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Dietary Carotenoids and Non-Alcoholic Fatty Liver Disease among US Adults, NHANES 2003–2014

Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 N. Walnut Street, 1069 WARF Building, Madison, WI 53726, USA
Department of Nutritional Sciences, University of Wisconsin, 1415 Linden Drive, Madison, WI 53706, USA
Author to whom correspondence should be addressed.
Nutrients 2019, 11(5), 1101;
Received: 9 April 2019 / Revised: 6 May 2019 / Accepted: 10 May 2019 / Published: 17 May 2019
(This article belongs to the Special Issue Carotenoids and Human Health)
PDF [228 KB, uploaded 17 May 2019]


Non-alcoholic fatty liver disease (NAFLD) is highly prevalent worldwide. Oxidative stress is thought to be a major mechanism, and previous epidemiological studies found higher serum levels of antioxidant carotenoids were associated with reduced risk for development and progression of NAFLD. The objective of this analysis is to examine cross-sectional associations between dietary and serum levels of carotenoids in relation to NAFLD among a nationally representative sample of US adults. We used data from the 2003–2014 National Health and Nutrition Examination Survey (NHANES). Dietary carotenoid intake was estimated from a 24-hour recall, while serum carotenoids were measured from 2003 to 2006. The NAFLD status was determined based upon US Fatty Liver Index (FLI) value ≥30. Regression models were used to estimate associations between carotenoids and NAFLD by controlling for covariates and adjusting for survey design variables. Overall, 33% of participants were classified as having NAFLD. Intake of all carotenoids, with the exception of lycopene, was lower among those with NAFLD. This association was significant for the highest quartiles of intake of α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin. For serum measures, the highest level of all carotenoids was associated with significantly reduced odds of NAFLD. In conclusion, higher intake and serum levels of most carotenoids were associated with lower odds of having NAFLD. Identification of such modifiable lifestyle factors provide an opportunity to limit or prevent the disease and its progression. View Full-Text
Keywords: nutrition; chronic disease; lutein; zeaxanthin; lycopene; beta-carotene; alpha-carotene; beta-cryptoxanthin nutrition; chronic disease; lutein; zeaxanthin; lycopene; beta-carotene; alpha-carotene; beta-cryptoxanthin
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Christensen, K.; Lawler, T.; Mares, J. Dietary Carotenoids and Non-Alcoholic Fatty Liver Disease among US Adults, NHANES 2003–2014. Nutrients 2019, 11, 1101.

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