Top reports of 2017 on diet, nutrition’s effect on GI, liver health

Over the past year, researchers have advanced knowledge regarding diet and nutrition’s role in gastrointestinal and liver health. Chief among our recent reports include sugar’s connection with liver fat, especially in children; the protective qualities of coffee and herbal tea for liver health; and the effects of nutrition on the gut microbiome.

The obesity epidemic, similarly, has been a focus of gastroenterologists and hepatologists lately, because the effects of increased BMI, visceral fat, and even waist circumference can increase risks for several diseases, including nonalcoholic fatty liver disease.

Healio.com/Hepatology presents the following nutritional study results:

Sugar-to-starch exchange diet decreases liver fat in pediatric obesity

Isocaloric fructose restriction in children with obesity showed a decrease in liver fat, visceral fat and de novo lipogenesis and improved insulin kinetics after a 9-day diet, according to recently published data.

“The improvements in these outcome measures occurred irrespective of baseline liver fat content or weight change,” Jean-Marc Schwarz, PhD, from the Touro University, California, and colleagues wrote. “These short-term data support an intervention focusing on fructose restriction as an approach to both combat [nonalcoholic fatty liver disease] and improve insulin kinetics.” Read more

GI nutrition conference highlights latest in diet therapies, microbiome, telemedicine

Last month, dieticians, gastroenterologists and other health care providers from across the world gathered in Ann Arbor, Michigan, for a 3-day program focused on the role of nutrition and lifestyle interventions in the management of patients with digestive and liver diseases.

The conference, called Food: The Main Course to Digestive Health, was developed by the University of Michigan Digestive Disorders Nutrition and Lifestyle Program and the Department of Nutritional Sciences in the School of Public Health, and sponsored by the American College of Gastroenterology. It featured a series of lectures and panel discussions on topics ranging from diet therapies for GI conditions like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and non-alcoholic fatty liver disease (NAFLD), as well as the latest developments in gut microbiome science and telemedicine. Read more

Mediterranean diet linked to lower risk for gallbladder removal surgery

New data have revealed a link between high adherence to a Mediterranean diet, rich in fruits, vegetables, legumes and olive oil, and a lower risk for cholecystectomy among French women.

“A decreased risk of cholecystectomy was observed in women with higher intakes of legumes, fruit, vegetable oil, and whole-meal bread, as well in those with a high adherence to the Mediterranean diet,” Amélie Barré, MD, of Paris-Sud University Hospitals, told Healio Gastroenterology. “In addition, postmenopausal women using menopausal hormone therapy had a decreased risk of cholecystectomy when they had a dietary pattern characterized by large consumptions of fruits, vegetables, seafood, and olive oil.” Read more

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Low-carb diet superior to low-fat in Korean patients with NAFLD

A low-carbohydrate diet program was more realistic and effective in reducing total energy intake and hepatic fat contents in Korean patients with nonalcoholic fatty liver disease compared with a low-fat diet, according to the results of a randomized trial.

“Ratio of fat energy consumption is less than 20% in most Asian cultures; therefore, for Korean NAFLD patients the conventional low-fat diet education might be both unrealistic and ineffective. Energy percent of carbohydrate is absolutely high in Asian compared to Western,” the researchers wrote. “[Our study] indicated that low carbohydrate education strategy was more effective not only [in] reducing body weight but also [in] improving metabolic parameters among Koreans whose carbohydrates share a large proportion of total energy intake.” Read more

FGF21 hormone associated with sugar intake in humans

Variants of the hepatokine fibroblast growth factor 21 hormone, or FGF21, found in the liver, are associated with an increased intake of and preference for “sweets,” according to a recently published study. However, these variants do not correlate with obesity, type 2 diabetes or glucose intolerance.

“Our data suggest that the liver hormone FGF21 may regulate sweet consumption in humans, offering insight into the fundamental biology of nutrient appetite as well as a potential avenue for developing therapeutics to decrease intake,” Susanna Søberg, from the Novo Nordisk Foundation Center for Basic Metabolic Research, and colleagues wrote. “We show that the rs838133 A-allele and highly correlated rs838145 G-allele associate specifically with increased total intake of sugars rather than complex carbohydrates, as well as the propensity to consume sweet snacks rather than fatty-sweet or salty snacks. Importantly, this change in diet structure does not affect total energy intake, as both protein and fat intake decrease.” Read more

Drinking coffee reduces risk for death

Among people of various ethnicities and cultures, higher coffee consumption — whether caffeinated or decaffeinated — was associated with all-cause and cause-specific mortality benefits, according to two new studies published in the Annals of Internal Medicine.

“Coffee is one of the most widely consumed beverages in the world and in the U.S. population,” Song-Yi Park, PhD, from the University of Hawai’i Cancer Center, and colleagues wrote. “Therefore, even a small health-promoting effect of coffee could have a substantial impact on public health.” Read more

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Frequent coffee, herbal tea intake linked to lower levels of liver stiffness

Researchers observed an association between more frequent coffee and herbal tea consumption and lower liver stiffness measurements, according to a recently published study.

“Coffee and tea are the most consumed beverages worldwide and emerging as promising nutraceuticals for liver health. Consumption of these nutraceuticals has been associated with lower all-cause and cause-specific mortality, presumably through reducing the risk of features of the metabolic syndrome,” Louise J.M. Alferink, MD, from the Erasmus MC University Medical Center, Rotterdam, Netherlands, and colleagues wrote. “This large population-based cohort study shows an inverse and independent association between coffee and herbal tea consumption and log-transformed [liver stiffness measurement].” Read more

Infant nutrition, maternal obesity affect risk for NAFLD in adolescents

Breast-feeding for at least the first 6 months of life, while avoiding infant formula consumption, and normal maternal pre-pregnancy BMI may reduce the later risk for developing nonalcoholic fatty liver disease during adolescence, according to results of a longitudinal prospective study.

“Maternal obesity has been associated with shorter durations of breast-feeding, early introduction of supplementary formula milk and complementary food, possibly unhealthy food preferences in childhood and later obesity,” Oyekoya T. Ayonrinde, MBBS, FRACP, from the University of Western Australia, Perth, and colleagues wrote. “We report an inverse association between the duration of infant breast-feeding as well as the age at introducing supplementary formula milk on the subsequent diagnosis of NAFLD in adolescence.” Read more

AAP: Fruit juice should not be given to children younger than 1 year

Because of to its high sugar and calorie content, in addition to its lack of protein and fiber, fruit juice should not be given to infants younger than 1 year, according to a joint AAP policy statement from the Committee on Nutrition and the Section on Gastroenterology, Hepatology and Nutrition.

“Children and adolescents continue to be the highest consumers of juice and juice drinks,” Melvin B. Heyman, MD, FAAP, from the Division of Pediatric Gastroenterology, Hepatology and Nutrition at the University of California, and Steven A. Abrams, MD, FAAP, from the Department of Pediatrics at Dell Pediatric Research Institute, wrote. “Unfortunately, children 2 to 18 years of age consume nearly half of their fruit intake as juice, which lacks dietary fiber and predisposes to excessive calorie intake.” Read more