Prospective association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus cohort study.


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Article
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Authors
Khalatbari-Soltani, Saman  ORCID logo  https://orcid.org/0000-0001-8437-1906
Marques-Vidal, Pedro  ORCID logo  https://orcid.org/0000-0002-4548-8500
Abstract

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 0.84 (95% CI 0.73 to 0.96) per 1 SD of MDS; 0.85 (0.73 to 0.99) adjusted for BMI; and 0.85 (0.71 to 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 to 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 physiological markers.

Description
Keywords
epidemiology, hepatology, nutrition & dietetics, public health, Adult, Aged, Cohort Studies, Diet, Mediterranean, Female, Humans, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Prospective Studies, Switzerland
Journal Title
BMJ Open
Conference Name
Journal ISSN
2044-6055
2044-6055
Volume Title
10
Publisher
BMJ
Rights
All rights reserved
Sponsorship
Medical Research Council (MC_UU_12015/5)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
MRC (MC_UU_00006/3)
Swiss National Science Foundation (177535)
National Institute for Health and Care Research (IS-BRC-1215-20014)
GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation, United Kingdom National Institute of Health Research