{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:37:04Z","timestamp":1788413824910,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Food insecurity affects diet quality (DQ) and is associated with non\u2010alcoholic fatty liver disease (NAFLD). While racial and ethnic disparities in NAFLD exist, the relationship between food insecurity and DQ by race and ethnicity is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the relationship between food insecurity and DQ in adults with NAFLD and significant fibrosis by race and ethnicity in a nationally representative cohort<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a cross\u2010sectional analysis of U.S. adults (\u226520\u2009years) in the National Health and Nutrition Examination Survey 2017\u20132018 with vibration\u2010controlled transient elastography (VCTE), DQ, and food security (FS) measurements. NAFLD and significant fibrosis were defined using validated VCTE cut\u2010offs. We assessed total and component DQ by the healthy eating index (HEI)\u20102015, with poor scores defined as &lt;25th percentile. We used multivariable linear and logistic regression to examine associations of FS and race\/ethnicity with DQ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1351 adults with NAFLD (17% food insecure; 248 with fibrosis), mean (standard error [SE]) DQ score was 49 (1) and 47(1.2) for food secure and insecure groups, respectively. Mean (SE) DQ was lowest for White (47[1.1]), followed by Black (49[0.9]), Hispanic (50[1.2]) and Asian persons (56[2.1]). In multivariable models, there was an inverse relationship between FS and DQ, although this did not reach statistical significance (estimated difference [coef]:\u20101.8 mean HEI score, 95% CI: \u22124.3\u20130.7;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.14). Adjusted mean DQ scores were higher for Black (coef:+3.0, 95% CI:0.5\u20135.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.02), Asian (coef:+7.4, 95% CI:3.4\u201311.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.001) and Hispanic (coef: +4.3, 95% CI: 0.6\u20137.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.03) compared to White persons. Greatest differences in DQ components by food security status were seen in White persons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among adults with NAFLD, White persons had poorer DQ than other races\/ethnicities. The influence of food insecurity on DQ may be potentiated in this group. Exploration of the sociocultural factors influencing DQ is needed to mitigate NAFLD disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.17219","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T07:19:56Z","timestamp":1664435996000},"page":"1383-1393","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Racial and ethnic differences in diet quality and food insecurity among adults with fatty liver and significant fibrosis: a U.S. population\u2010based study"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0068-0099","authenticated-orcid":false,"given":"Ani","family":"Kardashian","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal and Liver Diseases University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Dodge","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal and Liver Diseases University of Southern California  Los Angeles California USA"},{"name":"Department of Population and Public Health Sciences University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4143-1950","authenticated-orcid":false,"given":"Norah A.","family":"Terrault","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal and Liver Diseases University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367"},{"key":"e_1_2_10_3_1","first-page":"76","article-title":"Non\u2010alcoholic fatty liver disease: growing burden, adverse outcomes and associations","volume":"8","author":"Kumar R","year":"2020","journal-title":"J Clin Transl Hepatol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.02.034"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16494"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32207"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.005"},{"key":"e_1_2_10_8_1","volume-title":"Household food security in the United States in 2017, ERR\u2010256","author":"Coleman\u2010Jensen A","year":"2018"},{"issue":"21","key":"e_1_2_10_9_1","first-page":"01267","article-title":"Food Insecurity is associated with mortality among U.S. adults with nonalcoholic fatty liver disease and advanced fibrosis","volume":"1542","author":"Kardashian A","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxz212"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.09.041"},{"key":"e_1_2_10_12_1","unstructured":"National Health and Nutrition Examination Survey (NHANES).Liver Ultrasound Transient Elastography Procedures Manual.2018. 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