Inflammatory biomarker profiles and their associations with Nordic dietary habits and metabolic outcomes in adults affected by MAFLD

Metabolic dysfunction-associated fatty liver disease (MAFLD) is commonly accompanied by chronic low-grade inflammation. The Aggregate Index of Systemic Inflammation (AISI) is an accessible inflammatory marker, while the Healthy Nordic diet may have favorable metabolic effects. This study investigated relationships among AISI, healthy Nordic Food Index (HNDI), and metabolic health in adults with MAFLD. In this cross-sectional study, 253 adults with MAFLD were evaluated. Dietary intake was assessed using a validated food frequency questionnaire and HNFI using a composite score. Anthropometric, biochemical, and hematological variables were assessed. Participants were categorized into AISI quartiles. Mean age was 40.27 ± 8.37 years. Higher AISI was associated with higher triglycerides (adjusted P = 0.031) and lower HDL-cholesterol (adjusted P = 0.004). AISI was positively associated with white blood cell count (β = 0.453, P < 0.001) and MCH (β = 0.191, P = 0.005), and was inversely associated with HDL-cholesterol (β=−0.250, P < 0.001). Higher AISI was associated with lower apple/pear intake (adjusted P = 0.034) and root vegetable intake (P-trend = 0.029). The HNFI score (β=−0.149, P = 0.020) and root vegetable intake (β=−0.154, P = 0.016) were independently associated with lower AISI. Higher AISI was associated with an unfavorable lipid and inflammatory profile and lower adherence to the HNFI. Greater Nordic diet adherence and root vegetable intake were independently associated with lower AISI. Causal relationships cannot be inferred.