Association of Dietary Patterns with MRI Markers of Hepatic Inflammation and Fibrosis in the MAST4HEALTH Study.

Athina I Amanatidou,Charalampia Amerikanou,Rajarshi Banerjee,Amalia Gastaldelli,Ioanna-Panagiota Kalafati,M Pilar Francino,Andriana C Kaliora,Ilias Smyrnioudis,Stefan Stojanoski,Mary Jo Kurth,Mirjana Beribaka,Chara Vezou,Fernando Marascio,Panos Deloukas,Maria Giovanna Trivella,Aimo Kannt,Milica Medić-Stojanoska ,Sophie Visvikis‐Siest ,Nataša Milić ,Carlos Lloréns ,Nataša Milošević ,George Dedoussis

doi:10.3390/ijerph19020971

Abstract

Whereas the etiology of non-alcoholic fatty liver disease (NAFLD) is complex, the role of nutrition as a causing and preventive factor is not fully explored. The aim of this study is to associate dietary patterns with magnetic resonance imaging (MRI) parameters in a European population (Greece, Italy, and Serbia) affected by NAFLD. For the first time, iron-corrected T1 (cT1), proton density fat fraction (PDFF), and the liver inflammation fibrosis score (LIF) were examined in relation to diet. A total of 97 obese patients with NAFLD from the MAST4HEALTH study were included in the analysis. A validated semi-quantitative food frequency questionnaire (FFQ) was used to assess the quality of diet and food combinations. Other variables investigated include anthropometric measurements, total type 2 diabetes risk, physical activity level (PAL), and smoking status. Principal component analysis (PCA) was performed to identify dietary patterns. Six dietary patterns were identified, namely “High-Sugar”, “Prudent”, “Western”, “High-Fat and Salt”, “Plant-Based”, and “Low-Fat Dairy and Poultry”. The “Western” pattern was positively associated with cT1 in the unadjusted model (beta: 0.020, p-value: 0.025) and even after adjusting for age, sex, body mass index (BMI), PAL, smoking, the center of the study, and the other five dietary patterns (beta: 0.024, p-value: 0.020). On the contrary, compared with low-intake patients, those with medium intake of the “Low-Fat Dairy and Poultry” pattern were associated with lower values of cT1, PDFF, and LIF. However, patients with a “Low-Fat Dairy and Poultry” dietary pattern were negatively associated with MRI parameters (cT1: beta: −0.052, p-value: 0.046, PDFF: beta: −0.448, p-value: 0.030, LIF: beta: −0.408, p-value: 0.025). Our findings indicate several associations between MRI parameters and dietary patterns in NAFLD patients, highlighting the importance of diet in NAFLD.

Highlights

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide
The present study examined the association of six dietary patterns of “High-Sugar”, “Prudent”, “Western”, “High-Fat and Salt”, “Plant-Based”, and “Low-Fat Dairy and Poultry” in MAST4HEALTH patients with magnetic resonance imaging (MRI) parameters related to non-alcoholic fatty liver disease (NAFLD) progression
The “Western” pattern, which consists mostly of a high intake of refined grains, red meat, and fast food, was associated with increased values of corrected T1 (cT1), which is strongly correlated with disease activity [36] and the fibrosis stage [37]

Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. It is an umbrella term for a variety of pathological conditions ranging from simple hepatic steatosis (SS) or non-alcoholic fatty liver (NAFL) to the more severe nonalcoholic steatohepatitis (NASH) and NASH cirrhosis [1]. Research advances in the last decade have demonstrated that NAFLD is a multisystem disease with many complex processes involved in its manifestation and development. An increasing number of studies demonstrate that NAFLD affects a variety of extrahepatic organs and regulatory pathways [2]. NAFLD is a severe public health issue in both industrialized and developing countries, with an estimated global incidence of 25% [3].

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