A new study published in The Journal of Nutrition demonstrated associations of higher diet quality scores with favorable hepatic fat and fibrosis measures, suggesting that healthy diet may reduce the progression of liver disease.

The rise in the prevalence of nonalcoholic fatty liver disease (NAFLD) parallels the rise in obesity. Higher diet quality is associated with a lower risk of NAFLD, which comprises a spectrum of pathological disorders including risk of liver-related events. Early detection and lifestyle modification are crucial for NAFLD prevention and early intervention. However, liver biopsies remain the gold standard method to evaluate fibrosis, which may not always be feasible due to cost, invasiveness, and poor patient acceptance. An alternative noninvasive technique, vibration-controlled transient elastography (VCTE) can be used to measure hepatic fat and fibrosis with good accuracy for identifying early compared with advanced stages of fibrosis. However, studies designed to comprehensively examine the relationship between diet quality and VCTE-derived hepatic fibrosis measures are limited. 

To bridge this knowledge gap, Ma (Tufts University) and colleagues conducted a cross-sectional association analysis to examine the relationship between multiple diet quality scores and hepatic fibrosis assessed using VCTE in well-established community-based studies – the Framingham Heart Study (FHS) and the National Health and Nutrition Examination Surveys (NHANES). To provide a more reliable estimation of the relationship between diet quality and hepatic fibrosis measures, a meta-analysis of combined data was conducted.

To assess dietary quality, cross-sectional associations between 3 dietary quality scores – the Dietary Approaches to Stop Hypertension score, the Alternative Healthy Eating Index, and a modified Mediterranean-style – were analyzed. Hepatic fat and fibrosis were measured by VCTE in 2532 FHS participants and 3295 participants of the NHANES.

Study results demonstrated an inverse association between diet quality scores and hepatic fat and fibrosis measures in adults using data from both independent sources – FHS and NHANES. Data also showed that adjustment for hepatic fat and body mass index substantially reduced the association strength between diet quality scores and hepatic fibrosis measures, which suggests that hepatic fat and general adiposity explain a large proportion of the association between diet quality and hepatic fibrosis. Taken together, these observations suggest that improved diet quality may reduce excessive hepatic fat accumulation and its progression to hepatic fibrosis. 

References

Gao V, Long MT, Singh SR, Kim Y, Zhang X, Rogers G, Jacques PF, Levy D, Ma J. A Healthy Diet is Associated with a Lower Risk of Hepatic Fibrosis. The Journal of Nutrition, Volume 153, Issue 5, May 2023, Pages 1587-1596, doi.org/10.1016/j.tjnut.2023.03.038

Images via canva.com.

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Kathy Beerman, PhD

Dr. Kathy Beerman teaches in the School of Biological Sciences at Washington State University. The author of several published articles, she is interested in research that focuses on the efficacy of a novel approach to treating iron deficiency anemia in rural regions of Guatemala and Ecuador. Dr. Beerman teaches an undergraduate nutrition course for health majors, as well as a course that prepares students to participate in a 10-day medical mission to Guatemala. Since joining the faculty at Washington State University in 1990, she has been the recipient of several teaching awards (the Burlington Northern Faculty Meritorious Achievement in Teaching Award, the R.M. Wade Foundation Award for Excellence in Teaching, and the Sahlin Faculty Excellence Award for Instruction). More recently, she received the CAS Outstanding Achievement Award in International Activities (2017) and the President’s Award for Leadership (2018). Other scholarly activities include co-author of two introductory nutrition textbooks (Nutritional Sciences: From Fundamentals to Food and NUTR).