Implications of diet on nonalcoholic fatty liver disease.
OBJECTIVE
This review examines the effects of diet on nonalcoholic fatty liver disease (NAFLD). This includes the effects of calories, both in excess and restricted, as well as macronutrients.


RESULTS
Recent findings suggest that short-term hypercaloric feeding leads to increased intrahepatic triglyceride (IHTG), whereas short-term hypocaloric feeding leads to decreased IHTG, despite little change in total body weight, suggesting that ongoing excess caloric delivery directly contributes to the development of NAFLD. Weight loss with either low-fat or low-carbohydrate diets can improve IHTG; however, specific macronutrients, such as fructose, trans-fatty acids, and saturated fat, may contribute to increased IHTG independent of total calorie intake. n-3 polyunsaturated fatty acids and monounsaturated fatty acids may play a protective role in NAFLD. The mechanisms behind these effects are not fully understood.


CONCLUSIONS
Diet plays a role in the pathophysiology of NAFLD. It is reasonable to advise patients with NAFLD to reduce calorie intake with either low-fat or low-carbohydrate diets as well as limit intakes of fructose, trans-fatty acids, and saturated fat.
Sullivan
Shelby
S
Washington University School of Medicine, Internal Medicine, St Louis, Missouri 63110, USA. ssulliva@dom.wustl.edu
D031204:Caloric Restriction / Q000379:methods*; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D002149:Energy Intake; D005234:Fatty Liver / Q000473:pathology / Q000628:therapy*; D005260:Female; D005632:Fructose / Q000378:metabolism; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D044242:Trans Fatty Acids / Q000378:metabolism; D016896:Treatment Outcome; D015431:Weight Loss
D044242:Trans Fatty Acids; D005632:Fructose