Inflammation, Injury and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK.
National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK.
Nutrients. 2022 Jul 8;14(14):2808. doi: 10.3390/nu14142808.
Non-alcoholic fatty liver disease (NAFLD) is a global problem growing in parallel to the epidemics of obesity and diabetes, with South Asians being particularly susceptible. Nutrition and behaviour are important modifiers of the disease; however, studies to date have only described dietary patterns and nutrients associated with susceptibility to NAFLD.
This cross-sectional case-control study included 993 NAFLD patients and 973 healthy controls from Trivandrum (India). Dietary data was collected using a locally validated food frequency questionnaire. A tree-based classification categorised 2165 ingredients into three levels (food groups, sub-types, and cooking methods) and intakes were associated with clinical outcomes.
NAFLD patients had significantly higher consumption of refined rice, animal fat, red meat, refined sugar, and fried foods, and had lower consumption of vegetables, pulses, nuts, seeds, and milk compared to controls. The consumption of red meat, animal fat, nuts, and refined rice was positively associated with NAFLD diagnosis and the presence of fibrosis, whereas consumption of leafy vegetables, fruits, and dried pulses was negatively associated. Fried food consumption was positively associated with NAFLD, whilst boiled food consumption had a negative association. Increased consumption of animal fats was associated with diabetes, hypertension, and cardiovascular outcomes among those with NAFLD, whereas consumption of wholegrain rice was negatively associated with these clinical-related outcomes.
The tree-based approach provides the first comprehensive method of classifying food intakes to enable the identification of specific dietary factors associated with NAFLD and related clinical outcomes. This could inform culturally sensitive dietary guidelines to reduce risk of NAFLD development and/or its progression.
非酒精性脂肪性肝病（NAFLD）是一个全球性问题，随着肥胖症和糖尿病的流行而日益严重，南亚人尤其容易患病。营养和行为是疾病的重要调节剂；然而，迄今为止的研究仅描述了与 NAFLD 易感性相关的饮食模式和营养素。
这项横断面病例对照研究包括来自特里凡得琅（印度）的 993 名 NAFLD 患者和 973 名健康对照者。使用经过本地验证的食物频率问卷收集饮食数据。基于树的分类将 2165 种成分分为三个级别（食物组、亚类和烹饪方法），并将摄入量与临床结果相关联。
与对照组相比，NAFLD 患者的精制米、动物脂肪、红肉、精制糖和油炸食品摄入量明显较高，而蔬菜、豆类、坚果、种子和牛奶摄入量较低。红肉、动物脂肪、坚果和精制米的摄入量与 NAFLD 诊断和纤维化的存在呈正相关，而叶菜、水果和干豆的摄入量则呈负相关。油炸食品的摄入量与 NAFLD 呈正相关，而煮食的摄入量则呈负相关。NAFLD 患者中动物脂肪摄入增加与糖尿病、高血压和心血管结局相关，而全谷物米的摄入与这些临床相关结局呈负相关。
基于树的方法提供了一种全面的分类食物摄入的方法，可用于识别与 NAFLD 相关的特定饮食因素及其相关的临床结果。这可以为制定文化敏感的饮食指南提供信息，以降低 NAFLD 发展和/或进展的风险。
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