Dietary Patterns Rich in Soybean Products, Vegetables, Fish, Fruits, and Miso Soup Were Inversely Associated with Fatty Liver Index: The Nagahama Study.

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prominent liver disease occurring in approximately 25% of the general population. As treatment, lifestyle modification is essential, but there are few reports on dietary patterns associated with MASLD except for the Mediterranean diet. This study examines dietary habits related to MASLD using the fatty liver index (FLI). Longitudinal analysis of a community-based cohort, the Nagahama Prospective Cohort for Comprehensive Human Bioscience, was performed. Dietary habits were assessed by a self-reported questionnaire on food intake frequency, and factor analysis was applied to identify dietary patterns. Multiple regression analysis was performed with baseline FLI or FLI after 5 y as the dependent variable and sex, age, and/or baseline FLI, and factor scores of each dietary pattern as simultaneous independent variables. The same analyses stratified by sex or body mass index (BMI) were also performed. Three thousand five hundred one participants were included. The 15 food items of the questionnaire were summarized into four dietary patterns. Dietary patterns rich in soybean products, vegetables, fish, fruits, and miso soup, which is characteristic of traditional Japanese diet, negatively correlated with FLI and FLI after 5 y (partial regression coefficient: -3.01 and -1.03, respectively; p<0.01 for both). The result was similar in sex-specific analysis and in BMI<23 kg/m² group, when the participants were stratified according to BMI. Our results suggest that dietary patterns rich in soybean products, vegetables, fish, fruits, and miso soup are protective factors against MASLD especially in individuals with BMI<23 kg/m².