[Association between dietary patterns and non-alcoholic fatty liver disease among adults from 15 provinces of China in 2015]

To analyze the relationship between dietary pattern and nonalcoholic fatty liver disease (NAFLD) among adults.

Individuals aged ≥18 years with completed data in China Health and Nutrition Survey 2015 were selected. Dietary survey was performed using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Dietary pattern was extracted using factor analysis, and scores were categorized into four groups by quartiles. NAFLD was screened using the fatty liver index (FLI) and NAFLD liver fat score (LFS). Association between dietary patterns and NAFLD was analyzed using multivariate logistic regression model. Subgroup analyses were conducted by age, gender and eating out.

A total of 9147 participants were included, and four dietary patterns were identified, named as Rice-Veg-Pork dietary pattern, Egg-Fruit dietary pattern, Wheat-Mixed Grain dietary pattern, and Poultry-and-Other-Red-Meat dietary pattern. The prevalence of NAFLD screened by FLI and NAFLD-LFS were 15.0% and 11.1%, respectively. The result showed that Rice-Veg-Pork dietary pattern and Egg-Fruit dietary pattern were not associated with the prevalence of NAFLD. Compared with the lowest quartile group (Q1), adults in the highest quartile group (Q4) of Wheat-Mixed Grain dietary pattern score had a significantly reduced odds of developing NAFLD (FLI: OR=0.766, 95%CI 0.623-0.942, Ptrend=0.002; NAFLD-LFS: OR=0.656, 95%CI 0.536-0.803, Ptrend<0.001). Similar result were observed in subgroups aged 45-59 years, ≥60 years, females, and those eating out. Poultry-and-Other-Red-Meat dietary pattern score was positively associated with odds of NAFLD (NAFLD-LFS: OR=1.088, 95%CI 1.017-1.163), and this association was not influenced by dining out.

Wheat-Mixed Grain dietary pattern could reduce the odds of NAFLD in adults, whereas Poultry-and-Other-Red-Meat dietary pattern is converse.