{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:18:51Z","timestamp":1784308731520,"version":"3.55.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Nonalcoholic fatty liver disease (NAFLD) is a common but complex chronic liver disease, driven by environmental and genetic factors. We assessed metabolic and dietary risk factor associations with NAFLD liver mortality using the Global Burden of Disease (GBD) 2017 data. NAFLD liver deaths were calculated (per 100,000) as age\u2010standardized rates (ASRs) from 195 countries and territories (21 GBD regions; 7 GBD superregions). Dietary risks included low intake of fruits, vegetables, legumes, whole grains, nuts\/seeds, milk, fiber, calcium, seafood omega\u20103 fatty acids, and polyunsaturated fatty acids, and high intake of red meat, processed meat, sugar\u2010sweetened beverages, trans fatty acids, and sodium. Metabolic risks included high low\u2010density lipoprotein cholesterol, systolic blood pressure (BP), fasting glucose (FG), body mass index (BMI), as well as low bone mineral density and impaired kidney function (IKF). Socio\u2010demographic index (SDI)\u2013adjusted partial Spearman correlation coefficients and multivariable generalized linear regression models\/bidirectional stepwise selection (significance level for entry, 0.2; for stay, 0.05) determined the associations. The ASR for NAFLD liver deaths was 2.3 per 100,000 (2017) and correlated with dietary risk factors (0.131, \u22120.010\u20100.267) and metabolic risk factors (SDI\u2010adjusted\u00a0=\u00a00.225, 95% CI 0.086\u20100.354). High intake of sugar\u2010sweetened beverages and red meat (0.358, 0.229\u20100.475; 0.162, 0.022\u20100.296), and low intake of nuts\/seed and milk (0.154, 0.014\u20100.289; 0.145, 0.004\u20100.280) was significant for NAFLD liver deaths. Other risk factors for liver death included IKF (0.402, 0.276\u20100.514), increased BMI (0.353, 0.223\u20100.407), FG (0.248, 0.111\u20100.376), and BP (0.163, 0.022\u20100.297). High intake of trans fatty acids (2.84% increase [1.65%\u20104.03%]) was the largest associated risk of NAFLD liver deaths. In addition to metabolic risks, dietary risks independently drive the global burden of NAFLD\u2010related liver mortality. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> These data provide additional support for policies to improve dietary environment for NAFLD burden reduction.<\/jats:p>","DOI":"10.1002\/hep4.1707","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T09:47:13Z","timestamp":1625737633000},"page":"90-100","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":49,"title":["Dietary Risks for Liver Mortality in NAFLD: Global Burden of Disease Data"],"prefix":"10.1097","volume":"6","author":[{"given":"James M.","family":"Paik","sequence":"first","affiliation":[{"name":"Betty and Guy Beatty Center for Integrated Research,Inova Health System,Falls Church,VA,USA"},{"name":"Center for Liver Disease,Department of Medicine,Inova Fairfax Medical Campus,Falls 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