The Relationship Between the Score of Adherence to the Mediterranean Diet, the Dietary Approaches to Stop Hypertension Diet, the Healthy Eating Index, and the Risk of Non-Alcoholic Fatty Liver Disease in Iranian Adults: A Case-Control Study

Abstract

Background: Evidence suggests that healthy dietary patterns such as Dietary Approaches to Stop Hypertension (DASH), Mediterranean diet (MED), and Healthy Eating Index 2015 (HEI-2015) may reduce the risk of non-alcoholic fatty liver disease (NAFLD) albeit with controversial results. Objectives: This study aimed to investigate possible associations between the NAFLD risk and adherence to the MED, DASH, and HEI-2015 diets. Methods: A case-control study was conducted involving 122 NAFLD patients and 122 non-NAFLD patients. A gastroenterologist confirmed the NAFLD diagnosis. A 147-item food frequency questionnaire (FFQ) was used to collect the dietary data, and the scores for MED, DASH diet, and HEI-2015 were obtained. Multivariable logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (Cis). Results: The highest pentile of adherence to the DASH diet was significantly associated with the lowest risk of NAFLD (OR: 0.37, 95% CI: 0.14 - 0.92, P trend = 0.03). This association remained significant after adjustment for the confounding variable NAFLD (OR: 0.33, 95% CI: 0.11 - 0.96, P trend = 0.04). No significant difference was found between NAFLD risk and adherence to the MED and HEI-2015. Conclusions: This study demonstrated that the highest score of adherence to the DASH diet was associated with the lowest risk of NAFLD.