# Association Between a Diabetes Risk Reduction Diet and Mortality From Chronic Liver Disease

## TL;DR

A diabetes risk reduction diet is linked to lower mortality from chronic liver disease, suggesting dietary changes can help prevent liver-related deaths.

## Contribution

This study is the first to show that a diabetes-focused diet reduces chronic liver disease mortality in a prospective cohort.

## Key findings

- Participants with high adherence to the diet had a 69% lower CLD mortality risk compared to those with low adherence.
- A dose-response trend was observed, with greater diet adherence linked to better outcomes.
- High DRRD adherence was associated with lower ALT levels and healthier baseline profiles.

## Abstract

Background: Chronic liver disease (CLD) is a major global health concern, closely linked with metabolic disorders such as obesity and type 2 diabetes mellitus (T2DM).

Objective: To examine the association between adherence to a Diabetes Risk Reduction Diet (DRRD) and mortality from CLD in a prospective adult cohort.

Methods: This prospective cohort study was conducted at the Pakistan Kidney and Liver Institute, Lahore, Pakistan, and the DHQ (District Headquarter) Hospital, Bagh, AJK, Pakistan, from January 2023 to June 2023. Data were collected from a large, population-based health and nutrition survey that incorporated detailed dietary intake assessments, clinical parameters, and long-term mortality follow-up. Participants were enrolled at baseline and followed over time to observe liver-specific mortality outcomes. A total of 435 adult participants were included in the study. Participants aged more than 18 years with complete dietary data, as well as relevant clinical and demographic information, were included.

Results: During the follow-up period, 48 liver-related deaths were recorded. Participants in the highest DRRD adherence tertile had a significantly lower risk of CLD mortality (adjusted HR (hazard ratio) 0.31; 95% CI (confidence interval): 0.13-0.72; p = 0.006) compared to the lowest tertile. A dose-response trend was observed (p < 0.001). Sensitivity analyses excluding diabetic participants yielded consistent findings. High DRRD adherence was also associated with lower ALT levels and healthier baseline profiles.

Conclusion: High adherence to a DRRD is significantly associated with reduced mortality from CLD. These findings underscore the potential of metabolic-focused dietary interventions in mitigating liver-related outcomes.