Diet Quality in Mid-Adulthood Predicts Visceral Adiposity and Liver Fatness in Older Ages: The Multiethnic Cohort Study

OBJECTIVE: We prospectively examined the relationship of diet quality assessed by established indices (HEI-2010, AHEI-2010. aMED, DASH) with adiposity measures, especially visceral adipose tissue (VAT) and nonalcoholic fatty liver (NAFL). METHODS: Close to 2,000 participants of the Multiethnic Cohort completed validated food frequency questionnaires at cohort entry (1993–96) and clinic visit (2013–16) when they underwent whole-body DXA and abdominal MRI scans. Using linear regression, we estimated mean values of adiposity measures by dietary index tertiles at baseline and standardized regression coefficients (β(s)) after adjusting for total adiposity and other covariates. We also performed logistic regression of VAT and NAFL on dietary indices. RESULTS: Higher dietary quality scores at cohort entry were inversely related to all adiposity measures with the strongest associations for percent liver fat (β(s)=−0.14 to −0.08) and followed by VAT (β(s)=−0.11 to −0.05), BMI (β(s)=−0.11 to −0.06), and total body fat (β(s)=−0.09 to −0.05). Odds ratios adjusted for total adiposity ranged between 0.57–0.77 for NAFL and 0.41–0.65 for high VAT when comparing the highest vs. lowest tertiles of diet quality. CONCLUSIONS: These longitudinal findings indicate that maintaining a high quality diet during mid-to-late adulthood may prevent adverse metabolic consequences related to VAT and NAFL.