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Diet Quality, Not Just Quantity, Matters in Mid to Late Adulthood

A new study in Obesity investigated the impact of diet quality in mid to late adulthood on visceral and liver fat not solely relying on BMI. Four different measures of diet quality were used to evaluate dietary intake of the multiethnic population over a 20-year span. Maintaining a high-quality diet during mid to late adulthood may prevent adverse metabolic consequences related to visceral adipose tissue (VAT) and nonalcoholic fatty liver (NAFL).

The study examined close to 2,000 participants of the Multiethnic Cohort living in Hawaii and Los Angeles from five ethnic groups (white, black, Native Hawaiian, Japanese American, and Latino). The participants completed food frequency questionnaires at cohort entry from 1993–1996 and at clinic visits from 2013–2016. Participants also underwent whole-body dual-energy X-ray absorptiometry, or DXA, and abdominal MRI scans. All four science-based diet quality scores predicted lower VAT and NAFL. Individuals with the best (highest) diet quality scores were 35% to 59% less likely to have high VAT and also were 22% to 43% less likely to have NAFL than those with the lowest scores after accounting for total body fat.

A long-term healthful diet can reduce the risk of cardiometabolic conditions. Gertraud Maskarinec, MD, PhD, a professor of epidemiology at University of Hawaii Cancer Center, says, "The message that diet quality, not just quantity, matters is important for everyone who wants to maintain both a healthy body weight and a healthy metabolism."

The Obesity Society Spokesperson Catherine M. Champagne, PhD, RDN, LDN, FADA, FAND, FTOS, a professor and chief of nutritional epidemiology/dietary assessment and nutrition counseling at Pennington Biomedical Research Center at Louisiana State University, says, "All health care providers should care about this research if their goal is to improve the health status of their patient population. There is benefit associated with both long-term adherence to a healthy diet and to encouraging individuals with poor diets to adapt a healthier diet."

Overall, the management of excess body weight suggests that body fat distribution beyond BMI is a critical feature to consider when advising individuals with overweight about the health effects of their regular diets, as the metabolic consequences of visceral adiposity may lead to chronic conditions.