Development of a food frequency questionnaire based on the evaluation of the habitual dietary intake of patients with Non-alcoholic Fatty Liver Disease

Authors

DOI:

https://doi.org/10.33448/rsd-v10i16.23506

Keywords:

Non-alcoholic Fatty Liver Disease; Food Consumption; Food Processing; Food Surveys; Food frequency questionnaire.

Abstract

Objective: to evaluate the usual food intake of patients with Non-alcoholic Fatty Liver Disease (NAFLD) according to the degree of hepatic steatosis, to verify the association with anthropometric variables and to develop a Food Frequency Questionnaire (FFQ) targeted at this population. Methods: Observational cross-sectional study developed with 60 adult patients diagnosed with mild or moderate NAFLD. Anthropometric evaluation and 24-hour recall were performed. For the analysis of the diet composition and food classification, the NOVA proposal was considered. For the development of FFQ, foods that contributed up to 95% of energy, macronutrients and micronutrients of interest were selected. The Mann Whithey test was used to verify the difference between the medians of the variables with the grade of hepatic steatosis and the Spearman correlation coefficient for the calculation of correlations. The significance level adopted in the test decision was 5%. Results: similar dietary intake was observed among patients with NAFLD, with predominance of natural or minimally processed foods. The degree of food processing did not present significant correlation with anthropometric measurements and steatosis degree. The FFQ was prepared from the selection of 96 foods. Conclusions: food consumption is like the basic pattern of the Brazilian population. The total intake of macro and micronutrients of these patients did not correlate with the severity of steatosis, nor with anthropometric data. The proposed FFQ is expected to become a useful tool in monitoring dietary practices of individuals with NAFLD.

References

Arab, J. P., Dirchwolf, M., Álvares-da-Silva M. R., Barrera, F., Benítez, C., Castellanos-Fernandez, M. & Arrese, M. (2020). Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease. Annals of Hepatology, 19(6), 674-690. 10.1016/j.aohep.2020.09.006

Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica (ABESO). (2016). Diretrizes brasileiras de obesidade. 4ed. São Paulo: ABESO. Disponível em: https://abeso.org.br/wp-content/uploads/2019/12/Diretrizes-Download-Diretrizes-Brasileiras-de-Obesidade-2016.pdf

Avelino, G.F., Previdelli, N. A., Castro, M. A., Marchioni, D. M. L., & Fisberg, R. M. (2014). Sub-relato da ingestão energética e fatores associados em estudo de base populacional. Cadernos de Saúde Pública, 30(3), 663-668. http://dx.doi.org/10.1590/0102-311X00073713

Bambha, K., Wilson, L. A., Unalp, A., Loomba, R., Neuschwander-Tetri, B.A., Brunt, E. M., & Bass N. M. (2014). Coffee consumption in NAFLD patients with lower insulin resistance is associated with lower risk of severe fibrosis. Liver International, 34(8), 1250–1258. 10.1111/liv.12379

Berquó, E. (1981). Bioestatística. E.P.U.

Bischoff, S. C., Bernal, W., Dasarathy, S., Merli, M., Plank, L. D., Schütz, T., & Plauth, M. (2020). ESPEN practical guideline: Clinical nutrition in liver disease. Clinical Nutrition, 39(12), 3533-3562. 10.1016/j.clnu.2020.09.001

Block, G., Dresser, C. M., Hartman, A. M., & Carroll, M. D. (1985). Nutrient sources in the American diet: quantitative data from the NHANES II survey. II. Macronutrients and fats. The American Journal of Epidemiology, 122(1), 27-40. 10.1093/oxfordjournals.aje.a114084

Block, G., Hartman, A. M., Dresser, C. M., Carroll, M. D., Gannon, J., & Gardner, L. (1986). A data-based approach to diet questionnaire design and testing. The American Journal of Epidemiology, 124(3), 453-469. 10.1093/oxfordjournals.aje.a114416

Brasil. Ministério da Saúde. Instituto Nacional de Alimentação e Nutrição. (1996). Registro fotográfico para inquéritos dietéticos - utensílios e porções. Ministério da Saúde.

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. (2014). Guia alimentar para a população brasileira. 2.ed. Brasília: Ministério da Saúde. https://www.gov.br/saude/pt-br/assuntos/saude-brasil/publicacoes-para-promocao-a-saude/guia_alimentar_populacao_brasileira_2ed.pdf/view

Bredin, C., Naimimohasses, S. Norris, S., Wright, C., Hancock, N., & Hart, K., Moore, J. B. (2020). Development and relative validation of a short food frequency questionnaire for assessing dietary intakes of non-alcoholic fatty liver disease patients. European Journal of Nutrition, 59(2), 571-580. https://doi.org/10.1007/s00394-019-01926-5

Buzzard, M. (1998). 24-hours dietary recall and food record methods. In: Willett WC. Nutritional Epidemiology. 2ed. Oxford: Oxford University Press.

Cade, J., Thompson, R., Burley, V., & Warm, D. (2002). Development, validation and utilisation of food-frequency questionnaires - a review. Public Health Nutrition, 5(4), 567-587. 10.1079/PHN2001318

Cade, J. E., Burley, V. J., Warm, D. L., Thompson, R. L., & Margetts, B. M. (2004). Food-frequency questionnaires: a review of their design, validation and utilisation. Nutrition Research Reviews, 17(1), 5-22. 10.1079/NRR200370

Cardoso, M. A., & Stocco, P. R. (2000). Desenvolvimento de um questionário quantitativo de frequência alimentar em imigrantes japoneses e seus descendentes residentes em São Paulo, Brasil. Cadernos de Saúde Pública, 16(1), 107-114. https://doi.org/10.1590/S0102-311X2000000100011

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., Harrison, S.A., Brunt, E. M., & Arun, J. S. (2018). The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. 10.1002/hep.29367

Chen, X., Zhang, Z., Yang, H., Qiu, P., Wang, H., Wang, F., Zhao, Q., Fang, J., & Nie, J. (2020). Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutrition journal, 19(1). 10.1186/s12937-020-00604-1

Crispim, F. G. S., Elias, M. C., & Parise, E. R. (2016). Consumo alimentar dos portadores de Doença Hepática Gordurosa Não Alcoólica: comparação entre a presença e a ausência de Esteatoepatite Não Alcoólica e Síndrome Metabólica. Revista de Nutrição, 29(4), 495-505. https://doi.org/10.1590/1678-98652016000400005

Eslam, M., Sanyal, A. J., & George, J. (2020). International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology, 158(7), 1999-2014. 10.1053/j.gastro.2019.11.312

Estes, C., Razavi, H., Loomba, R., Younossi, Z., & Sanyal, A.J. (2018). Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology, 67(1), 23–133. 10.1002/hep.29466

Fisberg, R. M., Colucci, A. C., Morimoto, J. M., & Marchioni, D. M. (2008). Questionário de frequência alimentar para adultos com base em estudo populacional. Revista de Saúde Pública, 42(3), 550-554. https://doi.org/10.1590/S0034-89102008005000020

Fisberg, R. M., Marchioni, D. M., & Colucci, A. C. (2009). Avaliação do consumo alimentar e da ingestão de nutrientes na prática clínica. Arquivos Brasileiros de Endocrinologia & Metabologia, 53(5), 617-624. https://doi.org/10.1590/S0004-27302009000500014

Garcêz, L. S., Avelar, C. R., Fonseca, N. S. S., Costa P. R. F., Lyra A. C., Cunha C. M., Jesus R. P., & Oliveira, L. P. M. (2021). Effect of dietary carbohydrate and lipid modification on clinical and anthropometric parameters in nonalcoholic fatty liver disease: a systematic review and meta-analysis. Nutrition Reviews, 79(12), 1321-1337. 10.1093/nutrit/nuaa146

Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y. & Zhou, M. (2019). Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metabolism, 30(1), 67-77. 10.1016/j.cmet.2019.05.008.

Harttig, U., Haubrock, J., Knüppel, S., Boeing, H.; & EFCOVAL Consortium. (2011). The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method. European Journal of Clinical Nutrition, 65 Suppl 1:S87-9. 10.1038/ejcn.2011.92

Instituto Brasileiro de Geografia e Estatística [IBGE]. (2011). Pesquisa de orçamentos familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/livros/liv50063.pdf

Instituto Brasileiro de Geografia e Estatística [IBGE]. (2020). Pesquisa de orçamentos familiares 2017-2018: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/livros/liv101742.pdf

Jensen, T., Abdelmalek, M. F., Sullivan, S., Nadeau, K.J. Green, M. Roncal. C. & Johnson, R. J. (2018). Fructose and sugar: A major mediator of non-alcoholic fatty liver disease. Journal of Hepatology, 68(5), 1063-1075. 10.1016/j.jhep.2018.01.019

Jiménez, L. G. & Martín-moreno, M. (1995). Cuestionario de frecuencia de consumo alimentario. In: Majem LIS, Aranceta B, Verdú MJ. Nutrición y Salud Pública - Métodos, bases cientfflcas y aplicaciones. Espaiia: Masson.

Karnikowski, M., Córdova, C., Oliveira, R. J., Karnikowski, M. G., & Nóbrega, O. T. (2007). Non-alcoholic fatty liver disease and metabolic syndrome in Brazilian middle aged and older adults. São Paulo Medical Journal, 125(6), 333-337. 10.1590/s1516-31802007000600006

Kirpich, I. A, Miller, M. E., Cave, M. C., Joshi-Barve, S., & McClain, C. J. (2016). Alcoholic Liver Disease: Update on the Role of Dietary Fat. Biomolecules, 6(1), 1. 10.3390/biom6010001.

Lohman, T. G., Roche, A. F., & Martorell, R. (1988). Anthropometric standardization reference manual. 1ed. Champaign: Human Kinetics Books.

Lu, F. B., Hu, E. D., Xu, L. M., Chen, L., Wu, J. L., Li, H., Chen, D., & Chen, Y. (2018). The relationship between obesity and the severity of non-alcoholic fatty liver disease: systematic review and meta-analysis. Expert Review Gastroenteroly Hepatoly, 12(5), 491-502. 10.1080/17474124.2018.1460202

McClave, S. A, Taylor, B. E, Martindale, R. G, Warren, M. M, Johnson, D. R, Braunschweig, C., & Mckeever, L. (2016). American Society for Parenteral and Enteral Nutrition. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Journal of Parenteral and Enteral Nutrition, 40(2), 159-211. 10.1002/jpen.2267

Mendez-Sanchez, N., Arrese, M., Gadano, A., Oliveira, C. P., Fassio, E., Arab, J. P. & Silva, M. (2021). The Latin American Association for the Study of the Liver (ALEH) position statement on the redefinition of fatty liver disease. The Lancet Gastroenteroly & Hepatology, 6(1):65-72. 10.1016/S2468-1253(20)30340-X

Mirizzi, A., Franco, I., Leone, C.M., Bonfiglio, C., Cozzolongo, R., Notarnicola, M. & Osella, A. R. (2019). Effects of Some Food Components on Non-Alcoholic Fatty Liver Disease Severity: Results from a Cross-Sectional Study. Nutrients, 11(11), 2744. 10.3390/nu11112744. PMID: 31726714.

Monteiro, A. C., Pfrimer, K., Tremeschin, M. H., Molina, M. C., Chiarello, P., & Vannucchi, H. (2007). Consumo Alimentar: Visualizando Porções. 1ed. Rio de Janeiro: Guanabara Koogan.

Monteiro, C. A., Cannon, G., Levy, R., Moubarac, J. C., Jaime, P., Martins, A. P. & Parra, D. (2016). NOVA. The star shines bright. Food classification. Public Health. World Nutrition Journal, 7(28-38). Disponível em: https://www.worldnutritionjournal.org/index.php/wn/article/view/5/4

Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J. C., Louzada, M. L., Rauber, F. & aime, P. C. (2019) Ultra-processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. 10.1017/S1368980018003762

Monteiro, C. A., Cannon, G., Moubarac, J. C., Levy, R. B., Louzada, M. L. C., & Jaime, P. C. (2018). The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition, 21(1), 5-17. https://doi.org/10.1017/S1368980017000234

Moshfegh, A.J., Rhodes, D. G., Baer, D. J., Murayi, T., Clemens, J.C., Rumpler, W. V. & Cleveland, L. E. (2008). The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. The American Journal of Clinical Nutrition, 88(2), 324-332. 10.1093/ajcn/88.2.324

Pagliai, G., Dinu, M., Madarena, M. P., Bonaccio, M., Iacoviello, L., & Sofi, F. (2021). Consumption of ultra-processed foods and health status: a systematic review and meta-analysis. British Journal of Nutrition, 125(3), 308-318. https://doi.org/10.1017/S0007114520002688.

Pedraza, D. F. & Menezes, T. N. (2015). Questionário de frequência alimentar desenvolvido e validado para a população brasileira: uma revisão da literatura. Ciencia e Saúde Coletiva, 20(9), 2697-2720. 10.1590/1413-81232015209.12602014

Pinheiro, A. V. B., Lacerda, E. M. A., Benzecry, E. H., Gomes, M. C. S., & Costa, V. M. (2005). Tabela para avaliação do consumo alimentar em medidas caseiras. 5ed. São Paulo: Atheneu.

Poti, J.M., Braga, B., & Qin, B. (2017). Ultra-processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content? Current Obesity Reports, 6(4), 420-431. 10.1007/s13679-017-0285-4

Rico-Campa, A., Martinez-Gonzalez, M. A., Alvarez-Alvarez, I., de Deus, M. R., de la Fuente-Arrillaga, C., Gómez-Donoso, C., & Bes-Rastrollo, M. (2019). Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ, 365, l1949. 10.1136/bmj.l1949.

Sanyal, A. J., Brunt, E. M., Kleiner, D. E., Kowdley, K. V., Chalasani, N., Lavine, J. E., Ratziu, V., & McCullough, A. (2011). Endpoints and clinical trial design for nonalcoholic steatohepatitis. Hepatology, 54(1), 344–353. 10.1002/hep.24376

Sarmento, R. A., Riboldi, B. P., da Costa Rodrigues, T., de Azevedo, M. J., & de Almeida, J. C. (2013). Development of a quantitative food frequency questionnaire for Brazilian patients with type 2 diabetes. BMC Public Health, 13(740). 10.1186/1471-2458-13-740.

Shiha, G., Korenjak, M., Eskridge, W., Casanovas, T., Velez-Moller, P., Högström, S. & Eslam, M. (2021). Redefining fatty liver disease: an international patient perspective. The Lancet Gastroenteroly & Hepatology, 6(1), 73-79. 10.1016/S2468-1253(20)30294-6

Slater, B., Philippi, S. T., Marchioni, D. M. L., & Fisberg, R. M. (2003). Validação de Questionários de Frequência Alimentar-QFA: considerações metodológicas. Revista Brasileira de Epidemiologia, 6(3): 200-208. Disponível em: https://www.scielosp.org/article/rbepid/2003.v6n3/200-208/

Sofi, F., Giangrandi, I., Cesari, F., Corsani, I,, Abbate, R., Gensini, G. F., & Casini, A. (2010). Effects of a 1-year dietary intervention with n-3 polyunsaturated fatty acid-enriched olive oil on non-alcoholic fatty liver disease patients: a preliminary study. International Journal of Food Sciences, 61(8), 792-802. 10.3109/09637486.2010.487480

Tutunchi, H., Saghafi-Asl, M., Asghari-Jafarabadi, M., & Ostadrahimi, A. (2021). Association between Dietary Patterns and Non-alcoholic Fatty Liver Disease: Results from a Case-Control Study. The Archives of Iranian Medicine, 24(1), 35-42. 10.34172/aim.2021.06

Verly Junior, E., Cesar, C. L., Fisberg, R. M., & Marchioni, D. M. (2013). Variância intrapessoal da ingestão de energia e nutrientes em adolescentes: correção de dados em estudos epidemiológicos. Revista Brasileira de Epidemiologia, 16(1), 170-177. https://doi.org/10.1590/S1415-790X2013000100016

Wang, C., Horby, P. W., Hayden, F. G., & Gao, G. F. A novel coronavirus outbreak of global health concern. (2020). Lancet, 395(10223), 470-473. 10.1016/S0140-6736(20)30185-9

Willett, W. C. & Stampfer, M. J. (1986). Total energy intake: implieations for epidemiologieal analyses. American Journal of Epidemiology, 124(1), 17-27. 10.1093/oxfordjournals.aje.a114366.

World Health Organization [WHO] [Internet]. Emergency situation reports. Geneva: WHO. https://www.who.int/emergencies/situation-reports.

World Health Organization [WHO]. (1998). Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. 1ed. Geneva: World Health Organization.

Younossi, Z.M., Tacke, F., Arrese, M., Chander, S. B., Mostafa I, Bugianesi E. & Vos, M. B. (2019). Global Perspectives on Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis. Hepatology, 69(6), 2672-2682. 10.1002/hep.30251.

Younossi, Z. M., Koenig, A. B., Abdelatif, D., Fazel, Y., Henry, L., & Wymer, M. (2016). Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 64(1), 73–84. 10.1002/hep.28431

Published

13/12/2021

How to Cite

GARCÊZ, L. S. .; CUNHA , C. de M. .; LYRA, A. C. .; JESUS, R. P. de .; OLIVEIRA, L. P. M. de . Development of a food frequency questionnaire based on the evaluation of the habitual dietary intake of patients with Non-alcoholic Fatty Liver Disease. Research, Society and Development, [S. l.], v. 10, n. 16, p. e280101623506, 2021. DOI: 10.33448/rsd-v10i16.23506. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/23506. Acesso em: 27 dec. 2024.

Issue

Section

Health Sciences