DASH Diet May Be Protective of Incident Nonalcoholic Fatty Liver Disease Risk

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Researchers investigated whether adherence to specific diets were associated with changes in liver fat or incident nonalcoholic fatty liver disease.

Greater adherence to the Dietary Approach to Stop Hypertension (DASH) diet was strongly protective against the risk for incident nonalcoholic fatty liver disease (NAFLD) among middle-aged adults, and higher Mediterranean diet (MeDiet) scores were weakly but inversely associated with NAFLD, according to study results presented at Digestive Disease Week (DDW), held from May 21 to 24, 2022, in San Diego, California, and virtually.

Researchers investigated whether adherence to diets such as DASH and the MeDiet were associated with changes in liver fat or incident NAFLD in the Framingham Heart Study, and whether these associations were modified by other risk factors.

Participants’ liver fat attenuation was measured via computed tomography scan, and food frequency questionnaires were administered to obtain dietary data, which were then used to calculate DASH and MeDiet adherence scores.

Modified poison regression models were used to determine incident NAFLD risk ratios (RR) and 95% CIs. Linear regression models were used to compute adjusted means of liver fat change after a median follow-up period of 6 years.

Participants who had higher DASH or MeDiet scores were primarily women with a mean age of 51±9 years and were less likely to be current smokers compared with those with lower scores. The participants with higher scores also had lower baseline body mass index or abdominal adiposity. Among the cohort, 18.6% developed NAFLD, and liver fat increased on average for all participants.

Greater adherence to the DASH diet was associated with a 37% lower risk of incident NAFLD (95% CI, 0.43-0.92) and a statistically significantly less increase in liver fat compared with lower adherence. The protective effects of the DASH score were modified by anthropometric and medical-related factors.

Participants with higher DASH scores and lower abdominal adiposity had a lower NAFLD risk (relative risk [RR], 0.15; 95% CI, 0.07-0.32) vs those with either risk factor alone (RR for higher DASH scores: 0.82; 95% CI, 0.56-1.19; RR for lower adiposity: 0.30; 95% CI, 0.21-0.43).

A higher DASH score and no prevalent hypertension or diabetes was associated with the lowest NAFLD risk. The association with higher MeDiet adherence scores was weaker except among participants who had a lower ratio of fasting triglyceride to high-density lipoprotein (RR, 0.51; 95% CI, 0.37-0.71).


Yiannakou I, Singer MR, Moore LL, Long MT. Higher diet quality is associated with lower non-alcoholic fatty liver disease in the Framingham Heart Study. Presented at: DDW 2022; May 21-24, 2022; San Diego, CA. Presentation EP1221.