Observational Study
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World J Hepatol. May 27, 2022; 14(5): 1006-1015
Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.1006
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
Zahra Darabi, Sayyed Saeid Khayyatzadeh, Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Zahra Darabi, Hassan Mozaffari-Khosravi, Sayyed Saeid Khayyatzadeh, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Richard James Webb, School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, United Kingdom
Hassan Mozaffari-Khosravi, Nutrition and Food Security Research Center, Shahid Sadoghi University of Medical Sciences, Yazd, Iran
Masoud Mirzaei, Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Ian Glynn Davies, School of Sports and Exercise Sciences, Faculty of Science, Liverpool John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17 6AF, United Kingdom
Mohsen Mazidi, Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
Mohsen Mazidi, Department of Twin Research & Genetic Epidemiology, King’s college London, South Wing St Thomas', London SE1 7EH, United Kingdom
Author contributions: Darabi Z, Mozaffari-Khosravi H, Mirzaei M, Khayyatzadeh SS, and Mazidi M conceived and designed the study, acquired and analysed the data; Darabi Z and Webb RJ interpreted the data and wrote the first draft of the manuscript; All authors critically revised the manuscript.
Institutional review board statement: The study was also approved by the ethics committee of Shahid Sadoughi University of Medical Sciences (approval code: IR.SSU.SPH.REC.1397.161).
Informed consent statement: All involved persons gave their informed consent prior to study inclusion.
Conflict-of-interest statement: The authors know of no conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at mohsen.mazidi@ndph.ox.ac.uk.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohsen Mazidi, PhD, Research Scientist, Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford OX3 7LF, United Kingdom. mohsen.mazidi@ndph.ox.ac.uk
Received: November 6, 2021
Peer-review started: November 6, 2021
First decision: December 27, 2021
Revised: January 28, 2022
Accepted: May 7, 2022
Article in press: May 7, 2022
Published online: May 27, 2022
Processing time: 199 Days and 4.2 Hours
ARTICLE HIGHLIGHTS
Research background

Dietary phytochemicals are plant-derived bioactive compounds. It has been previously suggested that these compounds may be hepatoprotective; however, the existing literature concerning this is equivocal.

Research motivation

In addition to the debatable hepatoprotective nature of dietary phytochemicals, there has been little research investigating this specifically in an Iranian population.

Research objectives

To determine the if the intake of dietary phytochemicals is hepatoprotective.

Research methods

Participants recruited to the PERSIAN cohort study were asked to complete a validated food frequency questionnaire. We applied a dietary phytochemical index to this data in order to categorise participants based upon their phytochemical intake. We then used linear regression to investigate the association between the dietary phytochemical index and levels of liver enzymes using both crude and adjusted models.

Research results

We found significant and inverse associations between dietary phytochemical intake and alkaline phosphatase. This is possibly indicative of improved liver function. We also found that participants with higher intakes of dietary phytochemicals also had an overall healthier dietary pattern yet increased levels of serum cholesterol, low-density lipoprotein cholesterol, blood pressure and blood glucose.

Research conclusions

Although there may be hepatoprotective effects associated with increased dietary phytochemical intake in addition to a healthier overall dietary pattern, these may be accompanied by a a number of metabolic abnormalities.

Research perspectives

Future research should seek to determine the validity of our findings and to elucidate any factors which may be responsible for any metabolic abnormalities associated with an increased intake of dietary phytochemicals.