Dietary Patterns Modulate the Risk of Non-Alcoholic Fatty Liver Disease in Chinese Adults

Abstract

Although previous studies reported the associations between the intakes of individual foods or nutrients and the risk of non-alcoholic fatty liver disease (NAFLD), the relationship between dietary patterns and NAFLD in the Chinese population has been rarely studied to date. This study aimed to investigate the associations between dietary patterns and the risk of NAFLD in a middle-aged Chinese population. The Study subjects were 999 Chinese adults aged 45–60 years in the Anhui province who participated in the Hefei Nutrition and Health Study. Dietary intake was collected by a semi-quantitative food frequency questionnaire. NAFLD was defined as the presence of moderate-severe hepatic steatosis (by B-ultrasonic examination); the absence of excessive alcohol use (>20 g day−1 in men and 10 g day−1 in women); no use of steatogenic medications within the past six months; no exposure to hepatotoxins; and no history of bariatric surgery. Log-binomial regression analysis was used to examine the association between dietary patterns and NAFLD with adjustment of potential confounding variables. Out of 999 participants, 345 (34.5%) were classified as having NAFLD. Four major dietary patterns were identified: “Traditional Chinese”, “Animal food”, “Grains-vegetables” and “High-salt” dietary patterns. After adjusting for potential confounders, subjects in the highest quartile of the “Animal food” pattern scores had greater prevalence ratio for NAFLD (prevalence ratio (PR) = 1.354; 95% confidence interval (CI): 1.063–1.724; p < 0.05) than did those in the lowest quartile. After adjustment for body mass index (BMI), compared with the lowest quartile of the “Grains-vegetables” pattern, the highest quartile had a lower prevalence ratio for NAFLD (PR = 0.777; 95% CI: 0.618–0.977, p < 0.05). However, the “traditional Chinese” and “high-salt” dietary patterns showed no association with the risk of NAFLD. Our findings indicated that the “Animal food” dietary pattern was associated with an increased risk of NAFLD.

Association of Blood Fatty Acid Composition and Dietary Pattern with the Risk of Non-Alcoholic Fatty Liver Disease in Patients Who Underwent Cholecystectomy

“…On the other hand, a healthy diet pattern [4,24] and the Mediterranean diet [5,6] were negatively associated with the risk of NAFLD in the general population. Consistently, the risk for NAFLD has been shown to be negatively associated with an intake of vegetables [11,25], fruit [25], whole grains [26], and legumes [25].…”

Nutritional Approaches to Achieve Weight Loss in Nonalcoholic Fatty Liver Disease

“…In another Chinese study, patients in the high-salt quartile group had an increased prevalence of NAFLD compared with patients in the lowest quartile group (37.5% compared with 28%, P < 0.05) (52). However, in a multivariable analysis that adjusted for BMI, there was no association of NAFLD with a high-salt diet, which suggests that the association between salt and NAFLD may still be secondary to obesity (52). Only subjects in the highest quartile of regular animal food pattern consumers were associated with NAFLD (HR: 1.35; 95% CI: 1.063, 1.724; P < 0.05) compared with subjects in the lowest quartile.…”

“…In this study, patients were given questionnaires that quantified their sodium intake and were divided into quintile groups, and NAFLD Men and women who were in the top quintile group for consuming sodium (mean sodium intake of 3485 mg/d in men and 3310 mg/d in women) had an increased prevalence of NAFLD, by 25% and 32%, respectively [prevalence ratio (PR) = 1.25; 95% CI: 1.18, 1.32; P < 0.001 and PR = 1.32; 95% CI: 1.18, 1.47; P < 0.001, respectively] compared with sodium users in the lower quintile group. In another Chinese study, patients in the high-salt quartile group had an increased prevalence of NAFLD compared with patients in the lowest quartile group (37.5% compared with 28%, P < 0.05) (52). However, in a multivariable analysis that adjusted for BMI, there was no association of NAFLD with a high-salt diet, which suggests that the association between salt and NAFLD may still be secondary to obesity (52).…”

Nutrition and Hepatocellular Cancer

“…There is sufficient evidence that NAFLD is associated with certain dietary patterns [21][22][23] . Several large cohort studies and few prospective randomized controlled trials have been conducted to analyze the role of diet and nutrition in liver cancer prevention, but the evidence for potential associations between nutrition and HCC is much weaker.…”