A case-control study on nutritional risk factors in non-alcoholic fatty liver disease in Indian population

Abstract

Background/Objectives: Non-alcoholic fatty liver disease (NAFLD) is considered an integral part of metabolic syndrome (MS). We aimed to explore the inter-relations of MS and dietary composition in subjects with and without hepatic steatosis and to identify the nutritional risk factors contributing to NAFLD. Subjects/Methods: In all 98 subjects with steatosis and 102 controls were selected for the study after screening 260 consecutive healthy individuals. Anthropometric and nutritional information, biochemical data and clinical profile were analyzed. Prevalence of MS was determined based on the consensus statement for diagnosis of MS for Asian Indians. Multiple logistic regression analysis was done to predict the dietary risk factors in NAFLD. Results: Prevalence of MS was 44.9% among NAFLD cases and 25.5% among controls (P ¼ 0.003). Subjects with NAFLD had significantly higher values of body mass index (BMI), waist circumference (WC), percent body fat, total cholesterol, triglycerides and blood pressure than controls. The total calorie intake, percent of carbohydrate and fat intake of NAFLD cases was significantly higher than controls. Multiple logistic regression analysis showed BMI (odds ratio 6.03 (95% confidence interval 3.26-11.14)), WC (5.49 (2.59-11.57)) and percent dietary fat intake (2.51 (1.99-3.31)) as independent nutritional risk factors in NAFLD. Conclusions: In this study, there is a high prevalence of MS among subjects with steatosis and metabolic disorders were closely related to NAFLD. BMI, WC and percent fat intake are independent dietary risk factors in NAFLD. Decreased nutritional intake with restricted fat may constitute an important therapy in subjects with NAFLD.

The Role of Nutrients in the Development, Progression, and Treatment of Nonalcoholic Fatty Liver Disease

“…A similar study done in India compared the dietary intakes of 98 patients with that of 102 healthy controls through another semiquantitative FFQ and showed that the percentage of fat in the diet was a risk factor for the development of NAFLD. 20 Contrary to that, a US-based study of 74 patients undergoing bariatric surgery revealed that increased carbohydrate intake (measured through 24-h FR) was associated with increased odds of intrahepatic inflammation, whereas increased fat intake decreased the odds of inflammation. 21 Total caloric and protein intake were not associated with liver biopsy results in this study.…”

Etiopathogenesis of Nonalcoholic Steatohepatitis: Role of Obesity, Insulin Resistance and Mechanisms of Hepatotoxicity

“…Patients with NALFD are shown to have increased percentage of dietary fat content and also get much lower percentage of their calories from fruits [23, 24]; not only total fat content in the diet but also the composition of fat has seen considerable interest in recent times. Current literature supports the fact that diet of patients with NAFLD might be high in saturated fatty acids and n-6 polyunsaturated fatty acids and low in n-3 polyunsaturated fatty acids and monounsaturated fatty acids [25–27].…”

Nonalcoholic Fatty Liver Disease Management: Dietary and Lifestyle Modifications

“…Studies examining the dietary habits of patients with NAFLD when compared with healthier controls have reported various patterns. Notable dietary trends have included higher energy intake, 65,66 lower total dietary fiber, 67,68 higher CHOs, 65,[69][70][71] higher saturated fatty acids and cholesterol, 67 low PUFAs, 67,69,72 higher n-6:n-3 ratios, 68 higher fructose, 69,73 and higher protein from meat sources. 73 Results are therefore somewhat disparate, and not unexpectedly, ethnicity would appear to have some influence (e.g., higher CHO intakes seen mostly among Asian and Continental regions); dietary patterns, and thus their nutrient content, vary considerably across different areas and populations of the world.…”