Associations between Dietary Total Antioxidant Capacity and Risk of Nonalcoholic Fatty Liver Disease (NAFLD) in Adults: A Case-Control Study

Background and Objectives: Dietary total antioxidant capacity (DTAC) is suggested as a useful tool for the assessment of relationships between cumulative antioxidant food capacities and several chronic disorders. However, relationships between the total antioxidant capacity of the diet (TAC) and the risk of NAFLD has not previously been assessed. The aim of this study was to assess relationships between DTAC and risk of NAFLD in a casecontrol study. Materials and Methods: This casecontrol study was carried out on 158 patients with NAFLD and 357 healthy individuals aged 18 -55 years. Dietary data were collected using validated 168 items quantitative food frequency questionnaires. Triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDLC), low density lipoprotein (LDLC) and fasting blood glucose (FBS) concentrations were assessed using enzymatic methods and commercial kits. The DTAC was calculated based on the oxygen radical absorbance capacity of each food (except for coffee) reported by US Department of Agriculture. Statistical Analysis was carried out using SPSS Software. Results: The mean ±SD (standard deviation) for age and body mass index (BMI) of the study participants were 43.9 years ±5.9 and had 30.5 kg/m² ±2.6. The NAFLD patients included higher BMI and female proportion, compared to control group. The NAFLD patients included higher smoking rates, biochemical parameters (TG, TC, HDLC, LDLC and FBS) and DTAC scores, compared to control groups. However, patients with NAFLD included lower HDL levels and physical activities, compared to control group. The highest tertile of DTAC showed lower risks of NAFLD, compared to the lowest tertile. This association was significant after controlling for potential confounders (p for trend 0.001). Conclusions: Findings suggest that promotion of naturally increased antioxidant capacities may help prevent development of NAFLD.