Red Meat Consumption and Risk of Nonalcoholic Fatty Liver Disease in a Population with Low Red Meat Consumption

Abstract

Abstract Objectives Non-alcoholic fatty liver disease (NAFLD), as the most common liver disease, can range from simple steatosis, i.e., non-alcoholic fatty liver (NAFL), to hepatocellular fibrosis (non-alcoholic steatohepatitis or NASH). We evaluated the association between meat consumption and the risk of NAFLD in the Golestan Cohort Study (GCS). Methods The GCS enrolled 50,045 participants, aged 40 to 75 years, in Golestan Province, Iran. Dietary information was collected using a 116-item semi-quantitative FFQ at baseline (2004–2008). A random sample of 1612 participants participated in a liver study after a median of 5 years. NAFL were ascertained via ultrasound. We defined NASH as NAFL plus elevated alanine transaminase levels above 45 and 30 IU/L for men and women, respectively. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Meat consumption was categorized into quartiles based on the GCS population, with the first quartile as the referent group. Results The median intakes of red and white meat were 17 and 53 grams/day, respectively. During follow-up, 505 individuals (37.7%) were diagnosed with NAFL, and 124 (9.2%) with NASH. High total red meat consumption was associated with higher risk for NAFL (ORQ4 vs Q1 = 1.59, 95% CI = 1.06 to 2.38, p trend = 0.03). The highest quartile of unprocessed meat consumption (OR Q4 vs Q1 = 1.73, 95% CI = 1.13 to 2.66, p trend = 0.16) and organ meat consumption were associated with NAFL (OR Q4 vs Q1 = 1.70, 95% CI = 1.19 to 2.44, p trend = 0.003). High total red meat consumption showed a non-significant association with NASH, but this association was statistically significant for the highest quantile of unprocessed red meat intake (ORQ4 vs Q1 = 2.29, 95% CI = 1.09 to 4.80). Processed meat, total white meat, chicken and fish consumption were not significantly associated with NAFLD. Conclusions This is a population with relatively low consumption of red meat, even so, red meat intake was associated with a higher risk of NAFLD. Furthermore, this is the first study to show a dose-response association between organ meat consumption and NAFL. Funding Sources The Intramural Program of the US National Cancer Institute (NIH), Tehran University of Medical Sciences, Cancer Research UK, and the International Agency for Research on Cancer.