Association between Dietary Patterns and Non-alcoholic Fatty Liver Disease: Results from a Case-Control Study

Background: This study aimed to investigate the association between dietary patterns and non-alcoholic fatty liver disease (NAFLD) among Iranian adults. Methods: This case-control study was conducted on 210 subjects. NAFLD diagnosis was made by ultrasound examination. Anthropometric measures, physical activity, fasting serum levels of glucose, alanine aminotransferase (ALT), aspartate aminotransferase, and lipid profile were assessed. A three-day food diary was used to assess dietary intakes of the subjects. Dietary patterns were determined using factor analysis. To determine the relationship between dietary patterns and NAFLD, multivariable-adjusted odds ratio (OR) obtained from the logistic regression analysis was used. Results: Two dietary patterns were extracted as follows: vegetables, legumes, fruits, and low-fat dairy products (VLFD) ; and sweet, hydrogenated fat, red and processed meat, and soft drink (SHMS) dietary patterns. By taking all possible confounders into account, the VLFD dietary pattern was found to be significantly related to lower odds of NAFLD, while the SHMS dietary pattern was independently related to higher odds of NAFLD (P < 0.05). Among major food groups, high consumption of processed meat, hydrogenated fats, sweets and desserts, and soft drinks was positively related to NAFLD (P < 0.05), whereas vegetable consumption exhibited a protective role against NAFLD (P = 0.01). Conclusion: The VLFD dietary pattern was associated with reduced likelihood of having NAFLD, while the SHMS dietary pattern was associated with higher likelihood. Therefore, the VLFD dietary pattern might be useful in the nutritional strategies for NAFLD patients. Further studies with larger sample sizes and prospective design are warranted.