The new year has begun and with it, resolutions for
change. A study from Keck Medicine of USC
published last week in Clinical
Gastroenterology and Hepatology gives people extra
motivation to reduce fast-food consumption.
The study found that eating fast food is associated
with nonalcoholic fatty liver disease, a potentially life-threatening condition
in which fat builds up in the liver.
Researchers discovered that people with obesity or
diabetes who consume 20% or more of their daily calories from fast food have
severely elevated levels of fat in their liver compared to those who consume
less or no fast food. And the general population has moderate increases of
liver fat when one-fifth or more of their diet is fast food.
"Healthy livers contain a small amount of fat,
usually less than 5%, and even a moderate increase in fat can lead to
nonalcoholic fatty liver disease," said Ani Kardashian, MD, a hepatologist
with Keck Medicine and lead author of the study. "The severe rise in liver
fat in those with obesity or diabetes is especially striking, and probably due
to the fact that these conditions cause a greater susceptibility for fat to
build up in the liver."
While previous research has shown a link between fast
food and obesity and diabetes, this is one of the first studies to demonstrate
the negative impact of fast food on liver health, according to Kardashian.
The findings also reveal that a relatively modest
amount of fast food, which is high in carbohydrates and fat, can hurt the
liver. "If people eat one meal a day at a fast-food restaurant, they may
think they aren't doing harm," said Kardashian. "However, if that one
meal equals at least one-fifth of their daily calories, they are putting their
livers at risk."
Nonalcoholic fatty liver disease, also known as liver
steatosis, can lead to cirrhosis, or scarring of the liver, which can cause
liver cancer or failure. Liver steatosis affects over 30% of the U.S.
population.
Kardashian and colleagues analyzed the most recent
data from the nation's largest annual nutritional survey, the 2017-2018
National Health and Nutrition Examination Survey, to determine the impact of
fast-food consumption on liver steatosis.
The study characterized fast food as meals, including
pizza, from either a drive-through restaurant or one without wait staff.
The researchers evaluated the fatty liver measurement
of approximately 4,000 adults whose fatty liver measurements were included in
the survey and compared these measurements to their fast-food consumption.
Of those surveyed, 52% consumed some fast food. Of
these, 29% consumed one-fifth or more daily calories from fast food. Only this
29% of survey subjects experienced a rise in liver fat levels.
The association between liver steatosis and a 20% diet
of fast food held steady for both the general population and those with obesity
or diabetes even after data was adjusted for multiple other factors such as
age, sex, race, ethnicity, alcohol use and physical activity.
"Our findings are particularly alarming as
fast-food consumption has gone up in the last 50 years, regardless of
socioeconomic status," said Kardashian. "We've also seen a
substantial surge in fast-food dining during the COVID-19 pandemic, which is
probably related to the decline in full-service restaurant dining and rising
rates of food insecurity. We worry that the number of those with fatty livers
has gone up even more since the time of the survey."
She hopes the study will encourage health care
providers to offer patients more nutrition education, especially to those with
obesity or diabetes who are at higher risk of developing a fatty liver from
fast food. Currently, the only way to treat liver steatosis is through an
improved diet.
Jennifer Dodge,
MPH, assistant professor of research medicine and population and public health
sciences at the Keck School of Medicine of USC and Norah Terrault, MD, MPH, a
Keck Medicine gastroenterologist and division chief of gastroenterology and
liver diseases at the Keck School, were also authors on the study.
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