Mediterranean Diet Adherence and Non-Alcoholic Fatty Liver Disease Risk in Turkish Adults: a case-control study


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Khoshbakht Farshad R., AKBAŞ E., Ertaş Öztürk Y.

British Journal of Nutrition, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1017/s0007114526107545
  • Dergi Adı: British Journal of Nutrition
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, CINAHL, EMBASE, Environment Index, MEDLINE
  • Anahtar Kelimeler: dietary pattern, Mediterranean diet, non-alcoholic fatty liver disease, nutrition
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Marmara Üniversitesi Adresli: Evet

Özet

The Mediterranean diet has emerged as a promising dietary pattern for preventing non-alcoholic fatty liver disease (NAFLD). This study aimed to examine the role of the Mediterranean diet on the risk of NAFLD in Turkish adults. A total of 252 individuals (126 NAFLD and 126 age- and sex-matched controls) participated in this case-control study. Dietary intake was assessed with a 24-h recall, and adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Screener (MEDAS). Logistic regression models were applied to estimate odds ratios (ORs). The prevalence of NAFLD was higher in the lowest tertile (64.6%) and lower in the highest tertile (30.5%; p<0.001). Moderate adherence to the Mediterranean diet was associated with a 57.0% lower risk of NAFLD after adjusting for age, sex, BMI, and energy intake. High adherence conferred an 86.0% reduction after adjusting for age, sex, BMI, energy intake, and comorbidities. Frequent consumption of butter, margarine, cream, (OR=2.75; 95% CI: 1.72–6.43) and sugar-sweetened beverages (OR=2.87; 95% CI: 1.20–6.87) significantly increased the risk. However, consuming nuts three or more servings per week was protective (OR=0.46; 95% CI: 0.21–0.99). In individuals who did not consume ≥3 servings of fruit daily, the risk of NAFLD was significantly reduced (OR=0.28; 95% CI: 0.16–0.69). Adherence to the Mediterranean diet was strongly associated with a reduced risk of NAFLD, highlighting the importance of limiting saturated fats and sugar-sweetened beverages while promoting nuts as practical strategies for prevention.