Diet associations with nonalcoholic fatty liver disease in an ethnically diverse population: the multiethnic cohort
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BACKGROUND AND AIMS: Epidemiological data on dietary risk factors for nonalcoholic fatty liver disease (NAFLD) from population-based studies, particularly in an ethnically diverse population, are scarce. We examined dietary factors in relation to NAFLD risk in African Americans, Japanese Americans, Latinos, native Hawaiians, and whites in the Multiethnic Cohort (MEC). APPROACH AND RESULTS: A nested case-control analysis was conducted within the MEC, a large prospective study with >215,000 older adult participants in Hawaii and California. NAFLD was identified using Medicare claims data, and controls were selected among participants without liver disease and individually matched to cases by birth year, sex, ethnicity, and length of Medicare enrollment. Diet was assessed at baseline through a validated quantitative food frequency questionnaire. Diet-NAFLD associations were quantified by odds ratios and 95% confidence intervals using multivariable conditional logistic regression. The study consisted of 2,974 NAFLD cases (518 with cirrhosis, 2,456 without cirrhosis) and 29,474 matched controls. Red meat (P trend = 0.010), processed red meat (P trend = 0.004), poultry (P trend = 0.005), and cholesterol (P trend = 0.005) intakes were positively associated with NAFLD, while dietary fiber intake (P trend = 0.003) was inversely associated with risk. Stronger associations were observed between red meat and cholesterol and NAFLD with cirrhosis than without cirrhosis (P heterogeneity ≤0.014). CONCLUSIONS: Dietary factors are independently associated with NAFLD and NAFLD-related cirrhosis in a multiethnic population. Decreasing the consumption of cholesterol, red and processed meat, and poultry and increasing consumption of fiber may reduce the risk for NAFLD and related advanced liver disease.
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Several observational and cross-sectional studies have shown the harmful association between MASLD and high intake of red and processed meat.
“Several observational and crosssectional studies have shown the harmful association between MASLD and high intake of red and processed meat. 302 -304”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [304]
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- Authors
- Noureddin, M., Zelber‐Sagi, S., Wilkens, L. R., Porcel, J., Boushey, C. J., Le Marchand, L., Rosen, H. R., & Setiawan, V. W.
- Affiliations
- Cedars-Sinai Medical Center (US)
- University of Haifa (IL)
- University of Hawaii Cancer Center (US)
- University of Southern California (US)
- Epidemiology Program,University of Hawaii Cancer Center,Honolulu,HI
- Corresponding author
- Setiawan, Veronica Wendy
- ORCID
- Venue
- Hepatology
- Published
- 2020-02-14
- Volume
- 71
- Issue
- 6
- Pages
- 1940-1952
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- PMC
- PMC7093243
- OpenAlex
- W2975965901
- Cited by
- 148
- References
- 45
- Citations by year
- 2026: 22 · 2025: 14 · 2024: 25 · 2023: 24 · 2022: 24 · 2021: 24 · 2020: 13 · 2019: 2
- FWCI
- 12.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (UM1CA164973, R01CA228589, P30CA071789, U01CA164973)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- non-alcoholic fatty liver disease, dietary risk factors, red meat consumption, processed meat, poultry, dietary cholesterol, dietary fiber, liver cirrhosis, multi-ethnic cohort, ethnic diversity, older adults
- MeSH terms
- Red Meat, Correlation of Data, Cholesterol, Dietary, Diet, Dietary Fiber, Ethnicity, Female, Food Preferences, Medicare, Humans, Liver Cirrhosis, Male, Middle Aged, Risk Factors, United States, Cohort Studies, Risk Assessment, Non-alcoholic Fatty Liver Disease
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