Dietary Factors in Relation to Liver Fat Content: A Cross-sectional Study

Cora Watzinger,Cornelia M Ulrich,Hans-Ullrich Kauczor,Johanna Nattenmüller,Solomon A Sowah,Tilman Kühn,Rudolf Kaaks,Mirja Grafetstätter,Tobias Nonnenmacher,Ruth Schübel

doi:10.3390/nu12030825

Abstract

Non-alcoholic fatty liver disease (NAFLD) can lead to functional liver impairment and severe comorbidities. Beyond energy balance, several dietary factors may increase NAFLD risk, but human studies are lacking. The aim of this cross-sectional study was to investigate the associations between food consumption (47 food groups, derived Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet quality scores) and liver fat content (continuous scale and NAFLD, i.e., >5% liver fat content). Liver fat content was measured by magnetic resonance imaging (MRI) in 136 individuals (BMI: 25–40 kg/m2, age: 35–65, 50.7% women) and food intake was recorded by food frequency questionnaires (FFQs). Associations between food items and liver fat were evaluated by multi-variable regression models. Intakes of cake and cookies as well legumes were inversely associated with liver fat content, while positive associations with intakes of high-fat dairy and cheese were observed. Only cake and cookie intake also showed an inverse association with NAFLD. This inverse association was unexpected, but not affected by adjustment for reporting bias. Both diet quality scores were inversely associated with liver fat content and NAFLD. Thus, as smaller previous intervention studies, our results suggest that higher diet quality is related to lower liver fat, but larger trials with iso-caloric interventions are needed to corroborate these findings.

Highlights

The global prevalence of non-alcoholic fatty liver disease (NAFLD) is rising, and Non-alcoholic fatty liver disease (NAFLD) may affect approximately 25% of the adult world population [1]
The HELENA Trial (NCT02449148), which has been described in detail elsewhere [16], was designed to investigate the effects of intermittent calorie restriction (ICR) on metabolism and body weight compared to continuous calorie restriction (CCR)
Seven participants did not take part in the magnetic resonance imaging (MRI) assessment of the HELENA Trial, three individuals did not fill out the food frequency questionnaires (FFQs), and covariate information was missing for four participants; we analyzed the associations between food consumption and liver fat content among 136 individuals

Summary

Introduction

The global prevalence of non-alcoholic fatty liver disease (NAFLD) is rising, and NAFLD may affect approximately 25% of the adult world population [1]. NAFLD is characterized by a liver fat content of at least 5% [2] and used as an umbrella term for the different histological and clinical subtypes of a fatty liver [3]. The main goals in NAFLD management are moderate body weight reduction (7%–10%) and increased physical activity [6], while, despite first promising clinical studies with anti-diabetic and anti-inflammatory drugs [4], no specific medical treatment for NAFLD is approved so far [7]. Several studies have analyzed the relationships between dietary factors and NAFLD in recent years [7,8,9]

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Discussion

Conclusion