title: Survey of health status, nutrition and geography of food selection of chronic liver disease patients.
abstract: BACKGROUND
  Obesity, a complex disease determined both by genetic and environmental factors, is strongly associated with NAFLD, and has been demonstrated to have a negative impact on HCV and other chronic liver diseases (CLD).
  
  
  BACKGROUND
  This study assessed the association between type and location of food sources and chronic liver disease (CLD) using Geographic Information Systems (GIS).
  
  
  RESULTS
  CLD patients completed surveys [267 subjects, 56.5% female, age 55.8 ± 12.0, type of CLD: 36.5% hepatitis C (HCV), 19.9% hepatitis B (HBV), 19.9% non-alcoholic fatty liver disease (NAFLD); primary food source (PFS): 80.8% grocery store, secondary: 26.2% bulk food store, tertiary: 20.5% restaurants; fresh food (FF): 83%, pre-packaged (PP) 8.7%, already prepared (AP) 8.3%]. FF consumers had significantly fewer UEH servings/month (p = 0.030) and lived further away from convenience stores (1.69 vs. 0.95 km, p = 0.0001). Stepwise regression reveals the lowest FF consumers were NAFLD patients, subjects with UEH or restaurants and ethnic food stores as their PFS (R = 0.557, p = 0.0001). Eating already-packaged foods and utilizing restaurants or ethnic food stores as the PFS positively correlated with NAFLD (R = 0.546, p = 0.0001).
  
  
  CONCLUSIONS
  Environmental food source measures, including type and density, should be included when examining areas hyper-saturated with a variety of food options. In hyper-saturated food environments, NAFLD patients consume more prepared food and less FF. CLD patients with UEH also eat significantly more prepared food and frequent restaurants and ethnic food stores as their PFS.
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Department of Geography & Geoinformation Science, George Mason University, Fairfax, VA, United States.
authors.forename: Timothy
authors.initials: T
authors.lastname: Leslie
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, United States.
authors.forename: Lisa
authors.initials: L
authors.lastname: Pawloski
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States.
authors.forename: Jillian
authors.initials: J
authors.lastname: Kallman-Price
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States.
authors.forename: Carey
authors.initials: C
authors.lastname: Escheik
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States.
authors.forename: Noreen
authors.initials: N
authors.lastname: Hossain
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States.
authors.forename: Yun
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States; Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States.
authors.forename: Lynn H
authors.initials: LH
authors.lastname: Gerber
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States.
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004777:Environment; D057140:Fast Foods; D005260:Female; D005518:Food Preferences; D005523:Food Supply; D005638:Fruit; D040362:Geographic Information Systems; D006304:Health Status; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D012111:Residence Characteristics; D012147:Restaurants; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014675:Vegetables