Association of Dietary Patterns with MRI Markers of Hepatic Inflammation and Fibrosis in the MAST4HEALTH Study

Whereas the etiology of non-alcoholic fatty liver disease (NAFLD) is complex, the role of nutrition as a causing and preventive factor is not fully explored. The aim of this study is to associate dietary patterns with magnetic resonance imaging (MRI) parameters in a European population (Greece, Italy, and Serbia) affected by NAFLD. For the first time, iron-corrected T1 (cT1), proton density fat fraction (PDFF), and the liver inflammation fibrosis score (LIF) were examined in relation to diet. A total of 97 obese patients with NAFLD from the MAST4HEALTH study were included in the analysis. A validated semi-quantitative food frequency questionnaire (FFQ) was used to assess the quality of diet and food combinations. Other variables investigated include anthropometric measurements, total type 2 diabetes risk, physical activity level (PAL), and smoking status. Principal component analysis (PCA) was performed to identify dietary patterns. Six dietary patterns were identified, namely High-Sugar, Prudent, Western, High-Fat and Salt, Plant-Based, and Low-Fat Dairy and Poultry. The Western pattern was positively associated with cT1 in the unadjusted model (beta: 0.020, p-Value: 0.025) and even after adjusting for age, sex, body mass index (BMI), PAL, smoking, the center of the study, and the other five dietary patterns (beta: 0.024, p-Value: 0.020). On the contrary, compared with low-intake patients, those with medium intake of the Low-Fat Dairy and Poultry pattern were associated with lower values of cT1, PDFF, and LIF. However, patients with a Low-Fat Dairy and Poultry dietary pattern were negatively associated with MRI parameters (cT1: beta: -0.052, p-Value: 0.046, PDFF: beta: -0.448, p-Value: 0.030, LIF: beta: -0.408, p-Value: 0.025). Our findings indicate several associations between MRI parameters and dietary patterns in NAFLD patients, highlighting the importance of diet in NAFLD.

Automated summary

This study investigated the association between dietary patterns and MRI parameters in European NAFLD patients. The results showed a positive correlation between the Western dietary pattern and the severity of liver disease, while the Low-Fat Dairy and Poultry dietary pattern was associated with lower liver disease values. These findings emphasize the importance of diet in NAFLD.