Role of dietary carbohydrates and macronutrients in the pathogenesis of nonalcoholic fatty liver disease.
OBJECTIVE
The prevalence of nonalcoholic fatty liver disease is increasing worldwide and there is strong evidence that dietary factors play a role in its pathogenesis. The present review aims to provide a better understanding of how carbohydrates and other macronutrients may affect the disease.


RESULTS
The effects of carbohydrates on the development of nonalcoholic fatty liver disease differ depending upon the carbohydrate type; high-glycemic index foods are related to increased hepatic fat in both rodents and humans. Similarly, simple carbohydrates, such as fructose, stimulate hepatic de-novo lipogenesis and decrease lipid oxidation, thus leading to increased fat deposition. The underlying mechanisms may involve the activation of transcription factors. Fat intake broadly leads to hepatic fat deposition in rodents but few data are available on humans. Both carbohydrates and fat trigger inflammatory factors, which are closely related to metabolic disorders and nonalcoholic fatty liver disease. Lifestyle interventions appear to be the most appropriate first-line treatment for nonalcoholic fatty liver disease.


CONCLUSIONS
There is strong evidence that the diet may affect the development of nonalcoholic fatty liver disease. Although simple carbohydrates are clearly shown to have deleterious effects in humans, the role of fat remains controversial. Further studies will be required to evaluate the effects of macronutrient composition on the development of nonalcoholic fatty liver disease.
Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. Kim-Anne.Le@unil.ch
Kim-Anne
KA
Lê
Murielle
M
Bortolotti
D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000009:adverse effects; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D005234:Fatty Liver / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D038321:Glycemic Index; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D007333:Insulin Resistance
D004040:Dietary Carbohydrates; D004041:Dietary Fats