TY - JOUR
T1 - Empirically-Derived Dietary Patterns in Relation to Non-Alcoholic Fatty Liver Diseases Among Adult Participants in Amol, Northern Iran
T2 - A Structural Equation Modeling Approach
AU - Doustmohammadian, Azam
AU - Pishgar, Elham
AU - Clark, Cain C T
AU - Sobhrakhshankhah, Elham
AU - Nikkhah, Mehdi
AU - Faraji, Amir Hossein
AU - Motamed, Nima
AU - Mansourian, Mohsen Reza
AU - Amirkalali, Bahareh
AU - Maadi, Mansooreh
AU - Kasaii, Maryam Sadat
AU - Ebrahimi, Hamidreza
AU - Zamani, Farhad
N1 - Copyright © 2022 Doustmohammadian, Pishgar, Clark, Sobhrakhshankhah, Nikkhah, Faraji, Motamed, Mansourian, Amirkalali, Maadi, Kasaii, Ebrahimi and Zamani.
PY - 2022
Y1 - 2022
N2 - Dietary modifications remain the mainstay in managing nonalcoholic fatty liver disease (NAFLD). Published data on the effect of overall dietary patterns on NAFLD is scarce. The present study aims to extract the dietary patterns and investigate their association to NAFLD by gender, using structural equation modeling, among adult participants in Amol, northern Iran. In this cross-sectional study, data from 3,149 participants in the Amol cohort study (55.3% men,
n = 1,741) were analyzed. Usual dietary intake was assessed by a validated 168-items semiquantitative food frequency questionnaire. We classified major dietary patterns by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). NAFLD diagnosis was based on ultrasound scanning, including increased hepatic echogenicity, abnormal appearance of hepatic arteries, and diaphragm in the absence of excessive alcohol consumption. Multivariable logistic regression and structural equation modeling (SEM) were used to explore the relationship between dietary patterns and NAFLD. Three distinct dietary patterns, including western, healthy, and traditional/mixed dietary patterns, were identified. Adult male who adhere to the western dietary pattern were more affected with NAFLD risk [Q1, Q2, Q3, Q4, odds ratio
(OR) = 1, 1.16, 1.34, 1.39; 95% confidence interval
(CI) = 0.83-1.61, 0.96-1.85, 0.98-1.96,
p
trend
= 0.04, respectively]. A full mediating effect of healthy dietary pattern, western dietary pattern, and traditional dietary pattern
via dietary acid load (DAL) proxy (of dietary patterns to DAL: βstd = -0.35,
p < 0.006, β
std = 0.15,
p = 0.009, and β
std = 0.08,
p = 0.001, respectively), on NAFLD was found through mediation analysis using SEM. A western dietary pattern comprising frequent intake of salty and sweet snacks, soft drinks, refined grains, processed meats, cooked and fried potatoes, eggs, and coffee was associated with a higher odds of NAFLD in an Iranian male population. Additionally, our findings might provide a mechanistic explanation for the association between dietary patterns and NAFLD
via DAL proxy. However, further prospective studies, including assessing acid-base biomarkers, are needed.
AB - Dietary modifications remain the mainstay in managing nonalcoholic fatty liver disease (NAFLD). Published data on the effect of overall dietary patterns on NAFLD is scarce. The present study aims to extract the dietary patterns and investigate their association to NAFLD by gender, using structural equation modeling, among adult participants in Amol, northern Iran. In this cross-sectional study, data from 3,149 participants in the Amol cohort study (55.3% men,
n = 1,741) were analyzed. Usual dietary intake was assessed by a validated 168-items semiquantitative food frequency questionnaire. We classified major dietary patterns by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). NAFLD diagnosis was based on ultrasound scanning, including increased hepatic echogenicity, abnormal appearance of hepatic arteries, and diaphragm in the absence of excessive alcohol consumption. Multivariable logistic regression and structural equation modeling (SEM) were used to explore the relationship between dietary patterns and NAFLD. Three distinct dietary patterns, including western, healthy, and traditional/mixed dietary patterns, were identified. Adult male who adhere to the western dietary pattern were more affected with NAFLD risk [Q1, Q2, Q3, Q4, odds ratio
(OR) = 1, 1.16, 1.34, 1.39; 95% confidence interval
(CI) = 0.83-1.61, 0.96-1.85, 0.98-1.96,
p
trend
= 0.04, respectively]. A full mediating effect of healthy dietary pattern, western dietary pattern, and traditional dietary pattern
via dietary acid load (DAL) proxy (of dietary patterns to DAL: βstd = -0.35,
p < 0.006, β
std = 0.15,
p = 0.009, and β
std = 0.08,
p = 0.001, respectively), on NAFLD was found through mediation analysis using SEM. A western dietary pattern comprising frequent intake of salty and sweet snacks, soft drinks, refined grains, processed meats, cooked and fried potatoes, eggs, and coffee was associated with a higher odds of NAFLD in an Iranian male population. Additionally, our findings might provide a mechanistic explanation for the association between dietary patterns and NAFLD
via DAL proxy. However, further prospective studies, including assessing acid-base biomarkers, are needed.
U2 - 10.3389/fnut.2022.821544
DO - 10.3389/fnut.2022.821544
M3 - Article
C2 - 35419401
SN - 2296-861X
VL - 9
SP - 821544
JO - Frontiers in nutrition
JF - Frontiers in nutrition
ER -