New findings suggest that increased adherence to the Dietary Approach to Stop Hypertension (DASH) diet provides strong protection against incidental nonalcoholic fatty liver disease (NAFLD). On the other hand, higher scores in the Mediterranean diet study cohort had a weak, but inverse relationship with the same outcome.
“Across the cohort, 18.6% developed NAFLD and, on average, liver fat increased for all participants,” wrote study author Ioanna Yiannakou, MS, Department of Medicine, Preventive Medicine and Epidemiology, Boston University School of Medicine.
These findings were presented at the 2022 Digestive Disease Week Meeting in San Diego, California.
While diet is essential for the treatment of NAFLD, especially in the early stages of the disease course, the optimal diet still needs to be known, according to researchers. The present study examined whether following a specific diet was associated with changes in liver fat or incident NAFLD in the Framingham Heart Study.
In addition, Yiannakou and colleagues examined whether these associations were altered by cardiometabolic dysfunction. They included individuals who had undergone an abdominal computed tomography scan and were NAFLD free, for the NAFLD analyzes of the incident.
However, they excluded those with heavy alcohol intake, which they defined as >7 drinks per week for women or >14 drinks per week for men. Researchers then calculated liver fat attenuation on a CT scan to determine liver fat and derived nutritional data from food frequency questionnaires for both DASH and Mediterranean Diet adherence scores.
Furthermore, they used modified Poisson regression models to calculate the incidence NAFLD risk ratios (RR) and 95% confidence intervals (CI) associated with scoring categories after adjusting for age, gender, educational status, alcohol intake, current cigarette smoking, physical activity, and multivitamin. usage. Linear regression models calculated the adjusted means of liver fat change over 6 years of median follow-up, according to the study authors.
The data show that participants with higher DASH or Mediterranean diet scores were mostly women with a mean age of 51 ± 9 years and less likely to be current smokers, with lower BMI and abdominal adiposity at baseline.
Higher adherence to the DASH diet compared to a lower one was associated with a 37% reduced risk of incident NAFLD (95% CI, 0.43 – 0.92) and a statistically significant less increase in liver fat during follow-up. the study, the researchers found.
In addition, they observed anthropometric and medical-related factors that altered the protective effects of the DASH score. They illustrated these findings by showing that participants with a higher DASH score with lower abdominal adiposity had a lower NAFLD risk (RR: 0.15; 95% CI, 0.07 – 0.32) than those with only the risk factor (RR for higher DASH scores: 0.82, 95% CI: 0.56 – 1.19; RR for lower adiposity: 0.30, 95% CI, 0.21 – 0.43).
Meanwhile, a higher DASH score combined with no prevalent hypertension or diabetes had the lowest NAFLD risk. In addition, the association with a higher adherence score of the Mediterranean diet was weaker, except in those with a lower ratio of fasting triglyceride to high-density lipoprotein (RR: 0.51, 95% CI, 0.37 – 0.71).
The study, “Higher food quality is associated with lower non-alcoholic fatty liver disease in the Framingham Heart Study”, was presented on DDW 2022†