{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:11:39Z","timestamp":1753891899293,"version":"3.41.2"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:p>Non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD)-related mortality have increased dramatically in past decades. Our study aims to investigate the association between plain water and this prevalent metabolic disease, as water plays a crucial role in regulating metabolic processes. A total of 3,543\/3,428 individuals with NAFLD\/MASLD were included in this study from National Health and Nutrition Examination Survey (NHANES). Daily plain water intake was recorded, and mortality status was tracked until December 31, 2019. Multivariate Cox regression models and restricted cubic spline (RCS) regression models were used to assess the association between plain water intake and long-term all-cause as well as cause-specific mortality among participants with NAFLD\/MASLD. Furthermore, we investigated the relationship between substituting other beverages with plain water intake and the risk of mortality. The multivariate Cox regression analyses revealed a significant association between higher plain water intake and lower all-cause mortality, cerebrovascular diseases mortality, and cancer mortality in both NAFLD or MASLD patients. Dose-response analyses revealed a non-linear trend between plain water intake and mortality among NAFLD\/MASLD patients. Additionally, replacing sugar or artificial beverages with plain water was linked to reduced all-cause mortality, cerebrovascular diseases mortality, and cancer mortality in patients with NAFLD\/MASLD. Higher plain water intake is independently linked to lower risk of all-cause, cerebrovascular diseases mortality, and cancer mortality in NAFLD\/MASLD patients. Increasing plain water intake may be an effective way for these patients to reduce their risk of mortality.<\/jats:p>","DOI":"10.3389\/fnut.2024.1478194","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T12:11:45Z","timestamp":1730290305000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of plain water intake with risk of all-cause and cause-specific mortality in individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease"],"prefix":"10.3389","volume":"11","author":[{"given":"Na","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","article-title":"The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review","volume":"77","author":"Younossi","year":"2023","journal-title":"Hepatology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2263","DOI":"10.1001\/jama.2015.5370","article-title":"Nonalcoholic fatty liver disease: a systematic review","volume":"313","author":"Rinella","year":"2015","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1002\/hep.32427","article-title":"Metabolic subtypes of patients with NAFLD exhibit distinctive cardiovascular risk profiles","volume":"76","author":"Mart\u00ednez-Arranz","year":"2022","journal-title":"Hepatology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1136\/gutjnl-2020-320622","article-title":"NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications","volume":"69","author":"Targher","year":"2020","journal-title":"Gut"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1038\/s41575-021-00472-y","article-title":"Dietary carbohydrates and fats in nonalcoholic fatty liver disease","volume":"18","author":"Yki-J\u00e4rvinen","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4829","DOI":"10.3390\/nu15224829","article-title":"Dietary and nutritional interventions in nonalcoholic fatty liver disease in pediatrics","volume":"15","author":"Far\u00edas","year":"2023","journal-title":"Nutrients"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.gtc.2020.10.013","article-title":"The impact of dietary patterns and nutrition in nonalcoholic fatty liver disease","volume":"50","author":"Kim","year":"2021","journal-title":"Gastroenterol Clin N Am"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1016\/j.jhep.2023.06.003","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"79","author":"Rinella","year":"2023","journal-title":"J Hepatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/ejcn.2009.111","article-title":"Water as an essential nutrient: the physiological basis of hydration","volume":"64","author":"J\u00e9quier","year":"2010","journal-title":"Eur J Clin Nutr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1111\/j.1753-4887.2010.00304.x","article-title":"Water, hydration, and health","volume":"68","author":"Popkin","year":"2010","journal-title":"Nutr Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1111\/jgh.13264","article-title":"Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. 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