Objective: This study assessed the cross-sectional associations of low-carbohydrate diets (LCDs) and low-fat diets (LFDs) with hepatic steatosis in the National Health and Nutrition Examination Survey.
Methods: Diet was measured using the 24-hour recalls. Hepatic steatosis was defined by vibration-controlled transient elastography. The odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Substitution analysis was performed using the leave-one-out model.
Results: Participants with higher adherence scores (comparing extreme tertiles) for an overall (OR = 0.76, 95% CI: 0.61-0.96, ptrend = 0.049) or a healthful LCD (OR = 0.61, 95% CI: 0.43-0.87, ptrend < 0.001) exhibited lower odds of steatosis. Replacing 5% of the energy from carbohydrates with total fat and protein (OR = 0.91, 95% CI: 0.83-0.99) or unsaturated fat and plant protein (OR = 0.89, 95% CI: 0.84-0.94) was associated with lower steatosis prevalence. High overall (OR = 1.65, 95% CI: 1.13-2.40, ptrend = 0.006) or unhealthful (OR = 1.41, 95% CI: 1.10-1.80, ptrend < 0.001) LFD scores were associated with increased likelihood of steatosis.
Conclusions: These findings suggest that the associations between LCDs and LFDs and steatosis may depend on the quality and food sources of the macronutrients.
© 2022 The Obesity Society.