Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study

Background The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM). Methods A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional s...

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Published in:European journal of clinical nutrition 2023-03, Vol.77 (3), p.370-379
Main Authors: Doustmohammadian, Azam, Amirkalali, Bahareh, Gholizadeh, Esmaeel, Khoonsari, Mahmoodreza, Faraji, Amir Hossein, Nikkhah, Mehdi, Maadi, Mansooreh, Motamed, Nima, Mansourian, Mohsen Reza, Hajjar, Melika, Clark, Cain C. T., Chaibakhsh, Samira, Tameshkel, Fahimeh Safarnezhad, Afzali, Arian, Zamani, Farhad
Format: Article
Language:English
Subjects:
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Adults
Animal protein
Animals
Blood pressure
Chi-square test
Clinical Nutrition
Cohort Studies
Cross-Sectional Studies
Diet
Epidemiology
Fatty liver
Food sources
Fruits
Humans
Internal Medicine
Iran - epidemiology
Latent Class Analysis
Liver
Liver diseases
Mathematical models
Meat
Medicine
Medicine & Public Health
Metabolic Diseases
Modelling
Multivariate statistical analysis
Non-alcoholic Fatty Liver Disease - epidemiology
Non-alcoholic Fatty Liver Disease - etiology
Protein sources
Public Health
Structural equation modeling
Vegetables
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Summary:Background The current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM). Methods A sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols. Results DDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: β = 0.14, P  
ISSN:0954-3007
1476-5640
DOI:10.1038/s41430-022-01240-0