Human Nutrition & Metabolism (Jun 2023)
Association of nutrient intake with non-alcoholic fatty liver disease and liver steatosis in adult Indian population – A case control study
Abstract
Background: Dietary and nutrient intake is an important factor in the development and management of non-alcoholic fatty liver disease (NAFLD) however, optimal dietary and nutrient composition remains unclear. Data on detailed nutrient intake of NAFLD patients from India is scarce. There are no studies on the relationship between nutrient intake and markers of liver health (liver fibrosis and liver steatosis) in Indian adults diagnosed with NAFLD. Objectives: The objectives of this study were to (i) Assess the intake of macro and micro nutrients between NAFLD Cases and Controls (ii) to compare the nutrient intake of adult participants with the EAR (Estimated Average Requirements for Indians) (2020) (iii) to study the association of nutrients with NAFLD (iv) to explore the relationships between select nutrients and markers of metabolic and liver health (liver fibrosis and liver steatosis). Methods & materials: 160 NAFLD Cases and 160 Controls (n = 320) from Gastro and Medicine OPD of AIIMS hospital were recruited for the study.24 h nutrient intake for 2 days, anthropometrics, blood biomarkers. Fibro scan to study both hepatic fibrosis and steatosis was undertaken to assess Liver stiffness measurement (LSM) and Controlled attenuation parameter (CAP score).Nutrient intake was compared with EAR 2020 for Indians. Association between NAFLD and nutrient intake was done by logistic regression. Results: The NAFLD Cases showed significantly higher amounts of SFA(g), percent SFA (%), PUFA(g), percent PUFA (%), n6 (g) and n6/n3 ratio compared to controls (p 8% of the total calories. Significant inverse association of percent proteins (5–15%) with NAFLD was observed(p < 0.05). Percent carbohydrates and percent SFA (saturated fatty acid) emerged as significant risk factors for increase in CAP score (liver steatosis) of NAFLD subjects, whereas percent proteins, magnesium and Vitamin C were inversely associated with liver steatosis (p < 0.05). Conclusion: The overall nutrient intake in NAFLD cases and Controls was low suggesting lower diet quality. High intake of SFA (g) increases the risk of NAFLD and increasing proteins in the diet maybe protective against NAFLD. Associations between select macro and micronutrients and liver health markers warrant further investigation.
