Consuming dietary fiber may reduce NAFLD risk among multiple ethnicities

Researchers found that while consumption of red and processed meat, poultry, and cholesterol correlated with nonalcoholic fatty liver disease, dietary fiber intake may reduce the risk for fatty liver and related advanced liver disease, according to data from a multiethnic cohort study.

“The association of insulin resistance and obesity with NAFLD highlights the importance of excess energy intake,” Mazen Noureddin, MD, from Cedars-Sinai Medical Center in Los Angeles, California, and colleagues wrote. “However, diet composition can also contribute to the development of insulin resistance and NAFLD.”

Noureddin and colleagues performed an analysis of dietary risk factors for NAFLD alone and NAFLD with cirrhosis. The cohort comprised more than 215,000 adults aged 45 years to 75 years, of whom 2,974 had NAFLD. Patient ethnicities included Japanese Americans (50%), Latino Americans (21%), Caucasian Americans (16%), African Americans (7%), and Native Hawaiians (6%).

Results revealed that the consumption of red meat (OR = 1.16; 95% CI, 1.04-1.3), processed red meat (OR = 1.18; 95% CI, 1.05-1.32), and poultry correlated with NAFLD (OR = 1.16; 95% CI, 1.04-1.3), and processed poultry showed a similar trend (OR = 1.12; 95% CI, 1.01-1.24). The correlation for combined red meat and processed red meat was stronger for those with NAFLD and cirrhosis than those without (OR = 1.43; 95% CI, 1.08-1.9).

Dietary effects on risk for NAFLD: increased risk from red meats and poultry vs. lower risk from dietary fiber.

Cholesterol also correlated with NAFLD (OR = 1.16; 95% CI, 1.03-1.29), especially among those with cirrhosis compared with those without cirrhosis (OR = 1.52; 95% CI, 1.15-2.01).

In contrast, dietary fiber intake correlated inversely with NAFLD (OR = 0.84; 95% CI, 0.74-0.95), with no significant differences in correlations of dietary fiber between NAFLD with and without cirrhosis.

“Only few, smaller observational studies reported that NAFLD patients consume less vegetables and dietary fibers than controls,” the researchers wrote. “Randomized intervention studies have shown that fiber intake improves liver enzymes and non-invasive NAFLD scores among participants with NAFLD.”

Noureddin and colleagues noted that high fiber intake is one of the plausible molecular mechanisms for the beneficial effect of the Mediterranean diet that has been previously observed in NAFLD. They encourage further studies to support these findings and a recommendation for these kinds of dietary changes in patients with NAFLD. – by Talitha Bennett

Disclosures: The authors report no relevant financial disclosures.