Abstract
BackgroundSpinach has high antioxidants and polyphenols and showed protective effects against liver diseases in experimental studies. We aimed to assess the association between dietary intake of spinach and odds of nonalcoholic fatty liver disease (NAFLD) in a case–control study among Iranian adults.MethodsTotally 225 newly diagnosed NAFLD patients and 450 controls, aged 20–60 years, were recruited in this study. Participants’ dietary intakes were collected using a valid and reliable 168-item semi-quantitative food frequency questionnaire (FFQ). The logistic regression test was used for assessing the association between total, raw, and boiled dietary spinach with the odds of NAFLD.ResultsThe mean (SD) age and BMI of participants (53% male) were 38.1 (8.8) years and 26.8 (4.3) kg/m2, respectively. In the final adjusted model for potential confounders, the odds (95% CI) of NAFLD in individuals in the highest tertile of daily total and raw spinach intake was [0.36 (0.19–0.71), P_trend = 0.001] and [0.47 (0.24–0.89), P_trend = 0.008], respectively compared with those in the lowest tertile. Furthermore, in the adjusted analyses, an inverse association was observed between the highest yearly intake versus no raw spinach consumption and odds of NAFLD [(OR 0.41; 95% CI 0.18–0.96), P for trend = 0.013]. However, there was no significant association between higher boiled spinach intake and odds of NAFLD.ConclusionsThe present study found an inverse association between total and raw spinach intake with the odds of NAFLD.
Highlights
Spinach has high antioxidants and polyphenols and showed protective effects against liver diseases in experimental studies
Smoking was higher among nonalcoholic fatty liver disease (NAFLD) patients than in control (p value = 0.006), and smoking was higher among men than women (p value = 0.006, data not shown)
There were no significant differences between the two groups in age and sex distribution and dietary intakes of carbohydrate, protein, fat, fiber, whole grains, fruits, nuts, and legumes (P > 0.05)
Summary
Spinach has high antioxidants and polyphenols and showed protective effects against liver diseases in experimental studies. We aimed to assess the association between dietary intake of spinach and odds of nonalcoholic fatty liver disease (NAFLD) in a case–control study among Iranian adults. Nonalcoholic fatty liver disease (NAFLD) refers to the state of accumulation of fat in hepatocytes in persons who do not consume excessive alcohol [1]. This disease includes a wide range of conditions from fatty liver to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis [2]. The average prevalence of NAFLD among the general population is estimated at 25% worldwide [8]. The prevalence in Iranian adults is reported between 20 and 50% [6] reports show a growing prevalence of NAFLD worldwide, attributed to the upward trend of adverse lifestyle changes, including unhealthy diet, sedentary behavior, and overweight [10]
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