A case-control study on nutritional risk factors in non-alcoholic fatty liver disease in Indian population.

BACKGROUND/OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is considered an integral part of metabolic syndrome (MS). We aimed to explore the inter-relations of MS and dietary composition in subjects with and without hepatic steatosis and to identify the nutritional risk factors contributing to NAFLD. SUBJECTS/METHODS: In all 98 subjects with steatosis and 102 controls were selected for the study after screening 260 consecutive healthy individuals. Anthropometric and nutritional information, biochemical data and clinical profile were analyzed. Prevalence of MS was determined based on the consensus statement for diagnosis of MS for Asian Indians. Multiple logistic regression analysis was done to predict the dietary risk factors in NAFLD. RESULTS: Prevalence of MS was 44.9% among NAFLD cases and 25.5% among controls (P=0.003). Subjects with NAFLD had significantly higher values of body mass index (BMI), waist circumference (WC), percent body fat, total cholesterol, triglycerides and blood pressure than controls. The total calorie intake, percent of carbohydrate and fat intake of NAFLD cases was significantly higher than controls. Multiple logistic regression analysis showed BMI (odds ratio 6.03 (95% confidence interval 3.26-11.14)), WC (5.49 (2.59-11.57)) and percent dietary fat intake (2.51 (1.99-3.31)) as independent nutritional risk factors in NAFLD. CONCLUSIONS: In this study, there is a high prevalence of MS among subjects with steatosis and metabolic disorders were closely related to NAFLD. BMI, WC and percent fat intake are independent dietary risk factors in NAFLD. Decreased nutritional intake with restricted fat may constitute an important therapy in subjects with NAFLD.

Dietary alterations due to perceptions in acute viral hepatitis lead to sub-optimal calorie intake and increased length of hospitalization.

Although there are no dietary restrictions recommended in acute viral hepatitis (AVH), there is an altered food intake, probably because of perceptions and traditional nutritional practices, leading to sub-optimal intake and poorer clinical outcome. Therefore, we aimed to determine nutritional intake of AVH patients before and after disease onset and to investigate if optimal intake following nutrition education shortened the length of hospitalization (LOH). Seventy-five patients with AVH were interviewed for foods consumed and avoided because of perceptions during illness. Nutrition education was given to all patients with meal plan. In-patients were monitored for their nutritional intake until discharge. All patients were followed up after 2 weeks to assess compliance to the plan. There was a statistically significant decrease in mean calorie and protein intake in AVH patients during illness [1314 kcal (standard deviation, SD 291) and 27.5 g (SD 8.84)] when compared with that before onset of the disease [1873 kcal (SD 246) and 51.5 g (SD 8.03); P < 0.0001]. Mean LOH in patients consuming a high calorie diet [6.28 days (SD 2.91)] was significantly lower than those consuming low calories [8.36 days (SD 2.59), P = 0.024]. Two-week follow up revealed that 70% of patients modified their diet to a balanced normal diet as per the given plan. Our study showed that AVH patients consumed sub-optimal calories because of perceptions and traditional nutritional practices. Nutrition education played a major role in achieving overall nutritional goals and in decreasing the LOH.