title: Associations between dietary intake and the presence of the metabolic syndrome in patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Although dietary habits have been associated with the likelihood of the metabolic syndrome (MetS) in the general population, similar associations in non-alcoholic fatty liver disease (NAFLD) patients have not been explored. The aim of this cross-sectional study was to assess the presence of the MetS and to explore its potential association with dietary habits in a sample of NAFLD patients.
  
  
  METHODS
  Seventy-three adult patients with recent NAFLD diagnosis based on elevated liver enzyme levels and evidence of hepatic steatosis on ultrasound were enrolled. Participants' habitual food consumption was retrospectively assessed through a food frequency questionnaire and adherence to the Mediterranean diet (MD) was assessed via the Mediterranean Diet Score (MedDietScore). The presence of the MetS was defined as the concomitant presence of at least three of its individual components, according to the criteria proposed by a recent joint statement of several major organisations.
  
  
  RESULTS
  The MetS was present in 46.5% of the sample, with increased waist circumference values and decreased high-density lipoprotein cholesterol levels being the most prevalent disorders (63% and 88.7%, respectively). Consumption of refined grains [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.00-1.05] and red meat and products (OR = 1.10, 95% CI = 1.01-1.21) were positively associated with the presence of the MetS, whereas the consumption of whole grains (OR = 0.92, 95% CI = 0.84-0.99) and MedDietScore (OR = 0.87, 95% CI = 0.76-0.99) were negatively associated, after adjusting for participants' age, sex, daily energy intake and time spent in sedentary activities.
  
  
  CONCLUSIONS
  Low refined grain and red meat intake, high whole grain intake and high adherence to the MD were associated with lower odds of the MetS in NAFLD patients.
authors.affiliation: Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Georgoulis
authors.affiliation: Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: M D
authors.initials: MD
authors.lastname: Kontogianni
authors.affiliation: Second Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Margariti
authors.affiliation: Laboratory of Histology & Embryology, Medical School, National & Kapodistrian University of Athens, Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Tiniakos
authors.affiliation: Department of Nutrition & Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Fragopoulou
authors.affiliation: Second Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Athens, Greece.
authors.forename: R
authors.initials: R
authors.lastname: Zafiropoulou
authors.affiliation: Second Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Athens, Greece.|Department of Gastroenterology, Athens University Medical School, Laiko Hospital of Athens, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Papatheodoridis
mesh_terms: D000328:Adult; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet; D038441:Diet, Mediterranean; D002523:Edible Grain; D005247:Feeding Behavior; D005260:Female; D005511:Food Handling; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000453:epidemiology; D000069466:Red Meat; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL
keywords: Mediterranean diet; dietary habits; food groups; insulin resistance; liver steatosis