The Western dietary pattern is prospectively associated with nonalcoholic fatty liver disease in adolescence

Am J Gastroenterol. 2013 May;108(5):778-85. doi: 10.1038/ajg.2013.95. Epub 2013 Apr 2.


Objectives: Poor dietary habits have been implicated in the development of nonalcoholic fatty liver disease (NAFLD); however, little is known about the role of specific dietary patterns in the development of NAFLD. We examined prospective associations between dietary patterns and NAFLD in a population-based cohort of adolescents.

Methods: Participants in the Western Australian Pregnancy Cohort (Raine) Study completed a food frequency questionnaire at 14 years and had liver ultrasound at 17 years (n=995). Healthy and Western dietary patterns were identified using factor analysis and all participants received a z-score for these patterns. Prospective associations between the dietary pattern scores and risk of NAFLD were analyzed using multiple logistic regression.

Results: NAFLD was present in 15.2% of adolescents. A higher Western dietary pattern score at 14 years was associated with a greater risk of NAFLD at 17 years (odds ratio (OR) 1.59; 95% confidence interval (CI) 1.17-2.14; P<0.005), although these associations were no longer significant after adjusting for body mass index at 14 years. However, a healthy dietary pattern at 14 years appeared protective against NAFLD at 17 years in centrally obese adolescents (OR 0.63; 95% CI 0.41-0.96; P=0.033), whereas a Western dietary pattern was associated with an increased risk of NAFLD.

Conclusions: A Western dietary pattern at 14 years in a general population sample was associated with an increased risk of NAFLD at 17 years, particularly in obese adolescents. In centrally obese adolescents with NAFLD, a healthy dietary pattern may be protective, whereas a Western dietary pattern may increase the risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Body Mass Index
  • Carbonated Beverages / adverse effects
  • Cohort Studies
  • Diet / adverse effects*
  • Factor Analysis, Statistical
  • Fatty Liver / epidemiology*
  • Fatty Liver / etiology*
  • Feeding Behavior*
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Logistic Models
  • Male
  • Meat / adverse effects
  • Motor Activity
  • Multivariate Analysis
  • Non-alcoholic Fatty Liver Disease
  • Obesity, Abdominal / complications*
  • Odds Ratio
  • Risk Assessment
  • Risk Factors
  • Sedentary Behavior
  • Surveys and Questionnaires
  • Ultrasonography
  • Waist Circumference
  • Western Australia / epidemiology


  • Biomarkers