Nutrition literacy not enough to cause basic dietary changes in NAFLD

Patients with nonalcoholic fatty liver disease (NAFLD) continue to follow a poor dietary pattern despite receiving medical recommendations to lose weight and having nutritional literacy and perception that are similar to those without NAFLD, reports a study.

Data from the National Health and Nutrition Examination Survey 2017‒2017 cycle were used in this cross-sectional study, which included 2,938 adult patients with complete dietary and vibration-controlled transient elastography data and no alternative reason for hepatic steatosis.

The authors used questionnaires to assess nutrition literacy. They then evaluated diet perception quality by comparing self-reported diet quality with objective diet quality scores (eg, Healthy Eating Index [HEI] and alternative Mediterranean diet score) to assess the real-world application of nutrition knowledge.

No difference in nutrition literacy was observed between patients with or without NAFLD (p=0.17). Most of the participants (90 percent) reported using nutrition labels, and many of them correctly identified the meaning of daily value.

Patients with NAFLD had a poor diet quality (HEI: p=0.018; alternative Mediterranean diet: p=0.013) and even rated their diet as poorer (p<0.001). Self-assessment results revealed that only 27.8 percent of patients overestimated their diet quality, while 37.5 percent consumed more calories than their self-assessed needs.

Accuracy measures were comparable between patients with NAFLD and those without (p=0.71 and p=0.63, respectively).

Patients with NAFLD, compared to those without, were more likely to report receiving advice to lose weight (42.1 percent vs 16.5 percent; p<0.001) or to attempt losing weight (71.9 percent vs 60.9 percent; p<0.001). In addition, patients with NAFLD who received dietary recommendations did not show improvements in diet quality.

“Educational approaches may not be sufficient to promote weight loss and improve diet quality in NAFLD,” the authors said.