The association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus prospective cohort study
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Khalatbari-Soltani, S., Marques-Vidal, P., Imamura, F., & Forouhi, N. The association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus prospective cohort study. BMJ Open https://doi.org/10.17863/CAM.60289
Objective: The Mediterranean diet has been promoted as a healthy dietary pattern but, whether the Mediterranean diet may help to prevent hepatic steatosis is not clear. This study aimed to evaluate the prospective association between adherence to the Mediterranean diet and risk of hepatic steatosis. Design: Population-based prospective cohort study. Setting: The Swiss CoLaus study. Participants: We evaluated 2288 adults (65.4% women, aged 55.8±10.0 years) without hepatic steatosis at first follow-up in 2009-2012. Adherence to the Mediterranean diet was scaled as the Mediterranean diet score (MDS) based on the Mediterranean-diet Pyramid ascertained with responses to food-frequency questionnaires. Outcome measures: New onset of hepatic steatosis was ascertained by two indices separately: the fatty liver index (FLI, ≥60 points) and the non-alcoholic fatty liver disease (NAFLD) score (≥-0.640 points). Prospective associations between adherence to the Mediterranean diet and risk of hepatic steatosis were quantified using Poisson regression. Results: During a mean 5.3-years of follow-up, hepatic steatosis was ascertained in 153 (6.7%) participants by FLI criteria and in 208 (9.1%) by NAFLD-score. After multivariable adjustment, higher adherence to MDS was associated with lower risk of hepatic steatosis based on FLI: risk ratio (95% confidence interval) 0.84 (0.73, 0.96) per one standard deviation of MDS; 0.85 (0.73, 0.99) adjusted for BMI; and 0.85 (0.71, 1.02) adjusted for both BMI and waist circumference. When using NAFLD-score, no significant association was found between MDS and risk of hepatic steatosis [0.95 (0.83, 1.09)]. Conclusion: A potential role of the Mediterranean diet in the prevention of hepatic steatosis is suggested by the inverse association observed between adherence to the Mediterranean diet and incidence of hepatic steatosis based on the FLI. The inconsistency of this association when hepatic steatosis was assessed by NAFLD-score points to the need for accurate population-level assessment of fatty liver and its physiologic markers.
The CoLaus study was and is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 33CSCO-122661, 33CS30-139468 and 33CS30-148401). SKS was supported by the Swiss National Science Foundation (Doc.Mobility number P1LAP3-171805). NGF and FI acknowledge core MRC support (MC_UU_12015/5), and NGF acknowledges NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014).
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
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This record's DOI: https://doi.org/10.17863/CAM.60289
This record's URL: https://www.repository.cam.ac.uk/handle/1810/313184
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