Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study.

Autor: Doustmohammadian A; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Amirkalali B; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Gholizadeh E; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Khoonsari M; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Faraji AH; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Nikkhah M; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Maadi M; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Motamed N; Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran., Mansourian MR; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Hajjar M; Student Research Committee (National Nutrition and Food Technology Research Institute, Department of Community Nutrition, School of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Tehran, Iran., Clark CCT; Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK., Chaibakhsh S; Eye Reasearch Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., Tameshkel FS; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Afzali A; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran., Zamani F; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran. zamani.farhad@gmail.com.
Jazyk: angličtina
Zdroj: European journal of clinical nutrition [Eur J Clin Nutr] 2023 Mar; Vol. 77 (3), pp. 370-379. Date of Electronic Publication: 2022 Nov 28.
DOI: 10.1038/s41430-022-01240-0
Abstrakt: Background: The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM).
Methods: A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols.
Results: DDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: β = 0.14, P < 0.0001, and of WC to NAFLD: β = 0.50, P < 0.001). Vegetable and fruit diversity scores had a significant negative indirect relationship with NAFLD prevalence through DAL (β = -0.06, P = 0.001, β = -0.10, P < 0.001, respectively). Meat diversity score was positively associated with NAFLD prevalence in a full mediational process through DAL (β = 0.12, P < 0.001). The SEM fit indices suggested a reasonably adequate fit of the data to the DDS model (Χ2/df = 4.76, GFI = 0.98, AGFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.03, and SRMR = 0.02) and its sub-scores model (Χ 2 /df = 4.72, GFI = 0.98, AGFI = 0.97, IFI = 0.95, CFI = 0.95, RMSEA = 0.03, and SRMR = 0.02).
Conclusion: Meat diversity and lack of vegetable and fruit diversity were indirectly associated with NAFLD prevalence through DAL and WC mediators. Interventions for NAFLD may be more successful if they target a lower intake of animal protein sources and dietary diversity, particularly vegetable and fruit diversity.
(© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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