Dietary History and Physical Activity and Risk of Advanced Liver Disease in Veterans with Chronic Hepatitis C Infection
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- White, D.L., Richardson, P.A., Al-Saadi, M. et al. Dig Dis Sci (2011) 56: 1835. doi:10.1007/s10620-010-1505-x
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The role of customary diet and physical activity in development of advanced HCV-related liver disease is not well-established.
We conducted a retrospective association study in 91 male veterans with PCR-confirmed chronic HCV and biopsy-determined hepatic pathology. Respondents completed the Block Food Frequency and the International Physical Activity questionnaires. We conducted three independent assessments based on hepatic pathology: fibrosis (advanced = F3–F4 vs. mild = F1–F2), inflammation (advanced = A2–A3 vs. mild = A1) and steatosis (advanced = S2–S3 vs. mild = S1). Each assessment compared estimated dietary intake and physical activity in veterans with advanced disease to that in analogous veterans with mild disease. Multivariate models adjusted for total calories, age, race/ethnicity, biopsy-to-survey lag-time, BMI, pack-years smoking, and current alcohol use.
Average veteran age was 52, with 48% African-American. Advanced fibrosis was more prevalent than advanced inflammation or steatosis (52.7% vs. 29.7% vs. 26.4%, respectively). The strongest multivariate association was the suggestive 14-fold significantly decreased advanced fibrosis risk with lowest dietary copper intake (OR = 0.07, 95% CI 0.01–0.60). Other suggestive associations included the 6.5-fold significantly increased advanced inflammation risk with lower vitamin E intake and 6.2-fold significantly increased advanced steatosis risk with lower riboflavin intake. The only physical activity associated with degree of hepatic pathology was a two-fold greater weekly MET-minutes walking in veterans with mild compared to advanced steatosis (P = 0.02).
Several dietary factors and walking may be associated with risk of advanced HCV-related liver disease in male veterans. However, given our modest sample size, our findings must be considered as provisional pending verification in larger prospective studies.
KeywordsNutrition assessmentExerciseInfectious diseasesMilitary personnelEpidemiologyGastroenterology
Food Frequency Questionnaire
Hepatitis C virus
International Physical Activity Questionnaire, short form
Michael E. DeBakey VA Medical Center
Metabolic equivalent of task
Department of Veteran Affairs