Differences in the association of diet quality with body fat distribution between men and women
Open accessAbstract
Background/objective As dietary intake and endocrine metabolism are vastly different by sex, we evaluated differences in the association of diet quality with body composition between men and women.Subjects/methods Close to 2000 participants from the Multiethnic Cohort completed calibrated quantitative food frequency questionnaires at cohort entry (1993-96) and clinic visit (2013-16), from which the Healthy Eating Index (HEI-2010) was computed. Adiposity measures were obtained through DXA and MRI at clinic visit. Multivariable-adjusted mean adiposity measures were estimated by tertiles of HEI-2010 scores using general linear regression. The associations of diet quality with high visceral fat (VAT) and nonalcoholic fatty liver disease (NAFLD) were examined by logistic regression. To assess sex differences, cross-product terms with the HEI-2010 were added to the models.Results Mean HEI-2010 scores were higher for women than men at cohort entry (67.4 vs. 64.0) and clinic visit (73.6 vs. 71.0). Past and current diet quality was inversely associated with adiposity measures in men and women. Although interaction terms were not significant, the magnitude of the slopes and differences in adjusted means across tertiles suggested a stronger association for women than men. When comparing individuals who maintained a high vs. poor quality diet over 20 years, women but not men showed significantly lower risks for high VAT, whereas high HEI-2010 scores predicted a lower risk of NAFLD in both sexes.Conclusions The inverse association of diet quality with adiposity was similar in both sexes, but diet quality appeared to have a stronger influence on VAT in women than men.
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Observational prospective studies show an inverse association of MASLD development with the Mediterranean diet or similar healthy dietary patterns, and a direct association with unhealthy patterns.
“Observational prospective studies show an inverse association of MASLD development with the Mediterranean diet or similar healthy dietary patterns, 102,103 and a direct association with unhealthy patterns.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [103]
The Results (page not available) report that participants with high Healthy Eating Index scores at both assessments were less likely to have NAFLD. The Methods (page not available) specify that NAFLD was measured at the clinic visit, so the study does not establish prospectively observed new cases. It assessed neither the Mediterranean diet specifically nor a distinct unhealthy dietary pattern. (LLM, conf=0.86)
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- Authors
- Maskarinec, G., Namatame, L. A., Kang, M., Buchthal, S. D., Ernst, T., Monroe, K. R., Shepherd, J. A., Wilkens, L. R., Boushey, C. J., Marchand, L. L., & Lim, U.
- Affiliations
- University of Hawaii Cancer Center (US)
- University of Maryland, Baltimore (US)
- University of Southern California (US)
- Corresponding author
- Maskarinec, Gertraud
- ORCID
- Venue
- European Journal of Clinical Nutrition
- Published
- 2020-01-24
- Volume
- 74
- Issue
- 10
- Pages
- 1434-1441
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- PMC
- PMC7377951
- OpenAlex
- W3001290876
- Cited by
- 34
- References
- 30
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 8 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 1
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health & Human Services | NIH | National Cancer Institute (U01CA164973, P30CA071789)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- diet quality, Healthy Eating Index-2010, body fat distribution, visceral fat, non-alcoholic fatty liver disease, sex differences, body composition, adiposity, multi-ethnic cohort
- MeSH terms
- Diet, Healthy, Body Composition, Cross-Sectional Studies, Diet, Female, Humans, Male, Adiposity, Body Fat Distribution
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