Nutritional assessments of patients with non-alcoholic fatty liver disease.
BACKGROUND
Obesity is not only associated with nonalcoholic fatty liver disease (NAFLD) but it also adversely affects the progression of other liver diseases. There are limited data regarding the dietary habits of patients with chronic liver disease.


METHODS
Nutrition surveys containing 13 different food groups were mailed. Nutrition scores were calculated based on weekly servings. Foods were also divided into USDA food pyramid categories with conversion of each group into calories expended. Clinico-demographic data were available. NAFLD patients were compared to patients with chronic viral hepatitis.


RESULTS
A total of 233 subjects were included: age 52.5 +/- 10.0 years, Body mass index (BMI) 28.1 +/- 6.5, MS 24.2%, 31.8% NAFLD, 48.1% hepatitis C virus (HCV), and 20.2% hepatitis B virus (HBV). Six nutrition indices were different among the groups. NAFLD and HCV consumed more low-nutrient food (p = 0.0037 and 0.0011) and more high-sodium food than HBV (p = 0.0052 and 0.0161). Multivariate analysis showed that NAFLD and HCV consumed more high-fat sources of meat/protein than HBV (p = 0.0887 and 0.0626). NAFLD patients consumed less calories from fruits compared to HCV and HBV patients (p = 0.0273 and 0.0023). Nine nutrition indices differed according to BMI. Univariate analysis showed that obese/overweight patients consumed more high-fat sources of meat/protein (p = 0.0078 and 0.0149) and more high-sodium foods (p = 0.0089 and 0.0062) compared to the normal-weight patients. In multivariate analysis, normal-weight patients consumed more fruits than obese (p = 0.0307). Overweight patients also consumed more calories of meat and oil than normal-weight patients (p = 0.0185 and 0.0287).


CONCLUSIONS
NAFLD and HCV patients have similar dietary habits. Patients with HBV have the healthiest dietary habits. Specific dietary interventions should focus on decreasing intake of low-nutrient and high-sodium food, as well as high-fat sources of meat/protein.
Center for Liver Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
Chin Hee
CH
Kim
Jillian B
JB
Kallman
Chunhong
C
Bai
Lisa
L
Pawloski
Constance
C
Gewa
Aimal
A
Arsalla
Mary Ellen
ME
Sabatella
Zobair M
ZM
Younossi
D000704:Analysis of Variance; D015992:Body Mass Index; D004034:Diet Surveys; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D004044:Dietary Proteins / Q000008:administration & dosage; D005234:Fatty Liver / Q000209:etiology / Q000523:psychology*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology*; D005260:Female; D005518:Food Preferences; D005638:Fruit; D019694:Hepatitis B, Chronic / Q000523:psychology*; D019698:Hepatitis C, Chronic / Q000523:psychology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000523:psychology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000523:psychology; D018570:Risk Assessment; D012307:Risk Factors; D014675:Vegetables
D004041:Dietary Fats; D004044:Dietary Proteins