Food Insecurity and Lipid Profile Abnormalities Are Associated with an Increased Risk of Nonalcoholic Fatty Liver Disease (NAFLD): A Case–Control Study

Tutunchi, Helda; Saghafi-Asl, Maryam; Ebrahimi-Mameghani, Mehrangiz; Ostadrahimi, Alireza

doi:10.1080/03670244.2021.1875453

Cited by 13 publications

(3 citation statements)

References 52 publications

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“…Interventions should also address systemic barriers such as food insecurity to ensure equitable care. Food insecurity has been associated with increased NAFLD prevalence in adults (56.8% in Iranian adults; 29% in low-income American adults) (31,32). Notably almost half of this sample (43.7%) reported household food insecurity, which is problematic given dietary change is a mainstay intervention of NAFLD treatment (5).…”

Section: Discussionmentioning

confidence: 99%

Mycophenolate Mofetil Use Is Associated With Reduced Incidence of Food Allergy in Liver Transplanted Children

Hafliðadóttir

Østensen

Matthews

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Nonalcoholic fatty liver disease (NAFLD) is the leading chronic liver disease in youth, yet little is known about the adolescent patient's experience with NAFLD, which is key for treatment engagement. We examined adolescents' experiences with NAFLD diagnosis, thoughts on how NAFLD affects their daily life, understanding and perceptions of diagnosis and treatment, and impressions of how to improve care. Methods: Utilizing a mixed-method design, adolescents with NAFLD (N = 16; Mean age = 15.8 years; Mean BMI = 37 kg/m 2 ) participated in focus groups. To supplement qualitative data, adolescents and their caregiver completed measures assessing illness perceptions, adolescent quality of life, and eating/activity behaviors. Results: Focus group themes suggested reactions to diagnosis varied from unconcerned to anxious. NAFLD diagnosis occurred within the context of other psychological/medical concerns and was not perceived to affect most adolescents' daily lives. Although adolescents understood general contributors to NAFLD, comprehension of their diagnosis varied. Adolescents were more likely to make lifestyle changes when families were supportive, and they preferred tailored recommendations for health behavior change from the healthcare team. Notably, 62.5% of adolescents were more concerned about their weight than NAFLD. Almost half (43.8%) identified as food insecure. Conclusions: Adolescents with NAFLD may benefit from personalized treatment. Care could be enhanced by ensuring comprehension of diagnosis, problem-solving personal, and family barriers and increasing fam-ily support. Harnessing adolescents' desire for weight loss may be a more salient driver for change in disease status. Interventions should also address systemic barriers such as food insecurity to ensure equitable care.

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Section: Discussionmentioning

confidence: 99%

Mycophenolate Mofetil Use Is Associated With Reduced Incidence of Food Allergy in Liver Transplanted Children

Hafliðadóttir

Østensen

Matthews

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…[105] Given these associations with diabetes and obesity, it is reasonable to expect that NAFLD might impact patients from more deprived communities at higher rates than patients from less deprived households. [109] Alcohol-associated liver disease ALD has been increasing in incidence in recent years, with one study demonstrating a 43.0% increase in alcoholassociated cirrhosis between 2009 and 2015. [110] At the same time, the proportion of waitlisted patients with ALD increased from 22.0% in 2014 to 40.0% in 2019.…”

Section: Geographic Disparities By Liver Disease Etiologymentioning

confidence: 99%

“…Contextual poverty has been independently associated with increased risk of obesity 103,104 and diabetes, 104,105 with living in more deprived neighborhoods being associated with increased odds of obesity 106–108 and diabetes 105 . Given these associations with diabetes and obesity, it is reasonable to expect that NAFLD might impact patients from more deprived communities at higher rates than patients from less deprived households 109 …”

Section: Geographic Disparities By Liver Disease Etiologymentioning

confidence: 99%

Geographic disparities in access to liver transplantation

Yilma

Dalal

Wadhwani

et al. 2023

Liver Transplantation

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Since the Final Rule regarding transplantation was published in 1999, organ distribution policies have been implemented to reduce geographic disparity. While a recent change in liver allocation, termed acuity circles, eliminated the donor service area as a unit of distribution to decrease the geographic disparity of waitlisted patients to liver transplantation, recently published results highlight the complexity of addressing geographic disparity. From geographic variation in donor supply, as well as liver disease burden and differing model for end-stage liver disease (MELD) scores of candidates and MELD scores necessary to receive liver transplantation, to the urban-rural disparity in specialty care access, and to neighborhood deprivation (community measure of socioeconomic status) in liver transplant access, addressing disparities of access will require a multipronged approach at the patient, transplant center, and national level. Herein, we review the current knowledge of these disparities—from variation in larger (regional) to smaller (census tract or zip code) levels to the common etiologies of liver disease, which are particularly affected by these geographic boundaries. The geographic disparity in liver transplant access must balance the limited organ supply with the growing demand. We must identify patient-level factors that contribute to their geographic disparity and incorporate these findings at the transplant center level to develop targeted interventions. We must simultaneously work at the national level to standardize and share patient data (including socioeconomic status and geographic social deprivation indices) to better understand the factors that contribute to the geographic disparity. The complex interplay between organ distribution policy, referral patterns, and variable waitlisting practices with the proportion of high MELD patients and differences in potential donor supply must all be considered to create a national policy strategy to address the inequities in the system.

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