Wendy H. Oddy , BAppSci, MPH, PhD 1 , Carly E. Herbison , BSc (Hons) 1 , Peter Jacoby , BA, MSc 1 , Gina L. Ambrosini , BAppSci, MPH, PhD 2 , Therese A. O ’ Sullivan , BHlthSci, BAppSci, PhD 1 , 3 , Oyekoya T. Ayonrinde , MBBS, FRACP 4 – 6 , John K. Olynyk , MBBS, FRACP, MD 4 – 7 , Lucinda J. Black , BSc, PhD 1 , Lawrence J. Beilin , MBBS, FRCP, FRACP, FCSANZ, MD 4 , Trevor A. Mori , BSc (Hons), MRACI CChem,

PhD (Distinction) 4 , Beth P. Hands , BEd, BSocWk, MEd, PhD 8 and Leon A. Adams , MBBS, FRACP, PhD 4

OBJECTIVES: Poor dietary habits have been implicated in the development of nonalcoholic fatty liver disease (NAFLD); however, little is known about the role of specifi c 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 % confi dence interval (CI) 1.17 – 2.14; P < 0.005), although these associations were no longer signifi cant 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.

SUPPLEMENTARY MATERIAL is linked to the online version of the paper at http://www.nature.com/ajg

Am J Gastroenterol 2013; 108:778–785; doi: 10.1038/ajg.2013.95; published online 2 April 2013