Alcohol, NAFLD, Other : Associations between Intakes of Individual Nutrients or Whole Food Groups and Non-alcoholic Fatty Liver Disease among Korean Adults: A Nationwide Multicenter Case-Control Study

Background: Dietary factors are closely associated with the risk of non-alcoholic fatty liver disease (NAFLD). Asian and Western diets differ in energy-nutrient composition, fatty-acid composition, and main nutritional sources; therefore, the implications would be limited if the Western-oriented study results Methods: : In total, 348 subjects were recruited from 5 participating hospitals. Information on socio-demographic character- istics and health-related behaviors were obtained through faceto- face interviews. Dietary intakes were assessed with a 24- hour recall applying a multiple pass approach and 4-day food records that included 1 or 2 weekend days. Results: There were no significant differences in health-related behaviors between the cases and controls except for smoking behavior. The cases had elevated triacylglycerol, fasting glucose, and low-density lipoprotein cholesterol levels compared to the controls. In men, after adjusting for variables, low intakes of vitamin C (odds ratio [OR], 4.23), vitamin K (OR, 3.93), folate (OR, 3.37), omega-3 fatty acids (OR, 2.16), and nuts & seeds (OR, 3.66) were associated with a significantly higher risk for developing NAFLD. In women, vitamin K (OR, 2.54) and vegetable (OR, 4.11) intakes showed a significant beneficial effect for lowering NAFLD risk. Conclusions: Adequate intakes of vitamin C, vitamin K, folate, omega-3 fatty acids, nuts & seeds, and vegetables may help in preventing NAFLD in Korean adults.