Dietary phytochemical consumption is inversely associated with liver alkaline phosphatase in Middle Eastern adults

Zahra Darabi; Richard James Webb; Hassan Mozaffari-Khosravi; Masoud Mirzaei; Ian Glynn Davies; Sayyed Saeid Khayyatzadeh; Mohsen Mazidi

doi:10.4254/wjh.v14.i5.1006

Dietary phytochemical consumption is inversely associated with liver alkaline phosphatase in Middle Eastern adults

World J Hepatol. 2022 May 27;14(5):1006-1015. doi: 10.4254/wjh.v14.i5.1006.

Authors

Zahra Darabi¹, Richard James Webb², Hassan Mozaffari-Khosravi³, Masoud Mirzaei⁴, Ian Glynn Davies⁵, Sayyed Saeid Khayyatzadeh¹, Mohsen Mazidi⁶

Affiliations

¹ Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
² School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, United Kingdom.
³ Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁴ Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁵ School of Sports and Exercise Sciences, Faculty of Science, Liverpool John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17 6AF, United Kingdom.
⁶ Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom.

Abstract

Background: The hepatoprotective effects of phytochemicals are controversial. A dietary phytochemical index (DPI) has been suggested as an alternative method for quantifying the phytochemical content of foods.

Aim: To assess the DPI in relation to liver function tests among a representative sample of Iranian adults.

Methods: A total of 5111 participants aged 35-70 years old were included in this cross-sectional study by a multistage cluster random sampling method. Dietary intakes were collected by a validated and reliable food frequency questionnaire with 121 items. DPI was calculated by the percent of daily energy intake taken from phytochemical-rich foods. Fasting serum concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) were determined. Linear regression was used to investigate the association between DPI and levels of liver enzymes using crude and adjusted models.

Results: There was an inverse association between DPI score and serum ALP in the crude model (β = -0.05; P < 0.001). This association remained significant after adjustment for body mass index, age, smoking, energy intake, history of diabetes, and education (β = -0.03; P = 0.01). No significant associations were found between DPI score and serum levels of AST, ALT, and GGT. The individuals with the highest DPI scores consumed significantly higher amounts of fruits, vegetables, legumes, nuts, and cereals, yet were shown to have significantly higher serum total cholesterol and low-density lipoprotein cholesterol, as well as several other metabolic abnormalities.

Conclusion: Higher adherence to phytochemical-rich foods was associated with lower levels of ALP, but no change in other liver enzymes. Those with higher DPI scores also consumed food items associated with a healthier overall dietary pattern; however, they also presented several unexpected metabolic derangements. Additional randomised trials are needed to better determine the effects of phytochemical-rich foods on liver function.

Keywords: Diet; Dietary pattern; Dietary phytochemical index; Iran; Liver; Middle East; Nutrition; Phytochemical; Phytochemical index.