{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:58:31Z","timestamp":1786723111853,"version":"build-2736575974"},"reference-count":57,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Studies on the association between vegetarian diets and nonalcoholic fatty liver disease (NAFLD) are limited and have inconsistent results. This study aims to explore the association between vegetarian diets and NAFLD and compare the stage of fibrosis between vegetarians and nonvegetarians in a US representative sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional data from 23,130 participants aged \u226520 years were obtained from the National Health and Nutrition Examination Survey, 2005\u20132018. Vegetarian status was classified based on two 24\u2010h dietary recalls. We examined the association between vegetarian diets and the risk of NAFLD using the propensity score weighting method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vegetarian diets were significantly associated with decreases in hepatic steatosis index (HSI), US fatty liver index and nonalcoholic fatty liver disease fibrosis score with mean differences of \u22122.70 (95% confidence interval [CI]: \u22123.69, \u22121.70), \u22123.03 (95% CI: \u22127.15, \u22120.91) and \u22120.12 (95% CI: \u22120.26, \u22120.01), respectively. While modelling the risk of NAFLD, we estimated that vegetarians were 53% less likely to have NAFLD assessed by HSI (odds ratios [OR]: 0.47; 95% CI: 0.34, 0.65). The effect of vegetarian diets was higher among individuals with lower waist circumferences (OR: 0.20) than among those with higher waist circumferences (OR: 0.53, =\u20090.004). However, the association was largely attenuated after adjusting for body mass index and diabetes status. No significant association was identified between vegetarian diets and advanced fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vegetarian diets were associated with a lower prevalence of NAFLD among US adults, and the association appeared to be stronger in people with lower waist circumferences. Further studies are warranted to replicate our findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jhn.13290","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T09:28:30Z","timestamp":1707816510000},"page":"643-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Vegetarian diets and risk of nonalcoholic fatty liver disease: An observational study of National Health and Nutrition Examination Survey\u00a02005\u20132018 using propensity score methods"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1812-0046","authenticated-orcid":false,"given":"Rui","family":"Li","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics Indiana University Bloomington Bloomington Indiana USA"},{"name":"Department of Cardiology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Indiana University Bloomington Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyce D.","family":"Fly","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Health Science Ball State University Muncie Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelian","family":"Bidulescu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Indiana University Bloomington Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhua","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Indiana University Bloomington Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl20127"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-318813"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra011775"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.14218\/jcth.2019.00051"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.01.052"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32207"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxac230"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11122971"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2010.03209.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2006.10.001"},{"issue":"4","key":"e_1_2_9_12_1","first-page":"10","article-title":"How often do Americans eat vegetarian meals? 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