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Adherence to Uk Dietary Reference Values and Lower Odds of Non-Alcoholic Fatty Liver Disease: A Secondary Analysis of a Case–Control Study Publisher

Summary: Could diet quality relate to fatty liver risk? A case-control study linked higher UK dietary-guideline scores to lower odds of NAFLD, but cannot prove prevention. #Nutrition #LiverHealth

Khakian M ; Jamshidi S ; Jahromi M K ; Mokhtari E ; Alibakhshi S ; Saber N ; Sadeghi R ; Salehi Sahlabadi A ; Sobhrakhshankhah E ; Teymoori F ; Mirmiran P ; Farhadnejad H
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Source: Endocrinology, Diabetes and Metabolism Published:2026


Abstract

Background/Aim: The current study aimed to assess the association between the UK dietary reference values (UK-DRV) index and odds of non-alcoholic fatty liver disease (NAFLD). Methods: This case–control study enrolled 225 newly diagnosed NAFLD patients and 450 controls, aged 20–60 years. Dietary intake was assessed via a validated food frequency questionnaire, and the UK-DRV index was calculated for all participants. Using multivariable logistic regression, odds ratios (ORs) and 95% confidence intervals (95% CIs) of NAFLD were determined across tertiles of the UK-DRV index. Results: The mean ± SD of the UK-DRV index among control and case groups was 8.84 ± 2.92 and 8.54 ± 2.94, respectively. In the multivariable model, after controlling for potential confounders, the odds of NAFLD were reduced across tertiles of UK-DRV index (OR: 0.39; 95% CI: 0.20–0.74, P for trend: 0.001). Also, each 1-SD increase in UK-DRV index (OR: 0.72; 95% CI: 0.57–0.91, P: 0.007) and its components, including fruits and vegetables (OR: 0.65; 95% CI: 0.50–0.84, P: 0.001) and fibre intake (OR: 0.74; 95% CI: 0.54–0.99, P: 0.048), was inversely associated with odds of NAFLD. Furthermore, each 1-SD increase in sugar intake as a negative component of the UK-DRV index was positively associated with odds of NAFLD (OR: 1.52; 95% CI: 1.22–1.90, p < 0.001). Conclusions: Our findings suggest that a diet with a higher score of the UK-DRV index, characterised by higher intake of fruits, vegetables, and fish and lower intakes of refined carbohydrates, saturated fats, sodium, and simple sugars, may be related to lower odds of NAFLD in adults. © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
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