(P29-054-23) Higher Ultra-Processed Food Intake Is Associated With Adverse Liver Outcomes: A Prospective Cohort Study of UK Biobank Participants

Objectives: The increasing consumption of ultra-processed foods (UPF) has raised concerns about human health, including related to risk of obesity, diabetes, and specific cancers. However, the relationship between UPF intake and liver health has been scarcely studied. We evaluated the association of UPF intake with risk of adverse liver outcomes including non-alcoholic liver diseases (NAFLD), liver fibrosis and cirrhosis, liver cancer, severe liver diseases (SLD), and serum biomarkers of liver health.

Methods: We used data from the UK Biobank, a prospective cohort study with 174,095 participants aged 40-69 years old at baseline who completed at least one 24-hour dietary recall. We defined UPF according to the NOVA classification system and used energy-adjusted grams of UPF as the main exposure. Liver health outcomes were identified based on the International Classification of Diseases (10th Revision). Serum biomarkers were measured at baseline. We used Cox proportional hazard regression models to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for associations between UPF intake and adverse liver outcomes adjusting for multiple potential confounders.

Results: After a median follow-up of 8.9 years, we documented 1110 NAFLD, 350 liver cirrhosis, 134 liver cancer, and 550 SLD cases. We found positive associations between higher UPF intake and increased risk of NAFLD (HR _{Quartile 4 vs quartile 1}=1.43; 95% CI=1.20-1.70, P<sub>trend < 0.001), liver fibrosis and cirrhosis (HR _{Quartile 4 vs quartile 1}=1.17; 95% CI=0.86-1.58, P<sub>trend=0.008), and SLD (HR _{Quartile 4 vs quartile 1}=1.49; 95% CI=1.18-1.88, P<sub>trend < 0.001) but no association with incident liver cancer (HR _{Quartile 4 vs quartile 1}=1.00; 95% CI=0.63-1.58, P<sub>trend=0.89). Higher UPF intake also was associated with elevated levels of C-reactive protein (CRP) and triglycerides, lower cholesterols, and abnormal levels of alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) (all P<sub>trend < 0.01).

Conclusions: In the UK Biobank, higher intake of UPF is associated with an increased risk of NAFLD, liver fibrosis and cirrhosis, and SLD, as well as adverse levels of serum biomarkers such as CRP, ALP, GGT, and triglycerides. Our results suggest the potential importance of reducing UPF intake to improve liver health.

Funding Sources: No funding