A dietary assessment of non-alcoholic fatty liver disease in a Sri Lankan cohort: case control study

Abstract

INTRODUCTION AND OBJECTIVES: Sri Lanka is experiencing a rapidly rising incidence of Non Alcoholic Fatty Liver Disease (NAFLD) and its associated complications. The aim of the study was to evaluate dietary and lifestyle risk factors in an already diagnosed cohort of patients with NAFLD. METHOD: 50 patients with alcohol consumption not exceeding the safe limits and having ultrasonically detected fatty liver (NAFLD cases) from January to September 2015 were compared with age and the gender-matched patients who had normal ultra sound scans (controls). A pre-tested general questionnaire and a quantitative food frequency questionnaire (FFQ) was used to collect information and Food Base, 2000 analytical software was used to calculate per day macronutrient consumption. RESULTS: The mean age of the cases and the controls were 40 years. The mean BMI in cases and controls were 27.7(SD: ±4.6) and 25.2 ( SD : ±4.3 ) (p= 0.006) respectively. Prevalence of diabetes was higher among NAFLD cases (60% vs. 18%, P<0.000). In univariate analysis NAFLD cases had higher total energy consumption (2580.7 kcal vs. 1905.8 kcal, p=0.000) and individual macronutrient consumption. They had higher sweet consumption (72% vs 22%, p=0.000), but reduced fruits (48% vs 14%, p=0.000) and vegetables (48% vs 6%, p=0.000) consumption. In multivariate model, consumption of sweets (OR: 79.9, p= 0.027), vegetables (OR: 0.007, p=0.028) and fruits (OR : 0.014, p=0.031) individually predicted NAFLD. CONCLUSION: Increased consumption of sweets with reduced consumption of fruits and vegetables could be a risk factor for NAFLD.