Nutrition/Obesity
Adolescent dietary patterns and risk of chronic liver disease mortality and incident liver cancer: A prospective cohort study Longgang zhao* Longgang Zhao Xinyuan Zhang Yun Chen Yikyung Park Linda M. Liao Jessica L. Petrick Peter T. Campbell Katherine A. McGlynn Xuehong Zhang
Objectives: Healthy dietary patterns in adulthood have been associated with favorable liver health, but no study has examined the role of the adolescent diet in adverse liver outcomes. We evaluated the relationship between adolescent dietary patterns and the risk of chronic liver disease mortality and liver cancer in adulthood.
Methods: We conducted a prospective cohort study using data from the NIH-AARP Diet and Health Study, comprising 241,628 adult participants who had recalled their dietary intake at ages 12-13 when they participated in the study (mean: 61 years). We employed principal component analyses to derive dietary patterns based on 37 food items from the food frequency questionnaire. We used the Cox proportional hazards regression model to estimate the multivariable HRs and 95% CIs for associations between different dietary patterns and adverse liver outcomes with adjustments for potential confounders including adult and adolescent characteristics.
Results: With a median of 15.5 years follow-up, we documented 437 chronic liver disease deaths and 419 incident liver cancers. We identified three dietary patterns: a plant-based pattern (high in fruits and vegetables), a Western modern pattern (high in ice cream and doughnuts, but low in milk and vegetables), and a Western traditional pattern (high in hot dogs and French fries, but low in milk and butter). After controlling potential confounding factors, the adolescent Western modern pattern score was positively associated with the risk of chronic liver disease mortality (HR quartile 4 vs quartile 1=1.40, 95% CI=1.06-1.86, P trend=0.05). Dietary patterns during adolescence were not associated with liver cancer risk.
Conclusions: For the first time we found a positive correlation between Western modern patterns during adolescence and mortality from chronic liver disease. If confirmed by future research, these findings crucially inform the significance of a healthy adolescent diet in preventing liver disease.
