Dietary history and physical activity and risk of advanced liver disease in veterans with chronic hepatitis C infection

Donna L. White, Peter A. Richardson, Mukhtar Ahmed Al-Saadi, Stephanie J. Fitzgerald, Linda Green, Chami Amaratunge, Manvir Anand, Hashem B. El-Serag

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: The role of customary diet and physical activity in development of advanced HCV-related liver disease is not well-established. Methods: We conducted a retrospective association study in 91 male veterans with PCR-confirmed chronic HCV and biopsy-determined hepatic pathology. Respondents completed the Block Food Frequency and the International Physical Activity questionnaires. We conducted three independent assessments based on hepatic pathology: fibrosis (advanced = F3-F4 vs. mild = F1-F2), inflammation (advanced = A2-A3 vs. mild = A1) and steatosis (advanced = S2-S3 vs. mild = S1). Each assessment compared estimated dietary intake and physical activity in veterans with advanced disease to that in analogous veterans with mild disease. Multivariate models adjusted for total calories, age, race/ethnicity, biopsy-to-survey lag-time, BMI, pack-years smoking, and current alcohol use. Results: Average veteran age was 52, with 48% African-American. Advanced fibrosis was more prevalent than advanced inflammation or steatosis (52.7% vs. 29.7% vs. 26.4%, respectively). The strongest multivariate association was the suggestive 14-fold significantly decreased advanced fibrosis risk with lowest dietary copper intake (OR = 0.07, 95% CI 0.01-0.60). Other suggestive associations included the 6.5-fold significantly increased advanced inflammation risk with lower vitamin E intake and 6.2-fold significantly increased advanced steatosis risk with lower riboflavin intake. The only physical activity associated with degree of hepatic pathology was a two-fold greater weekly MET-minutes walking in veterans with mild compared to advanced steatosis (P = 0.02). Conclusions: Several dietary factors and walking may be associated with risk of advanced HCV-related liver disease in male veterans. However, given our modest sample size, our findings must be considered as provisional pending verification in larger prospective studies.

Original languageEnglish (US)
Pages (from-to)1835-1847
Number of pages13
JournalDigestive Diseases and Sciences
Issue number6
StatePublished - Jun 2011


  • Epidemiology
  • Exercise
  • Gastroenterology
  • Infectious diseases
  • Military personnel
  • Nutrition assessment

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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