No association between fruits or vegetables and non-alcoholic fatty liver disease in middle-aged men and women

Nutrition. 2019 May:61:119-124. doi: 10.1016/j.nut.2018.10.016. Epub 2018 Oct 23.


Objective: It has been hypothesized that fruit and vegetable intake is inversely associated with non-alcoholic fatty liver (NAFLD). However, some studies have speculated that fruit intake might be positively associated with NAFLD owing to the fructose content of the fruit. This might cause consumers to hesitate consuming fruit. The aim of this study was to assess the association between fruit and vegetable consumption and NAFLD.

Methods: This was a cross-sectional study of 977 men and 1467 women, 40 to 69 y of age without current liver disease other than NAFLD and who did not report excess alcohol intake (i.e., ≥30 g/d in men and ≥20 g/d in women). Dietary intake was assessed using a validated diet history questionnaire. NAFLD was diagnosed from abdominal ultrasonography results. The association between quartiles of fruit or vegetable consumption and NAFLD prevalence was assessed using logistic regression analysis, with lowest category as reference.

Results: The prevalence of NAFLD was 34.9% in men and 11.7% in women. Adjusted for age and lifestyle factors, fruit intake was inversely associated with NAFLD in both sexes. However, these associations disappeared after further adjustment for body mass index. Consumption of total vegetables was not associated with NAFLD. In women, a linear inverse association was demonstrated between green and yellow vegetable intake and NAFLD in the final model (Ptrend = 0.04), but odds ratios for any intake category did not reach significance.

Conclusions: No obesity-independent association was found between fruit or vegetable intake and NAFLD. According to the findings of this study, Japanese do not need to restrict fruit consumption to limit fructose intake as a means of preventing NAFLD.

Keywords: Diet history questionnaire; Fructose; Fruit intake; Lipogenesis; Non-alcoholic fatty liver disease; Vegetable intake.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Diet / adverse effects*
  • Diet / methods
  • Diet Surveys
  • Female
  • Fruit / adverse effects*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Odds Ratio
  • Prevalence
  • Risk Factors
  • Vegetables / adverse effects*