Comparative review of diets for the metabolic syndrome: implications for nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD) is a significant health problem and affects 70 million adults in the United States (30% of the adult population), and an estimated 20% of these individuals have the most severe form of NAFLD-nonalcoholic steatohepatitis (NASH). The mechanisms underlying disease development and progression are awaiting clarification. Insulin resistance and obesity-related inflammation, among other possible genetic, dietary, and lifestyle factors, are thought to play a key role. A program targeting gradual weight reduction and physical exercise continues to be the gold standard of treatment for all forms of NAFLD. Even though weight loss and dietary and lifestyle changes are recommended as primary treatment for fatty liver, little to no scientific evidence is available on diet and NAFLD. This article reviews the implications of current dietary approaches, including national guidelines and popular weight-loss diets, with a focus on determining the optimal diet to prescribe for NAFLD and NASH patients. The effects of macronutrient content (carbohydrate, fat, and protein ratios) and specific food components, such as soluble fiber, n-3 fatty acids, and fructose, are discussed. The premises, effects, barriers, and issues related to current dietary guidelines and specific diets are discussed, and the question, "Will it work for the pathogenesis of NAFLD and NASH? ", is addressed.
Department of Food Science and Technology, University of California, Davis, CA 95616, USA. amzivkovic@ucdavis.edu
Angela M
AM
Zivkovic
J Bruce
JB
German
Arun J
AJ
Sanyal
D004032:Diet; D004040:Dietary Carbohydrates / Q000378:metabolism; D004041:Dietary Fats / Q000378:metabolism; D005234:Fatty Liver / Q000453:epidemiology / Q000209:etiology*; D017408:Guidelines as Topic; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000502:physiology; D008099:Liver / Q000378:metabolism; D024821:Metabolic Syndrome / Q000178:diet therapy*; D014481:United States; D016885:United States Department of Agriculture
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D008055:Lipids