Favorable association between Mediterranean diet (MeD) and DASH with NAFLD among Iranian adults of the Amol Cohort Study (AmolCS)

Abstract

Nonalcoholic fatty liver disease (NAFLD) is an emerging cause of chronic liver diseases and a major health problem worldwide. Dietary patterns may play a critical role in controlling and preventing this disease, but the available evidence is scarce. The current study aims to ascertain the association of adherence to the Dietary Approach to Stop Hypertension (DASH) diet and Mediterranean diet (MeD) with nonalcoholic fatty liver disease (NAFLD) among Iranian adults of the Amol Cohort Study (AmolCS). In a cross-sectional analysis among 3220 adults (55.3% men), age ≥ 18 years (46.96 ± 14.67), we measured usual dietary intake with a validated food frequency questionnaire (FFQ) and then calculated dietary pattern scores for DASH and MeD. Sociodemographic and lifestyle factors were collected by a structured questionnaire. The presence and degree of NAFLD were also determined by abdominal sonography. Multiple regression models were used to estimate NAFLD odds across tertiles of DASH and Mediterranean dietary scores. Dietary DASH and Mediterranean components were adjusted for total energy intake, based on the residual methods. After adjusting for multiple potential confounders, we found an inverse association of DASH and MeD with NAFLD (Ptrend = 0.02, and Ptrend = 0.002, respectively). Those in the highest tertiles of adherence to the DASH and MeD had the lowest risk for NAFLD (OR = 0.80, 95%CI = 0.66–0.96, OR = 0.64, 95%CI = 0.52–0.78, respectively). The results of logistic analysis of MeD, stratified by gender and abdominal obesity, revealed the favorable association was more pronounced in women (OR = 0.42, 95%CI = 0.29–0.61, Ptrend = 0.004), and in participants with or without abdominal obesity (OR = 0.62, 95% CI = 0.47–0.81, Ptrend = 0.03, OR = 0.64, 95%CI = 0.475–0.91, Ptrend = 0.04, respectively). Similar results were obtained for the adherence to DASH diet score with the prevalence of NAFLD patients with abdominal obesity (OR = 0.75, 95% CI = 0.57–0.97, Ptrend = 0.04). The findings suggested the favorable association between DASH and MeD with NAFLD in Iranian adults, especially women and subjects with or without abdominal obesity. Further prospective investigations are needed to confirm the integrity of our findings.

Inverse Association of Fruit and Vegetable Consumption with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus

“…Many studies have verified that NAFLD, as a common metabolic disease, could benefit from dietary patterns rich in fruits and vegetables, such as the MeD, DASH and plant-based diets. They were proven to reduce hepatic lipid accumulation, liver stiffness and the likelihood of fatty liver in overseas studies [ 20 , 21 , 22 ]. A study conducted in Guangzhou, China, also showed a markedly lower prevalence of NAFLD associated with Chinese adults who adhered to DASH, especially in women and those without abdominal obesity [ 23 ].…”

Modification of dietary patterns in patients with non-alcoholic steatohepatitis

“…В отношении НАЖБП показано, что соблюдение средиземноморской диеты приводит к значительному снижению содержания жира в печени у пациентов с НАЖБП с избыточной массой тела [32]. Соблюдение принципов паттерна DASH (подразумевает использование рациона, богатого антиоксидантами, магнием, калием и пищевыми волокнами, с ограничением потребления мяса, сахара и соли) сопровождалось уменьшением риска развития НАЖБП у пациентов с избыточной массой тела и ожирением: относительный риск 0,75 (95% доверительный интервал 0,57-0,97; p=0,04) [33,34].…”

Dietary total antioxidant capacity is inversely associated with the odds of non-alcoholic fatty liver disease in people with type-2 diabetes

“…Similar metabolic abnormalities are common among these disorders, which are exacerbated by combination of diabetes and NAFLD. Previously, an inverse association of antioxidant-rich dietary patterns, including the Dietary Approaches to Stop Hypertension (DASH) diet ( 34 – 36 ), plant-based diet ( 37 , 38 ), with the risk of NAFLD and diabetes has been reported separately. All of these diets are rich in antioxidant compounds and therefore have antioxidant effects.…”