Adding a Pinch of Salt Can Affect Liver Health

TOPLINE:

Adding salt to foods with a higher frequency was associated with increased risks for metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, and hepatocellular carcinoma. The associations were stronger among nonsmokers, current alcohol drinkers, and individuals without diabetes or with a lower BMI and were partly mediated by adiposity.

METHODOLOGY:

• Previous studies have shown that added salt in foods is linked to adverse health outcomes such as type 2 diabetes, cardiovascular disease, and mortality, but its role in liver-related disorders is still underexplored.
• Researchers conducted a prospective cohort study with 492,265 participants (mean age, 56.5 years; 45.3% men) from the UK Biobank who had no prevalent liver diseases or alcohol/drug use disorders at baseline.
• Participants’ frequency of adding salt to foods was self-reported, with responses categorized as never/rarely, sometimes, usually, and always.
• The primary outcome was incident MASLD, with secondary outcomes including cirrhosis and hepatocellular carcinoma, identified using diagnostic codes through electronic health records.
• The association between frequency of adding salt and risks for liver-related disorders was assessed using models adjusted for sociodemographic characteristics, lifestyle factors, personal history of diseases, and diet factors, and linear trends were calculated on the basis of frequency of adding salt to foods.

TAKEAWAY:

• Adding salt more frequently was associated with an increased risk for incident MASLD, with adjusted hazard ratios (aHRs) of 1.08 for sometimes, 1.22 for usually, and 1.40 for always, compared with never/rarely (P for trend < .0001).
• A higher frequency of adding salt was also associated with increased risks for cirrhosis (aHRs, 1.11 for sometimes, 1.09 for usually, and 1.32 for always) and hepatocellular carcinoma (aHRs, 1.26 for sometimes, 1.45 for usually, and 2.25 for always) compared with never/rarely (P for trend < .0001 for both).
• The association between adding salt frequency and the risk for MASLD was stronger among nonsmokers, current alcohol drinkers, and individuals without diabetes or with a lower BMI (P for interaction < .05 for all).
• Adiposity measures, including BMI, waist-to-hip ratio, body fat mass, and body fat percentage, mediated over 20% of the associations between frequency of adding salt and the risk for incident MASLD. Similar factors mediated the effects for cirrhosis and hepatocellular carcinoma along with alcohol intake.

IN PRACTICE:

“These findings suggest that reducing salt/sodium intake could be a promising strategy for preventing liver-related disorders,” the study authors wrote.

SOURCE:

The study was led by Shunming Zhang, Xi’an Jiaotong University Health Science Center in Xi’an, China, and Lund University, Malmö, Sweden. It was published online in the European Journal of Nutrition.

LIMITATIONS:

The single baseline measurement of frequency of adding salt to food does not account for changes over time, potentially underestimating associations. The reliance on self-reported data for salt addition frequency and some covariates may lead to recall bias and measurement errors. The study’s observational design limits causal inference, and the predominantly European ancestry of participants may affect generalizability to other populations.

DISCLOSURES:

This study was supported by an open access funding provided by Lund University and grants from the National Natural Science Foundation of China, China Postdoctoral Science Foundation, Shaanxi Province Postdoctoral Science Foundation, and Young Elite Scientists Sponsorship Program by CAST. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.