ArticleEuropean journal of clinical nutrition2023
Mediators of dietary diversity score (DDS) on NAFLD in Iranian adults: a structural equation modeling study.
Article in European journal of clinical nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 12 citations in OpenAlex.
- Abdominal Obesity Phenotypes and Incidence of Type 2 DM, Cardiovascular Outcomes and All-Cause Mortality-A Systematic Review and Meta-Analysis.Health science reports · 2026Review
- Self-care behaviors among Iranian adults with non-alcoholic fatty liver disease based on the health belief model and structural equation modeling.Scientific reports · 2026Article
- The association between dietary consumption of amino acids and the risk of non-alcoholic fatty liver disease: a case-control study.Nutrition & metabolism · 2025Article
- Nutritional Strategies for Battling Obesity-Linked Liver Disease: the Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management.Current obesity reports · 2025Review
- The association between dietary diversity and hearing loss: results from a nationwide survey.Frontiers in nutrition · 2025Article
- The influence of healthy eating index on cognitive function in older adults: chain mediation by psychological balance and depressive symptoms.BMC geriatrics · 2024Article
- The relationship between social support and professional identity of health professional students from a two-way social support theory perspective: chain mediating effects of achievement motivation and meaning in life.BMC medical education · 2024Observational
- Dietary diversity and possible cataract among Chinese elderly population.Frontiers in nutrition · 2024Article
- Dietary diversity and possible sarcopenia among older people in China: a nationwide population-based study.Frontiers in nutrition · 2023Article
- Diet quality indices and odds of metabolic dysfunction-associated fatty liver disease: a case-control study.Frontiers in nutrition · 2023Article
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe current study examines the association between the Dietary Diversity Score (DDS) and nonalcoholic fatty liver disease (NAFLD) in Iranian adults using structural equation modeling (SEM).
methodsA sample of 3220 adults from the Amol Cohort Study was recruited for this cross-sectional study. Dietary acid load (DAL) and DDS were calculated using the data obtained from a validated food frequency questionnaire. Anthropometric parameters, blood pressure, biochemical measurements, and liver ultrasonography were evaluated according to standard protocols.
resultsDDS was neither directly nor indirectly associated with a greater prevalence of NAFLD. In the second model (DDS sub-scores model), the association of DAL with NAFLD was fully mediated through waist circumference (WC) (of DAL to WC: β = 0.14, P < 0.0001, and of WC to NAFLD: β = 0.50, P < 0.001). Vegetable and fruit diversity scores had a significant negative indirect relationship with NAFLD prevalence through DAL (β = -0.06, P = 0.001, β = -0.10, P < 0.001, respectively). Meat diversity score was positively associated with NAFLD prevalence in a full mediational process through DAL (β = 0.12, P < 0.001). The SEM fit indices suggested a reasonably adequate fit of the data to the DDS model (Χ2/df = 4.76, GFI = 0.98, AGFI = 0.97, IFI = 0.97, CFI = 0.97, RMSEA = 0.03, and SRMR = 0.02) and its sub-scores model (Χ
conclusionMeat diversity and lack of vegetable and fruit diversity were indirectly associated with NAFLD prevalence through DAL and WC mediators. Interventions for NAFLD may be more successful if they target a lower intake of animal protein sources and dietary diversity, particularly vegetable and fruit diversity.
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