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Association between dietary nutrient composition and the incidence of cirrhosis or liver cancer in the united states population
Author(s) -
Ioannou George N.,
Morrow Olivia B.,
Connole Marah L.,
Lee Sum P.
Publication year - 2009
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.22941
Subject(s) - medicine , cirrhosis , national health and nutrition examination survey , population , body mass index , liver cancer , confounding , diabetes mellitus , cancer , incidence (geometry) , national death index , cause of death , gastroenterology , physiology , hazard ratio , disease , environmental health , endocrinology , confidence interval , physics , optics
Little is known about the impact of dietary factors on the progression of liver disease. Our aim was to determine whether dietary intake was associated with the risk of cirrhosis‐related or liver cancer–related death or hospitalization in the U.S. population. Participants included 9221 persons aged 25‐74 years without evidence of cirrhosis at entry into the study or during the first 5 years of follow‐up, who were subsequently followed for a mean of 13.3 years as part of the first National Health and Nutrition Examination Survey. Dietary intake was ascertained at baseline using a 24‐hour dietary recall questionnaire. During follow‐up, 123 of 9221 participants had a diagnosis of cirrhosis (n = 118) or liver cancer (n = 5) in hospitalization records or death certificates, including 36 who were diagnosed only on the basis of death certificates. Participants who reported a diet high in protein were at a higher risk of hospitalization or death due to cirrhosis or liver cancer ( P = 0.001), whereas those who reported a diet high in carbohydrates were at a lower risk ( P = 0.003), after adjusting for potential confounders (daily consumption of protein, carbohydrate, fat, tea or coffee, and alcohol, gender, race, age, educational attainment, U.S. geographical region, diabetes, body mass index, and subscapular‐to‐triceps skinfold ratio). Although total fat consumption was not significantly associated with the risk of cirrhosis or liver cancer, cholesterol consumption was associated with higher risk ( P = 0.007), whereas serum cholesterol level was not associated with risk of cirrhosis or liver cancer. Conclusion: Diet may be an important and potentially modifiable determinant of liver disease. (H EPATOLOGY 2009.)