Association Between The Frequency Of Watermelon Consumption And Newly Diagnosed Non-alcoholic Fatty Liver Disease In Non-diabetics Adult Population

ObjectiveThis is a cross-sectional study conducted in Tianjin adult non-diabetic population.The aim was to explore the association between the frequency of watermelon consumption and the prevalence of newly diagnosed nonalcoholic fatty liver disease(NAFLD).So as to provide foundation for dietary advice for the high-risk population of NAFLD.MethodsDuring 2013-2016,a total of 21,851 participants were recruited from Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study(TCLSIHealth),and were underwent the annual health check in Health Management Center of Tianjin Medical University General Hospital.The cross-section information was collected by issuing questionnaires(Including the frequency of dietary watermelon),performing physical exams and testing blood biochemical indicators of the participants.The study showed that variables were recorded using astandard protocol.NAFLD and NAFLD with elevated alanine aminotransferase(ALT)levels were assessed using established ultrasound criteria and ALT levels.The frequency of watermelon consumption was assessed using a validated self-administered food frequency questionnaire.The final categories of the frequency of watermelon consumption according to the frequency distribution of the responses were as follows: < once per week,1-6 times per week,and ?7 times per week.Differences between groups with and without NAFLD were examined using analysis of variance for continuous variables and logistic-regression analysis for categorical variables.Analysis of variance and logistic-regression analysis were used to analyze.In the result,the prevalence of NAFLD was used as dependent variables,and the difference frequency of watermelon consumption were used as independent variables,multiple logistic regression analysis was used to examine the association between the frequency of watermelon consumption and the prevalence of newly diagnosed NAFLD.ResultsThe prevalence of NAFLD was 18.1% for the whole population,and 28.3% and 9.59% for males and females,respectively.The prevalence of overall NAFLD with elevated ALT levels was 4.24%,7.75% and 1.31% for males and females,respectively.Males have higher prevalence than females in both diseases.In baseline,it was found that the differences in age distribution,physical activity,education level,living habits and blood biochemical indexes of NAFLD and nonNAFLD were statistically significant(P <0.05).According to the grouping results of different frequencies of watermelon consumption,there was a difference between physical activity,nutrient intake,food intake such as vegetables and all other kinds of fruits and the frequency of watermelon consumption increases in males(trend P < 0.05).At the same time,similar differences were observed in females.Multivariate Logistic regression analysis showed that higher frequency of watermelon consumption was associated with higher prevalence of NAFLD.After adjustment for potential confounders(Adjusted factors including age,sex,body mass index,smoking/drinking status,educational level,employment status,household income,cardiovascular disease,hypertension,hyperlipidemia,diabetes mellitus,physical activity,metabolic syndromes,total energy intake,and intakes of protein,carbohydrate,fat,eicosapentaenoic acid(EPA)+ docosahexaenoic acid(DHA),soft drinks,vegetables,all other kinds of fruits,sweets,and tomatoes/tomato products),the odds ratios(95% confidence interval,CI)of NAFLD according to the watermelon consumption categories were 1.00(reference)for < once per week,1.06(0.95,1.18)for 1-6 times per week,and 1.23(1.04,1.44)for ?7 times per week,respectively.The results showed that higher frequency of watermelon consumption was associated with higher prevalence of NAFLD,but there were no significant associations in both genders for NAFLD and NAFLD with elevated ALT levels.ConclusionsThe present study is the first to show that the frequency of watermelon consumption have associations with the prevalence of newly diagnosed NAFLD in non-diabetics population.The results showed that there was a positive correlation between different frequency consumption of watermelon and the prevalence of NAFLD in general non-diabetics adult population.In the future,it is necessary to conduct more studies to explore and clarify the causality between the frequency of watermelon consumption and NAFLD,and explore the underlying mechanisms.