Relationship between dietary patterns and non‐alcoholic fatty liver disease: A systematic review and meta‐analysis

Zadeh, Shirin Hassani; Mansoori, Anahita; Hosseinzadeh, Mahdieh

doi:10.1111/jgh.15363

Cited by 85 publications

(65 citation statements)

References 52 publications

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“…In general, the Mediterranean diet is characterized by high proportion of unsaturated fatty acids, including polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA) whose main sources are vegetable oils, fish, nuts, and seeds. These can contribute to the beneficial effects on the liver fat (48). For instance, higher consumption of walnuts has been shown to associate with a greater improvement of the liver fat in patients with NAFLD (49).…”

Section: Discussionmentioning

confidence: 99%

“…For instance, higher consumption of walnuts has been shown to associate with a greater improvement of the liver fat in patients with NAFLD (49). In general, the Mediterranean diet is associated with a 56% decreased risk for NAFLD in a cross-sectional setting (48). Moreover, the Mediterranean diet is also composed of vegetables, fruits, legumes, and whole-grain products that are high in dietary fiber.…”

Section: Discussionmentioning

confidence: 99%

“…As CVD is the main cause of mortality among patients with NAFLD, the quality of dietary fats and other sources of fat, such as meat and dairy, require special attention (76). Additionally, the Western type of dietary pattern high in processed foods, refined grains, and saturated fatty acids from high fat dairy and meat increase the risk for NAFLD by 23% (48).…”

Section: Discussionmentioning

confidence: 99%

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Dietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

et al. 2021

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Background: With no approved pharmacotherapy to date, the present therapeutic cornerstone for non-alcoholic fatty liver diseases (NAFLD) is a lifestyle intervention. Guidelines endorse weight loss through dietary modifications, physical exercise, or both. However, no consensus exists on the optimal dietary treatment.Objectives: The aim of our systematic review and meta-analysis was to summarize and assess the evidence for applied types of dietary interventions on the liver and metabolic outcomes in patients with NAFLD, aside from any effects of exercise intervention.Methods: This systematic review was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement guidelines. The search was conducted in PubMed, Scopus, and Cochrane databases in February 2020. Included were only dietary interventions without exercise. This study was registered at PROSPERO: CRD42020203573.Results: Eight randomized controlled trials, seven with endpoint reduction of hepatic steatosis, one with an assessment of endpoint fibrosis, were included in this systematic review, five of which were included in the meta-analysis. Mediterranean dietary interventions without energy restriction (n = 3) showed significant reduction of intrahepatic lipid content (IHL) (SDM: −0.57, 95% CI: −1.04, −0.10), but there was no significant change in alanine transaminase (ALT) (SDM: 0.59, 95% CI: −0.5, −1.68). Hypocaloric dietary interventions with foods high in unsaturated fatty acids (n = 2) led to a significant decrease in ALT (SDM: −1.09, 95% CI: −1.49, −0.69) and aspartate aminotransferase (AST) (SDM: −0.75, 95% CI: −1.27, 0.23); yet effects on steatosis could not be aggregated due to different assessment techniques. Mediterranean diet did not lead to significant changes in concentrations of gamma-glutamyl transpeptidase (γGT), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), fasting glucose or insulin, or homeostatic assessment for insulin resistance.Conclusions: In patients with NAFLD, Mediterranean and hypocaloric dietary interventions favoring unsaturated fatty acids result in improvements in IHL and transaminases. Since many dietary intervention studies are combined with exercise interventions and there is a paucity of ample-sized studies examining dietary interventions on the more advanced and clinically relevant stages of NAFLD, that is active and fibrotic NASH, with multiparametric imaging and liver histology as outcome measures, the optimal dietary invention in NAFLD remains to be defined.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Dietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

et al. 2021

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“…Among these, increasing body mass index (BMI) and visceral fat (%) are important risk factors in NAFLD incidence that two-thirds of people with obesity and diabetes are diagnosed with hepatic steatosis [ 6 ]. NAFLD has multifactorial pathogenesis encompassing environmental factors such as poor dietary choices and sedentary lifestyle along with genetic predisposition [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The association between dietary inflammation scores and non-alcoholic fatty liver diseases in Iranian adults

et al. 2022

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Background Potential dietary inflammation can precursor chronic diseases such as hepatic disorders. We aimed to examine the association of empirical dietary inflammatory patterns (EDIP) and dietary inflammation scores (DIS) with the risk of nonalcoholic fatty liver diseases (NAFLD) in Iranian adults. Methods This case–control study was conducted on 225 newly diagnosed NAFLD cases and 450 controls aged 20–60 years. The individuals’ dietary data were collected using a validated food frequency questionnaire. The detection of NAFLD in subjects was done using the ultrasonography scan of the liver and confirmation of gastroenterologists. To calculate of EDIP score, the average daily intakes of each item (15 food items) were multiplied by the proposed weights, and then all the weighted values were summed. Also, to calculate the DIS score, each food item (18 food items) is multiplied by its specific weight to obtain the weighted values of each item. The weighted values were then standardized using the Z-score. Finally, the standardized weighted values of all the items were summed to get the overall DIS score for the individuals. Logistic regression models, adjusted for potential confounders, were used to estimate the odds ratios and 95% confidence interval (CI) of NAFLD across tertiles of EDIP and DIS. Results The mean (SD) age and BMI of the study population (53% male) were 38.1 (8.8) years and 26.8 (4.3) kg/m2, respectively. The median (IQR) of EDIP and DIS scores in individuals were 0.52 (0.34, 0.73), and 0.04 (− 0.55, 0.59), respectively. Based on the multivariable-adjusted model, after controlling for age, sex, physical activity, smoking, marital status, waist-to-hip ratio, and dietary energy intake, individuals in the second (OR 2.01, 95% CI 1.07–3.76) and third tertiles of DIS (OR 2.54, 95% CI 1.39–4.63) had a higher odds of NAFLD compared to the lowest tertile of DIS (Ptrend = 0.003). Also, in the final model, there is a significant direct association between EDIP score and odds of NAFLD [(OR T2 vs. T1 = 0.88, 95% CI 0.50–1.57) and (OR T3 vs. T1 = 1.82, 95% CI 1.02–3.23)], (Ptrend = 0.031). Conclusion Our results suggested that higher scores of EDIP and DIS, indicating the high inflammatory potential of dietary pattern, are associated with increased odds of NAFLD in Iranian adults.

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“…Previous studies have revealed that adherence to a western dietary pattern may increase the risk of NAFLD, whereas prudent and Mediterranean dietary patterns are more likely to be associated with a reduced risk of this disease ( 7 , 12 – 14 ). To our knowledge, no existing studies have explained the direct and indirect associations among different dietary patterns and NAFLD on a large scale.…”

Section: Introductionmentioning

confidence: 99%

Empirically-Derived Dietary Patterns in Relation to Non-Alcoholic Fatty Liver Diseases Among Adult Participants in Amol, Northern Iran: A Structural Equation Modeling Approach

et al. 2022

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Dietary modifications remain the mainstay in managing nonalcoholic fatty liver disease (NAFLD). Published data on the effect of overall dietary patterns on NAFLD is scarce. The present study aims to extract the dietary patterns and investigate their association to NAFLD by gender, using structural equation modeling, among adult participants in Amol, northern Iran. In this cross-sectional study, data from 3,149 participants in the Amol cohort study (55.3% men, n = 1,741) were analyzed. Usual dietary intake was assessed by a validated 168-items semiquantitative food frequency questionnaire. We classified major dietary patterns by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). NAFLD diagnosis was based on ultrasound scanning, including increased hepatic echogenicity, abnormal appearance of hepatic arteries, and diaphragm in the absence of excessive alcohol consumption. Multivariable logistic regression and structural equation modeling (SEM) were used to explore the relationship between dietary patterns and NAFLD. Three distinct dietary patterns, including western, healthy, and traditional/mixed dietary patterns, were identified. Adult male who adhere to the western dietary pattern were more affected with NAFLD risk [Q1, Q2, Q3, Q4, odds ratio (OR) = 1, 1.16, 1.34, 1.39; 95% confidence interval (CI) = 0.83–1.61, 0.96–1.85, 0.98–1.96, ptrend = 0.04, respectively]. A full mediating effect of healthy dietary pattern, western dietary pattern, and traditional dietary pattern via dietary acid load (DAL) proxy (of dietary patterns to DAL: βstd = −0.35, p < 0.006, βstd = 0.15, p = 0.009, and βstd = 0.08, p = 0.001, respectively), on NAFLD was found through mediation analysis using SEM. A western dietary pattern comprising frequent intake of salty and sweet snacks, soft drinks, refined grains, processed meats, cooked and fried potatoes, eggs, and coffee was associated with a higher odds of NAFLD in an Iranian male population. Additionally, our findings might provide a mechanistic explanation for the association between dietary patterns and NAFLD via DAL proxy. However, further prospective studies, including assessing acid-base biomarkers, are needed.

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Relationship between dietary patterns and non‐alcoholic fatty liver disease: A systematic review and meta‐analysis

Cited by 85 publications

References 52 publications

Dietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Dietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

The association between dietary inflammation scores and non-alcoholic fatty liver diseases in Iranian adults

Empirically-Derived Dietary Patterns in Relation to Non-Alcoholic Fatty Liver Diseases Among Adult Participants in Amol, Northern Iran: A Structural Equation Modeling Approach

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