Adherence to a Paleolithic Diet in Combination With Lifestyle Factors Reduces the Risk for the Presence of Non-Alcoholic Fatty Liver Disease: A Case-Control Study

Mohammad Hassan Sohouli; Somaye Fatahi; Elma Izze da Silva Magalhães; Bianca Rodrigues de Oliveira; Pejman Rohani; Neda Ezoddin; Mehdi Mehdinezhad Roshan; Azita Hekmatdoost

doi:10.3389/fnut.2022.934845

Adherence to a Paleolithic Diet in Combination With Lifestyle Factors Reduces the Risk for the Presence of Non-Alcoholic Fatty Liver Disease: A Case-Control Study

Front Nutr. 2022 Jul 19:9:934845. doi: 10.3389/fnut.2022.934845. eCollection 2022.

Authors

Mohammad Hassan Sohouli¹, Somaye Fatahi², Elma Izze da Silva Magalhães³, Bianca Rodrigues de Oliveira³, Pejman Rohani⁴, Neda Ezoddin⁴, Mehdi Mehdinezhad Roshan⁵, Azita Hekmatdoost⁶

Affiliations

¹ Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
³ Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís, Brazil.
⁴ Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶ Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background: Evidence suggests the role of changing traditional lifestyle patterns, such as Paleolithic, to the modern lifestyle in the incidence and epidemic of chronic diseases. The purpose of this study was to investigate the associations between the Paleolithic diet (PD) and the Paleolithic-like lifestyle and the risk of non-alcoholic fatty liver disease (NAFLD) among an adult population.

Materials and methods: This case-control study was carried out among 206 patients with NAFLD and 306 healthy subjects aged >18 years. PD score was evaluated using a validated 168-item quantitative food frequency questionnaire. In addition, to calculate the Paleolithic-like lifestyle score, the components of physical activity, body mass index (BMI), and smoking status of the participants were combined with the score of the PD.

Results: The mean PD and Paleolithic-like lifestyle scores were 38.11 ± 5.63 and 48.92 ± 6.45, respectively. After adjustment for potential confounders, higher scores of adherence to the PD diet conferred a protection for the presence of NAFLD [odds ratio (OR): 0.53; 95% confidence interval (CI): 0.28-0.98; P for trend = 0.021]. Furthermore, PD and healthy lifestyle habits were negatively associated with NAFLD (OR = 0.42, 95% CI 0.23-0.78; P for trend = 0.007).

Conclusion: Our data suggest that the PD alone and in combination with lifestyle factors was associated with decreased risk of NAFLD in a significant manner in the overall population. However, prospective studies are needed to further investigate this association.

Keywords: NAFLD; Paleolithic; case-control; chronic diseases; diet; lifestyle.