title: Dietary history and physical activity and risk of advanced liver disease in veterans with chronic hepatitis C infection.
abstract: BACKGROUND
  The role of customary diet and physical activity in development of advanced HCV-related liver disease is not well-established.
  
  
  METHODS
  We conducted a retrospective association study in 91 male veterans with PCR-confirmed chronic HCV and biopsy-determined hepatic pathology. Respondents completed the Block Food Frequency and the International Physical Activity questionnaires. We conducted three independent assessments based on hepatic pathology: fibrosis (advanced = F3-F4 vs. mild = F1-F2), inflammation (advanced = A2-A3 vs. mild = A1) and steatosis (advanced = S2-S3 vs. mild = S1). Each assessment compared estimated dietary intake and physical activity in veterans with advanced disease to that in analogous veterans with mild disease. Multivariate models adjusted for total calories, age, race/ethnicity, biopsy-to-survey lag-time, BMI, pack-years smoking, and current alcohol use.
  
  
  RESULTS
  Average veteran age was 52, with 48% African-American. Advanced fibrosis was more prevalent than advanced inflammation or steatosis (52.7% vs. 29.7% vs. 26.4%, respectively). The strongest multivariate association was the suggestive 14-fold significantly decreased advanced fibrosis risk with lowest dietary copper intake (OR = 0.07, 95% CI 0.01-0.60). Other suggestive associations included the 6.5-fold significantly increased advanced inflammation risk with lower vitamin E intake and 6.2-fold significantly increased advanced steatosis risk with lower riboflavin intake. The only physical activity associated with degree of hepatic pathology was a two-fold greater weekly MET-minutes walking in veterans with mild compared to advanced steatosis (P = 0.02).
  
  
  CONCLUSIONS
  Several dietary factors and walking may be associated with risk of advanced HCV-related liver disease in male veterans. However, given our modest sample size, our findings must be considered as provisional pending verification in larger prospective studies.
authors.affiliation: Section of Health Services Research, Department of Medicine, Baylor College of Medicine, 2450 Holcombe Blvd 01Y, Houston, TX 77021, USA. dwhite1@bcm.edu
authors.forename: Donna L
authors.initials: DL
authors.lastname: White
authors.forename: Peter A
authors.initials: PA
authors.lastname: Richardson
authors.forename: Mukhtar
authors.initials: M
authors.lastname: Al-Saadi
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Fitzgerald
authors.forename: Linda
authors.initials: L
authors.lastname: Green
authors.forename: Chami
authors.initials: C
authors.lastname: Amaratunge
authors.forename: Manvir
authors.initials: M
authors.lastname: Anand
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D000328:Adult; D003069:Coffee; D003625:Data Collection; D005234:Fatty Liver / Q000209:etiology; D005247:Feeding Behavior; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D003069:Coffee