Abstract
The Mediterranean (MED) diet was associated with a reduced risk of chronic disease, but the epidemiological studies reported inconsistent findings related to the MED diet and non-alcoholic fatty liver disease (NAFLD) risk. This age and the gender-matched case-control study were conducted among 247 adult patients. The MED diet score was obtained based on the Trichopoulou model. Multivariate logistic regression was used to examine the association between the MED diet and NAFLD risk. NAFLD prevalence in people with low, moderate and high adherence to the MED diet was 33, 13⋅1 and 4⋅6%, respectively. The increasing intake of the MED diet was significantly related to the increment intake of nuts and fruits, vegetables, monounsaturated fatty acid/polyunsaturated fatty acid ratio, legumes, cereals and fish. However, total energy consumption, low-fat dairy and meats intake were reduced (P for all < 0⋅05). Following control for age, the person in the highest of the MED diet tertile compared with the lowest, the odds of NAFLD decreased (OR: 0⋅40, 95% CI: 0⋅17-0⋅95). This relation became a little stronger after further adjusting for sex, diabetes, physical activity and supplement intake (OR: 0⋅36, 95% CI: 0⋅15-0⋅89). However, this association disappeared after adjusting for body mass index, waist and hip circumference (OR: 0⋅70, 95% CI: 0⋅25-1⋅97). High adherence to the MED diet was associated with a 64% reduction in NAFLD odds before some anthropometric variable adjustments. However, further prospective studies are required, particularly in BMI-stratified models.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide[1]
NAFLD includes a wide range of liver damage, from simple steatosis to cirrhosis[2]
The means of age and the MED diet scores in the NAFLD group compared to the healthy group were 44⋅07 ± 10⋅36 v. 43⋅31 ± 12⋅15 years and 4⋅05 ± 1⋅27 v. 4⋅16 ± 1⋅38, respectively
Summary
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide[1]. NAFLD prevalence is estimated in adults worldwide, and it is evaluated to be about 20–25, 5–18 and 21⋅5–31⋅5 % in Asian countries and Iranian populations, respectively[3,4,5]. Diabetes, hyperlipidaemia, inadequate physical activity and an unhealthy diet are the most critical risk factors for NAFLD[6,7,8,9]. Nutrition has been considered the dominant factor in preventing and treating non-communicable diseases, such as depression[10] and NAFLD. Many studies demonstrated that deficiency in some micro- or macronutrients and high intake of some food groups could be related to NAFLD[10,11,12].
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