Exploring The Impact of Dietary and Metabolic Risk Factors on Non-Alcoholic Fatty Liver Disease (NAFLD) : A Cross-Sectional Study

Objectives: This study aimed to investigate the associations between the severity of non-alcoholic fatty liver disease (NAFLD) and a range of dietary, anthropometric, and biochemical parameters in adults with clinically diagnosed NAFLD. Materials and Methods: A total of 114 adult NAFLD patients were included in this cross-sectional study. Dietary intake was assessed using three 24-hour recalls. Participants were stratified by steatosis grade (Grade 1–3) based on ultrasonographic evaluation. Anthropometric measurements and biochemical markers were analyzed across groups. Ordinal logistic regression and ANOVA were used to evaluate group differences and associations. Results: Dietary cholesterol intake was significantly higher in the moderate steatosis group (p=0.026). Waist circumference, body fat percentage, and muscle mass were significantly associated with steatosis severity. Hovewer, no significant differences were observed among steatosis grades in energy, macronutrients, fiber, or polyunsaturated fatty acids (PUFA) intake. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting glucose, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels were elevated in more advanced steatosis groups (p<0.05), while lipid parameters such as low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and triglycerides (TG) showed no significant differences. Conclusion: Findings suggest that metabolic and anthropometric parameters—rather than general dietary intake—are more strongly associated with the severity of NAFLD. Early monitoring of central adiposity, insulin resistance, and hepatic enzymes may improve risk stratification and support timely interventions.