream mediators nuclear factor erythroid-2-related factor 2 (Nrf2), Akt, and AMP-activated protein kinase (AMPK). Importantly, knockdown of Nrf2 by siRNA and specific inhibition of Akt and AMPK significantly reduced antioxidant enzyme expression induced by TBE and GA. Finally, in vivo effects on histopathology and gene expression were assessed in tissues collected after intraperitoneal injection of LPS with or without TBE treatment. TBE enhanced antioxidant enzyme expression and improved acute kidney injury in LPS-shock model mice. In conclusion, TBE and GA exert protective effects against inflammation and oxidative stress by suppressing MAPK/NF-κB pathway and by activating Akt/AMPK/Nrf2 pathway. These results suggest that TBE and GA might be effective for the treatment of inflammation-related diseases

Association of Hours of Paid Work with Dietary Intake and Quality in Japanese Married Women: A Cross-Sectional Study

This study investigated the association of hours of paid work with dietary intake and diet quality among Japanese married women. This cross-sectional study was a secondary analysis of a nationwide population survey in 2013. The analytic sample included 644 married women aged 20–59 years. The participants were categorized into five groups according to hours of paid work per week: 0 (housewives), 1–14, 15–34, 35–42, and ≥43 h. Dietary intake was assessed by a self-administered diet history questionnaire. The Nutrient-Rich Food Index 9.3 (NRF9.3) was used to measure the dietary quality. The association of hours of paid work with dietary intake and NRF9.3 score was assessed using a multivariable general linear regression analysis with adjustments for confounders. Hours of paid work were associated with a higher intake of rice and lower intake of vegetables, potatoes, soy products, and seaweeds and nutrients including protein, dietary fiber, and most vitamins and minerals. Hours of paid work were negatively associated with the NRF9.3 score. This study showed that Japanese married women engaging in paid work, especially those who work long hours, have less healthy diets. Efforts to improve the dietary intake of married women with paid work might be needed