Cohort studyindependent cross-checkabstract only checked I-WHT-06 standard review
Carbohydrates and liver fat
Associations between types and sources of dietary carbohydrates and liver fat: a UK Biobank study.
Overview
Orliacq J et al.. BMC Med 2023 · PMID 37968623 · DOI 10.1186/s12916-023-03135-8
Refined-grain starch linked to liver fat in one analysis but not on MRI; free sugars linked on MRI.
Does the study support the specific claim? Unclear · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Carbs and liver fat
- How was the study done?
Cohort
- How many people, animals or samples were studied?
UK Biobank
- What was actually found?
Mixed
- How large was the observed effect?
OR 1.33 (cross-sectional)
- What do the results mean in everyday life?
Unclear
- What are the study's limitations?
Recall-based diet
- What does it say about Elawady's specific claim?
Does not confirm claim
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cause
Scientific in-depth review
1. Full reference
- Authors
- Orliacq J et al.
- Journal
- BMC Med
- Year
- 2023
- Identifier
- PMID 37968623 DOI 10.1186/s12916-023-03135-8
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
One author: publicly funded trials with intervention donated by Nestle Health Sciences (outside work); others none.
2. Research question
Carbohydrate types and liver fat
3. Study design and population
- Study design
- Cohort study – Cross-sectional and prospective analyses in UK Biobank
- Population
UK Biobank adults without diabetes/liver/CVD
- Country
UK
- Period
MRI 2014-2020
- Sample size
22,973 cross-sectional; 9268 prospective MRI
4. Methods and endpoints
- Exposure / intervention
Free sugars, non-free sugars, starch from whole/refined grains, fibre
- Comparator
Lowest quintile
- Endpoints
Hepatic steatosis index; MRI liver fat (PDFF)
- Statistical methods
Logistic/linear regression
5. Actual results
- Results
Cross-sectional: starch from refined grains OR 1.33 (1.21-1.46) for high liver fat; fibre 0.46, whole-grain starch 0.52. Prospective PDFF: free sugars positively associated (+0.17); starch from refined grains not associated; fibre, non-free sugars, whole-grain starch inversely.
- Absolute risks
not reported
- Authors' conclusion
Fibre, non-free sugars and whole-grain starch may be protective; free sugars and refined-grain starch less clear.
6. Strengths
- MRI outcome
- Large
7. Weaknesses
- Diet measured by 24-h recall
- Inconsistent between analyses
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
Mixed for C-WHT-07; notes free sugars (allowed in system).
11. Independent contrary findings
12. Transferability to Germany and Europe
High (UK).
13. Overall methodological judgement
Mixed.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Heavy white-flour intake is linked to fatty liver (NAFLD). – Studies with mixed or unclear results