Higher adherence to plant-based diets are associated with lower likelihood of fatty liver
Journal article, 2019

Some plant-based diets have been suggested to have a beneficial impact on liver disease risk. We examined the association of the overall plant-based diet (PDI), hypothesized healthful PDI (hPDI) and unhealthful PDI (uPDI) with non-alcoholic fatty liver disease (NAFLD) in US adults from the 2005–2010 National Health and Nutrition Examination Survey (NHANES2005-2010). Analysis of covariance, linear and logistic regression models accounted for the survey design and sample weights. Overall, 18,345 participants were included, with a mean age of 47.9 years and comprising 51.7% women. Liver function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and fatty liver index (FLI) decreased across increasing thirds of PDI and hPDI (all p < 0.001), while adjusted mean of ALT, AST and FLI increased across increasing thirds of uPDI. Adjusted linear regressions showed that PDI and hPDI had negative and significant associations with ALT (PDI = β:-0.095, hPDI = β:-0.128), AST (PDI = β:-0.101, hPDI = β:-0.138) and FLI (PDI = β:-0.153, hPDI = β:-0.265), while uPDI had a positive and significant association with ALT (β: 0.103), AST (β: 0.112) and FLI (β: 0.241). After adjustment, participants in the upper third of PDI had 21% lower odd of NAFLD compared with those in the lowest third [odds ratio (OR): 0.79, 95% confidence interval (95%CI): 0.74–0.82]. A similar trend was observed with hPDI; and the opposite across increasing thirds of uPDI. Our findings confirm that healthy plant-based diets are associated with lower NAFLD risk and more favorable liver function tests profile.

Plant-based diet

Fatty liver index

Non-alcoholic fatty liver disease


Mohsen Mazidi

Chalmers, Biology and Biological Engineering, Food and Nutrition Science

Andre Pascal Kengne

South African Medical Research Council

University of Cape Town

Clinical Nutrition

0261-5614 (ISSN)

Vol. 38 4 1672-1677

Subject Categories

Gerontology, specialising in Medical and Health Sciences

Public Health, Global Health, Social Medicine and Epidemiology

Nutrition and Dietetics



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