Association of Diet Quality with Metabolic (Dysfunction) Associated Fatty Liver Disease in Veterans in Primary Care

• Published in: Nutrients Vol. 15; no. 11; p. 2598
• Main Authors: Heredia, Natalia I, Thrift, Aaron P, Ramsey, David J, Loomba, Rohit, El-Serag, Hashem B
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-06-2023; MDPI
• Subjects: Adult; Alcohol use; Alcoholism; Body mass index; Consent; Cross-Sectional Studies; Diabetes; Diet; Diet, Mediterranean; Dietary guidelines; Disease prevention; Eating; Energy intake; Fatty acids; Fatty liver; Female; Fibrosis; Food; Fruits; Grain; Healthy Eating Index; Humans; Legumes; Liver; Liver diseases; Male; Meat; Mediterranean Diet; metabolic (dysfunction) associated fatty liver disease; Metabolism; Middle Aged; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - etiology; Nuts; Obesity; Primary care; Primary Health Care; Quality assessment; Questionnaires; Regression analysis; Risk; Seafood; Statistical analysis; Type 2 diabetes; Vegetables; Veterans; Weight control; Texas; United States > US; Healthy Eating Index; Veterans; metabolic (dysfunction) associated fatty liver disease; Mediterranean Diet
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15112598

Diet is associated with metabolic (dysfunction)-associated fatty liver disease (MAFLD), but the dietary composition associated with MAFLD risk has not been well-examined.
The purpose of this study was to assess the association of two healthy eating indices with the presence and severity of MAFLD in a sample of Veterans in a primary care setting.
This was a single center cross-sectional study using a random stratified sample of Veterans enrolled in primary care. Participants underwent a Fibroscan and completed an interviewer-administered Diet History Questionnaire II from which we calculated the Healthy Eating Index-2015 and Alternate Mediterranean Diet Score. We used multivariable logistic regression models to assess associations of dietary quality with MAFLD.
We analyzed data from 187 participants, 53.5% of whom were female. On average, participants were 50.2 years of age (SD, 12.3 years) with an average BMI of 31.7 kg/m
. MAFLD was detected in 78 (42%) and at least moderate fibrosis in 12 (6%) participants. We found that the Alternate Mediterranean Diet Score was inversely associated with MAFLD (adjusted OR = 0.85, 95%CI 0.72-1.00), but controlling for BMI and total energy intake attenuated the association (adjusted OR = 0.92, 95%CI 0.74-1.15). We found no statistically significant associations between the Healthy Eating Index-2015 and MAFLD or advanced fibrosis.
We found that the Alternate Mediterranean Diet Score was significantly associated with lower MAFLD risk in Veterans; however, the association was mediated by BMI and total energy intake. A Mediterranean-style diet could potentially help reduce the risk of MAFLD, particularly if it helps control total energy intake and weight.