title: The impact of cereal grain consumption on the development and severity of non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  There is evidence that dietary habits contribute to the presence and severity of non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to explore any associations between consumption of grains and the development and severity of NAFLD.
  
  
  METHODS
  Seventy-three consecutive NAFLD patients were enrolled. Additionally, 58 controls matched for age, sex and body mass index with 58 patients were also included. Consumption of grains was estimated through a semi-quantitative food frequency questionnaire. Medical history, anthropometric indices, body composition analysis, physical activity data, biochemical and inflammatory markers were available for all the participants. Liver stiffness measurement by transient elastography was performed in 58 and liver biopsy in 34 patients.
  
  
  RESULTS
  In patients, consumption of whole grains was associated with lower abdominal fat level (β = -0.24, p = 0.02) and lower levels of insulin resistance index (β = -0.28, p = 0.009), while it also correlated inversely with interleukin-6 levels (ρ = -0.23, p = 0.05). Consumption of whole grains was associated with lower likelihood of having histological steatohepatitis (OR 0.97, 95% CI 0.94-1.000), after adjusting for sex and energy intake, but the association became weaker after further adjusting for abdominal fat or interleukin-6 levels. In the case-control analysis, consumption of refined grains was associated with higher odds of having NAFLD (OR 1.021, 95% CI 1.001-1.042), after adjusting for age, sex, energy intake, abdominal fat level, HOMA-IR, LDL, adiponectin and TNF-α.
  
  
  CONCLUSIONS
  Although refined grain consumption increased the likelihood of having NAFLD, whole-grain consumption favorably affected clinical characteristics of patients with NAFLD and tended to be associated with less severe disease.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, Kallithea, 17671, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Georgoulis
authors.forename: Meropi D
authors.initials: MD
authors.lastname: Kontogianni
authors.forename: Nafsika
authors.initials: N
authors.lastname: Tileli
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Margariti
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Fragopoulou
authors.forename: Dina
authors.initials: D
authors.lastname: Tiniakos
authors.forename: Rodessa
authors.initials: R
authors.lastname: Zafiropoulou
authors.forename: George
authors.initials: G
authors.lastname: Papatheodoridis
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D002523:Edible Grain; D005215:Fasting; D005234:Fatty Liver / Q000097:blood / Q000473:pathology; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008019:Life Style; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000473:pathology*
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015850:Interleukin-6