Effect of nut consumption on prevalence and severity of NAFLD, cardiovascular diseases and metabolic disorders

S Bachmayer; G Semmler; S Wernly; B Wernly; D Niederseer; U Huber-Schönauer; E Aigner; C Datz

doi:10.1055/s-0040-1712305

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2020; 58(05): e97
DOI: 10.1055/s-0040-1712305

Hepatologie

Effect of nut consumption on prevalence and severity of NAFLD, cardiovascular diseases and metabolic disorders

Authors

S Bachmayer

¹General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Department of Internal Medicine, Oberndorf, Salzburg, Austria
G Semmler

¹General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Department of Internal Medicine, Oberndorf, Salzburg, Austria
S Wernly

¹General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Department of Internal Medicine, Oberndorf, Salzburg, Austria
B Wernly

²Paracelsus Medical University of Salzburg, Salzburg, Austria
D Niederseer

³University Hospital Zurich, Department of Cardiology, Zurich, Switzerland
U Huber-Schönauer

¹General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Department of Internal Medicine, Oberndorf, Salzburg, Austria
E Aigner

⁴Paracelsus Medical University Salzburg, Department of Internal Medicine I, Salzburg, Austria.
C Datz

¹General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Department of Internal Medicine, Oberndorf, Salzburg, Austria

Abstract

Full Text

Background Nut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress due to polyphenolic acids and phytosterols. Therefore, we aimed to investigate the influence of nut consumption on cardiovascular diseases, metabolic disorders and non-alcoholic fatty liver disease (NAFLD).

Method 4655 patients were included as part of a colorectal carcinoma colonoscopy screening program (SAKKOPI) between 03/2007 and 07/2019. Patients were characterized using biochemical and metabolic parameters, as well as a detailed questionnaire on dietary and lifestyle habits. The diagnosis of NAFLD was established using ultrasound. Patients with excess alcohol consumption, autoimmune/viral/hereditary liver diseases were excluded. Consumption of nuts was graded as: no consumption or < 1 time/week; ≥ 1 time/week; ≥ 1 time/day and ≥ 2 times/day.

Results Mean age was 58.5 ± 9.8years with a mean BMI of 26.5 ± 4.7 kg/m². 2058 (44.2 %) patients suffered from the metabolic syndrome or its components (hypertension: 2407 [51.6 %]; prediabetes/diabetes: 2287 [49.1 %]; dyslipidemia: 1854 [39.4 %]) and 1984 patients (43.5 %) from NAFLD. On multivariate binary logistic regression analysis adjusting for sex, age, BMI, hypertension, diabetes, dyslipidemia, hepatic steatosis, alcohol consumption, smoking status and dietary patterns, nut consumption ≥ 1 time/week was associated with reduced risk of obesity, hypertension, diabetes, chronic coronary syndrome, peripheral arterial disease(PAD) and stroke (adjusted odds ratio [aOR]s: 0.513-0.845, all p < 0.05). Nut consumption ≥ 1 time/day was associated with reduced risk for NAFLD (aOR: 0.729 [95 %CI: 0.573-0.928], p = 0.010). Importantly, this association was confirmed in sub-group analysis of male patients (aOR:0.591 [95 %CI: 0.419-0.833], p = 0.003) but not in females (aOR:0.900 [95 %CI: 0.639-1.266], p = 0.544). Gender differences were also evident for effects on adiposity, hypertension, diabetes, PAD and stroke. Finally, NAFLD patients who consumed nuts ≥ 1time/week had a significantly lower risk of significant fibrosis (Fib-4 score > 2.67: aOR:0.437 [95 %CI:0.214-0.892], p = 0.023; > 3.25: aOR: 0.409 [95 %CI:0.167-0.998], p = 0.050).

Conclusion Nut consumption exerts beneficial effect on the prevalence and severity of NAFLD, cardiovascular health and metabolic disorders.