{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:05:54Z","timestamp":1791461154053,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Food Science &amp;amp; Nutrition"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Metabolic syndrome (MetS) is closely associated with non\u2010alcoholic fatty liver disease (NAFLD). Diet quality, acid\u2013base balance, and antioxidant intake may influence NAFLD risk. This study examines the relationship between the Diet Quality Index (AHEI), Dietary Acid Load (DAL), and Dietary Antioxidant Index (DAI) with liver enzyme levels, lipid profiles, and NAFLD predictors in individuals with MetS. A cross\u2010sectional study was conducted on 420 adults diagnosed with MetS according to International Diabetes Federation criteria in Zanjan, Iran. Dietary intake was assessed using a validated food frequency questionnaire. AHEI, DAL, and DAI were calculated. Liver enzymes, lipid profiles, and predictive indices, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Triglyceride\u2010Glucose (TyG) Index, were analyzed. Multivariable regression adjusted for confounders. Higher AHEI (tertile 3 vs. tertile 1) was associated with lower FLI (65.37\u2009\u00b1\u200910.46 vs. 74.37\u2009\u00b1\u200911.39 (all values presented as mean\u2009\u00b1\u2009standard deviation [SD]);\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), HSI (40.49\u2009\u00b1\u20096.17 vs. 47.28\u2009\u00b1\u20097.19;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02), triglycerides (163.40\u2009\u00b1\u200962.19\u2009mg\/dL vs. 174.43\u2009\u00b1\u200963.72\u2009mg\/dL;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.034), ALT (22.67\u2009\u00b1\u20096.29\u2009IU\/L vs. 29.39\u2009\u00b1\u20097.43\u2009IU\/L;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.023), and GGT (20.37\u2009\u00b1\u20097.12\u2009IU\/L vs. 27.91\u2009\u00b1\u20098.43\u2009IU\/L;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.033), and higher HDL cholesterol (49.23\u2009\u00b1\u200915.93\u2009mg\/dL vs. 43.24\u2009\u00b1\u200913.39\u2009mg\/dL;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.042). Higher DAL (tertile 3 vs. tertile 1) was linked to elevated FLI (79.43\u2009\u00b1\u200912.13 vs. 69.33\u2009\u00b1\u200910.36;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and ALT (30.75\u2009\u00b1\u20098.23\u2009IU\/L vs. 19.76\u2009\u00b1\u20095.43\u2009IU\/L;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002). Higher DAI (tertile 3 vs. tertile 1) was inversely associated with HSI (41.8\u2009\u00b1\u20095.1 vs. 46.5\u2009\u00b1\u20096.7;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). Higher AHEI and DAI scores were associated with better liver function and lipid profiles, while higher DAL correlated with worse outcomes. Improving diet quality and balancing acid\u2013base intake may be associated with reduced NAFLD risk in MetS patients.\n                  <\/jats:p>","DOI":"10.1002\/fsn3.71102","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T04:31:20Z","timestamp":1760761880000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Diet Quality, Dietary Acid Load, and Dietary Antioxidant Index With Cardiometabolic and NAFLD Risk Factors Among Patients With Metabolic Syndrome: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"13","author":[{"given":"Bijan","family":"Ghobadian","sequence":"first","affiliation":[{"name":"Metabolic Diseases Research Center, Health and Metabolic Research Institute Zanjan University of Medical Science  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyedeh Atiye","family":"Shahrokhi","sequence":"additional","affiliation":[{"name":"Metabolic Diseases Research Center, Health and Metabolic Research Institute Zanjan University of Medical Science  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman Rezaei","family":"Talabon","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health Zanjan University of Medical Sciences  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahid","family":"Notash","sequence":"additional","affiliation":[{"name":"Metabolic Diseases Research Center, Health and Metabolic Research Institute Zanjan University of Medical Science  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh Maleki","family":"Sedgi","sequence":"additional","affiliation":[{"name":"Metabolic Diseases Research Center, Health and Metabolic Research Institute Zanjan University of Medical Science  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6749-960X","authenticated-orcid":false,"given":"Mehran","family":"Rahimlou","sequence":"additional","affiliation":[{"name":"Metabolic Diseases Research Center, Health and Metabolic Research Institute Zanjan University of Medical Science  Zanjan Iran"},{"name":"Department of Nutrition, School of Public Health Zanjan University of Medical Sciences  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/1028415X.2020.1755792"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.1087985"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67402-8"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-02792"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2025.1494617"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-6-33"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-822130-3.00014-4"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20466"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2004.02103.x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17091379"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/rmhp.S437425"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac088"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000735"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/02601060221088383"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.022343"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.je20090083"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10010049"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i23.4146"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13041342"},{"issue":"5","key":"e_1_2_13_21_1","first-page":"329","article-title":"Non\u2010Alcoholic Fatty Liver Disease: Cause or Effect of Metabolic Syndrome","volume":"32","author":"Grander C.","year":"2016","journal-title":"Viszeralmedizin"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.00086.x"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17010143"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-016-0436-z"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-025-00599-1"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-023-01365-8"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.111.150540"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2024.07.015"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389450116666150427155342"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-7847.70902"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-016-1195-z"},{"key":"e_1_2_13_32_1","unstructured":"LuuHung N.2015.\u201cAre Dietary Antioxidant Intake Indices Correlated to Oxidative Stress and Inflammatory Marker Levels? Mary Ann Liebert Inc. 140 Huguenot Street 3rd Floor New Rochelle NY 10801 USA.\u201d"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12208"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6613827"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.116.231209"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-009-9158-6"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12415"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzaa024"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25115640"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13040614"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.34504"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(95)00219-7"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom10121702"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00508.x"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2016.173"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1089\/met.2008.0034"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2023.06.009"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/fsn3.3549"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2020.10.020"},{"key":"e_1_2_13_50_1","first-page":"11","article-title":"Dietary Acid Load and Rapid Progression to End\u2010Stage Renal Disease of Diabetic Nephropathy in Westernized South Asian People","volume":"24","author":"Berg E.","year":"2011","journal-title":"Group"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.993930"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70032-4"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tifs.2019.12.013"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.1043901"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002508"}],"container-title":["Food Science &amp; Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/fsn3.71102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/fsn3.71102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/fsn3.71102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:45:14Z","timestamp":1790167514000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/fsn3.71102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":55,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/fsn3.71102"],"URL":"https:\/\/doi.org\/10.1002\/fsn3.71102","archive":["Portico"],"relation":{},"ISSN":["2048-7177","2048-7177"],"issn-type":[{"value":"2048-7177","type":"print"},{"value":"2048-7177","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-06-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71102"}}