The anti-inflammatory potential of diet and nonalcoholic fatty liver disease

The ATTICA study

Stefanos Tyrovolas, Demosthenes B. Panagiotakos, Ekavi N. Georgousopoulou, Christina Chrysohoou, John Skoumas, William Pan, Dimitrios Tousoulis, Christos Pitsavos

Research output: Contribution to journalArticle

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is correlated with low-grade inflammation and dietary habits. Until today, there have been limited epidemiologic data assessing the role of diet’s inflammatory potential on NAFLD. The aim was to evaluate the relationship between an anti-inflammatory diet, as reflected by the Dietary Anti-Inflammation Index (D-AII), and NAFLD among cardiovascular disease (CVD)-free adults. Methods: ATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek population (Whites; age ⩾18 years; 1514 men and 1528 women). D-AII was calculated using a standard procedure. The baseline study captured various sociodemographic, lifestyle and clinical characteristics as well as hepatic markers. These were used to calculate four NAFLD assessment indices: triglyceride-glucose (TyG) index, fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD Fatty Liver Score (NAFLD-FLS). Specific cutoffs were applied to capture NAFLD. Results: D-AII showed a significant inverse association with NAFLD, applying the four indices with NAFLD cutoffs [odds ratio (OR) with 95% confidence interval (CI); TyG (0.95, 0.93–0.98); HSI (0.89, 0.86–0.92); FLI (0.88, 0.85–0.91); NAFLD-FLS (0.89, 0.86–0.92)], after adjusting for various confounders. Participants in the highest D-AII tertile had lower odds of having NAFLD, compared with those in the lowest D-AII tertile [(OR, 95% CI); TyG (0.33, 0.24–0.47); HSI (0.13, 0.08–0.23); FLI (0.05, 0.02–0.11); NAFLD-FLS (0.13, 0.07–0.23)]. Anti-inflammatory nutrition was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. Conclusions: Anti-inflammatory diet is an important predictor of NAFLD among adults without pre-existing CVD. Adherence to a high anti-inflammatory diet seems to contribute to NAFLD prevention.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalTherapeutic Advances in Gastroenterology
Volume12
DOIs
Publication statusPublished - 1 Jan 2019

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Anti-Inflammatory Agents
Diet
Fatty Liver
Inflammation
Preexisting Condition Coverage
Triglycerides
Cardiovascular Diseases
Liver
Non-alcoholic Fatty Liver Disease
Glucose
Odds Ratio
Confidence Intervals
Feeding Behavior
Population
Life Style
Alcohols

Cite this

Tyrovolas, S., Panagiotakos, D. B., Georgousopoulou, E. N., Chrysohoou, C., Skoumas, J., Pan, W., ... Pitsavos, C. (2019). The anti-inflammatory potential of diet and nonalcoholic fatty liver disease: The ATTICA study. Therapeutic Advances in Gastroenterology, 12, 1-11. https://doi.org/10.1177/1756284819858039
Tyrovolas, Stefanos ; Panagiotakos, Demosthenes B. ; Georgousopoulou, Ekavi N. ; Chrysohoou, Christina ; Skoumas, John ; Pan, William ; Tousoulis, Dimitrios ; Pitsavos, Christos. / The anti-inflammatory potential of diet and nonalcoholic fatty liver disease : The ATTICA study. In: Therapeutic Advances in Gastroenterology. 2019 ; Vol. 12. pp. 1-11.
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abstract = "Background: Nonalcoholic fatty liver disease (NAFLD) is correlated with low-grade inflammation and dietary habits. Until today, there have been limited epidemiologic data assessing the role of diet’s inflammatory potential on NAFLD. The aim was to evaluate the relationship between an anti-inflammatory diet, as reflected by the Dietary Anti-Inflammation Index (D-AII), and NAFLD among cardiovascular disease (CVD)-free adults. Methods: ATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek population (Whites; age ⩾18 years; 1514 men and 1528 women). D-AII was calculated using a standard procedure. The baseline study captured various sociodemographic, lifestyle and clinical characteristics as well as hepatic markers. These were used to calculate four NAFLD assessment indices: triglyceride-glucose (TyG) index, fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD Fatty Liver Score (NAFLD-FLS). Specific cutoffs were applied to capture NAFLD. Results: D-AII showed a significant inverse association with NAFLD, applying the four indices with NAFLD cutoffs [odds ratio (OR) with 95{\%} confidence interval (CI); TyG (0.95, 0.93–0.98); HSI (0.89, 0.86–0.92); FLI (0.88, 0.85–0.91); NAFLD-FLS (0.89, 0.86–0.92)], after adjusting for various confounders. Participants in the highest D-AII tertile had lower odds of having NAFLD, compared with those in the lowest D-AII tertile [(OR, 95{\%} CI); TyG (0.33, 0.24–0.47); HSI (0.13, 0.08–0.23); FLI (0.05, 0.02–0.11); NAFLD-FLS (0.13, 0.07–0.23)]. Anti-inflammatory nutrition was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. Conclusions: Anti-inflammatory diet is an important predictor of NAFLD among adults without pre-existing CVD. Adherence to a high anti-inflammatory diet seems to contribute to NAFLD prevention.",
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author = "Stefanos Tyrovolas and Panagiotakos, {Demosthenes B.} and Georgousopoulou, {Ekavi N.} and Christina Chrysohoou and John Skoumas and William Pan and Dimitrios Tousoulis and Christos Pitsavos",
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Tyrovolas, S, Panagiotakos, DB, Georgousopoulou, EN, Chrysohoou, C, Skoumas, J, Pan, W, Tousoulis, D & Pitsavos, C 2019, 'The anti-inflammatory potential of diet and nonalcoholic fatty liver disease: The ATTICA study', Therapeutic Advances in Gastroenterology, vol. 12, pp. 1-11. https://doi.org/10.1177/1756284819858039

The anti-inflammatory potential of diet and nonalcoholic fatty liver disease : The ATTICA study. / Tyrovolas, Stefanos; Panagiotakos, Demosthenes B.; Georgousopoulou, Ekavi N.; Chrysohoou, Christina; Skoumas, John; Pan, William; Tousoulis, Dimitrios; Pitsavos, Christos.

In: Therapeutic Advances in Gastroenterology, Vol. 12, 01.01.2019, p. 1-11.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The anti-inflammatory potential of diet and nonalcoholic fatty liver disease

T2 - The ATTICA study

AU - Tyrovolas, Stefanos

AU - Panagiotakos, Demosthenes B.

AU - Georgousopoulou, Ekavi N.

AU - Chrysohoou, Christina

AU - Skoumas, John

AU - Pan, William

AU - Tousoulis, Dimitrios

AU - Pitsavos, Christos

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Nonalcoholic fatty liver disease (NAFLD) is correlated with low-grade inflammation and dietary habits. Until today, there have been limited epidemiologic data assessing the role of diet’s inflammatory potential on NAFLD. The aim was to evaluate the relationship between an anti-inflammatory diet, as reflected by the Dietary Anti-Inflammation Index (D-AII), and NAFLD among cardiovascular disease (CVD)-free adults. Methods: ATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek population (Whites; age ⩾18 years; 1514 men and 1528 women). D-AII was calculated using a standard procedure. The baseline study captured various sociodemographic, lifestyle and clinical characteristics as well as hepatic markers. These were used to calculate four NAFLD assessment indices: triglyceride-glucose (TyG) index, fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD Fatty Liver Score (NAFLD-FLS). Specific cutoffs were applied to capture NAFLD. Results: D-AII showed a significant inverse association with NAFLD, applying the four indices with NAFLD cutoffs [odds ratio (OR) with 95% confidence interval (CI); TyG (0.95, 0.93–0.98); HSI (0.89, 0.86–0.92); FLI (0.88, 0.85–0.91); NAFLD-FLS (0.89, 0.86–0.92)], after adjusting for various confounders. Participants in the highest D-AII tertile had lower odds of having NAFLD, compared with those in the lowest D-AII tertile [(OR, 95% CI); TyG (0.33, 0.24–0.47); HSI (0.13, 0.08–0.23); FLI (0.05, 0.02–0.11); NAFLD-FLS (0.13, 0.07–0.23)]. Anti-inflammatory nutrition was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. Conclusions: Anti-inflammatory diet is an important predictor of NAFLD among adults without pre-existing CVD. Adherence to a high anti-inflammatory diet seems to contribute to NAFLD prevention.

AB - Background: Nonalcoholic fatty liver disease (NAFLD) is correlated with low-grade inflammation and dietary habits. Until today, there have been limited epidemiologic data assessing the role of diet’s inflammatory potential on NAFLD. The aim was to evaluate the relationship between an anti-inflammatory diet, as reflected by the Dietary Anti-Inflammation Index (D-AII), and NAFLD among cardiovascular disease (CVD)-free adults. Methods: ATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek population (Whites; age ⩾18 years; 1514 men and 1528 women). D-AII was calculated using a standard procedure. The baseline study captured various sociodemographic, lifestyle and clinical characteristics as well as hepatic markers. These were used to calculate four NAFLD assessment indices: triglyceride-glucose (TyG) index, fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD Fatty Liver Score (NAFLD-FLS). Specific cutoffs were applied to capture NAFLD. Results: D-AII showed a significant inverse association with NAFLD, applying the four indices with NAFLD cutoffs [odds ratio (OR) with 95% confidence interval (CI); TyG (0.95, 0.93–0.98); HSI (0.89, 0.86–0.92); FLI (0.88, 0.85–0.91); NAFLD-FLS (0.89, 0.86–0.92)], after adjusting for various confounders. Participants in the highest D-AII tertile had lower odds of having NAFLD, compared with those in the lowest D-AII tertile [(OR, 95% CI); TyG (0.33, 0.24–0.47); HSI (0.13, 0.08–0.23); FLI (0.05, 0.02–0.11); NAFLD-FLS (0.13, 0.07–0.23)]. Anti-inflammatory nutrition was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. Conclusions: Anti-inflammatory diet is an important predictor of NAFLD among adults without pre-existing CVD. Adherence to a high anti-inflammatory diet seems to contribute to NAFLD prevention.

KW - anti-inflammatory diet

KW - ATTICA study

KW - Greece

KW - hepatic health

KW - liver

KW - nonalcoholic fatty liver disease

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