The association between dietary antioxidant index (DAI) and nonalcoholic fatty liver disease (NAFLD) onset; new findings from an incident case-control study

Background Evidence suggests an increasing global trend in non-alcoholic fatty liver disease (NAFLD) prevalence. Researchers have noted the importance of the role of dietary antioxidants in reducing the incidence of NAFLD. The dietary antioxidant index (DAI) is a valid indicator that considers the -diet's total antioxidant properties. The present study was designed and conducted to investigate the relationship between DAI and NAFLD. We hypothesized that there is a link between the DAI and the NAFLD. Methods This case-control study included 295 patients with NAFLD and 704 controls. The patients’ dietary intake was assessed through a valid and reliable semi-quantitative food frequency questionnaire. We standardized each of vitamin A, C, E, and selenium, manganese, and zinc by subtracting the global mean and dividing by the global SD to calculate the DAI. Results Subjects with DAI score −0.46 < were at higher odds of having NAFLD compared to subjects with DAI -0.46 ≥ (ORDAI<-0.46/≥-0.46 = 0.55; 95% CI = 0.41–0.73). After adjustment for age, gender, and total energy intake (model B) a reverse and significant association was seen (ORDAI<-0.46/≥-0.46 = 0.57; 95% CI = 0.39–0.82). Conclusion The role of antioxidants in reducing the odds of NAFLD is fundamental. Taking antioxidants such as vitamins A, E, C, zinc, selenium, and manganese through food can effectively reduce NAFLD odds. On the other hand, studies should examine DAI's sensitivity and specificity in various settings and outcomes to use it in clinical work.