A Healthful Plant-Based Diet Is Associated with Lower Odds of Nonalcoholic Fatty Liver Disease

• Published in: Nutrients Vol. 14; no. 19; p. 4099
• Main Authors: Li, Xiude, Peng, Zhaohong, Li, Meiling, Zeng, Xueke, Li, Haowei, Zhu, Yu, Chen, Hui, Hu, Anla, Zhao, Qihong, Zhang, Zhuang, Wang, Hua, Yuan, Changzheng, Yang, Wanshui
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.10.2022; MDPI
• Subjects: Adult; Alcohol; Body mass; Body mass index; Body size; Clinical trials; controlled attenuation parameter; Cross-Sectional Studies; Diabetes; Diet; Diet - adverse effects; Diet, Healthy; Diet, Vegetarian; Drug approval; Family income; Fasting; Fatty liver; Food groups; Glucose; Health aspects; Health care; Hepatitis B; Hepatitis C; Humans; Liver; Liver diseases; Medical research; Medicine, Experimental; Minority & ethnic groups; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - etiology; nonalcoholic fatty liver diseases; Nutrition research; plant-based diet; Plant-based foods; Plants; Population; Prevention; Statistical analysis; Vegetarianism; Womens health; China; United States > US; controlled attenuation parameter; nonalcoholic fatty liver diseases; plant-based diet; body mass index
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14194099

There is little evidence for the associations of the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI) with the odds of nonalcoholic fatty liver disease (NAFLD). We present a nationwide cross-sectional study among US adults aged 18 years or older. Diet was assessed by 24-h recalls. Overall PDI, hPDI, and uPDI were constructed based on 18 food groups. NAFLD was defined based on controlled attenuation parameter derived via transient elastography (TE) in the absence of other causes of chronic liver disease. Among 3900 participants with eligible TE examination, 1686 were diagnosed with NAFLD. The overall PDI was not associated with NAFLD prevalence (comparing extreme tertiles of PDI score OR = 1.03, 95% CI 0.76, 1.38, ptrend = 0.609). However, hPDI was inversely (OR = 0.50, 95% CI 0.35, 0.72, ptrend < 0.001), while uPDI was positively associated with odds of NAFLD (OR = 1.37, 95% CI 0.93, 2.02, ptrend = 0.009) in the multivariable-adjusted models without body mass index (BMI). After further adjustment for BMI, only the association of hPDI with NAFLD remained statistically significant (OR = 0.64, 95% CI 0.46, 0.87, ptrend = 0.006). Such inverse association appeared stronger in non-Hispanic whites, but not in other racial/ethnic groups (pinteraction = 0.009). Our findings suggest that a plant-based diet rich in healthy plant foods might be associated with lower odds of NAFLD, particularly among US non-Hispanic whites. Clinical trials and cohort studies to validate our findings are needed.