G-3484

The relationship between the intake of ultra-processed foods and mortality risk among patients with liver cirrhosis: a prospective cohort study
 Rezvan Chaharlang 1 © ℗, Zahra Yari 2   

1  Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute ,Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2  Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran.

 Email: rezvanchaharlang@gmail.com
 
 

 
 
Abstract

Introduction: Cirrhosis is noted for the progressive deterioration of liver tissue and has become a notable cause of both morbidity and mortality. Diet plays a critical role in the initiation of liver cirrhosis, and adjusting dietary behaviors is an easy intervention that poses minimal risk of adverse effects and is cost-effective. This prospective cohort study aimed to investigate the association between consumption of ultra-processed foods (UPFs) and cirrhosis-related mortality Methods and Materials: In this cohort study, 166 patients with liver cirrhosis diagnosed within the previous six months were enrolled. A total 45 pateints were excluded due to several reasons such as cancer diagnosis within the first year and extreme body mass index. Finally, 121 patients were followed up for 4 years. The dietary intakes of the participants were assessed utilizing a validated and reliable food frequency questionnaire (FFQ) comprising 168 items. Food items were classified based on the NOVA classification system which categorizes foods into four distinct groups based on their level of processing. Crude and multivariable-adjusted hazard ratios (HR) along with 95% confidence intervals (CI) were calculated through Cox proportional hazard analyses. Survival analysis was conducted utilizing Kaplan-Meier curves and the log-rank test. The ethics committee at the National Nutrition and Food Technology Research Institute (NNFTRI) sanctioned the study protocol (IR.SBMU.NNFTRI.1396.186.). Results: After a follow-up period of four years, a total of 50 deaths were reported. The patients were categorized into three distinct groups according to the proportion of their caloric intake derived from UPFs. The recorded number of fatalities in the T1, T2, and T3 categories were 13, 15, and 22, respectively. The mortality rate was highest in the upper tertile of UPFs intake (T3: 13.6% of calories from UPFs) when compared to the lowest tertile (T1: 7.1%). Age and gender-adjusted analysis (Model 1) showed a significantly elevated risk of mortality for T3 (HR=2.34; 95% CI:1.15-4.75; P=0.018) in relation to T1. The survival analysis revealed that high consumers of UPFs had significantly lower five-year survival rates (35.3%) compared to low consumers (65.8%) (P=0.037), suggesting a potential link between UPF intake and decreased survival. Conclusion and Discussion: Increased consumption of ultra-processed foods (UPFs) is linked to a greater risk of mortality in individuals with liver cirrhosis. To further clarify these associations and reach more definitive conclusions, additional research with larger sample sizes is required.

Keywords: Cirrhosis, Mortality, NOVA, Ultra-processed food