Improving dietary patterns in patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is the liver epidemic of our time. Diet strongly influences its development and should be a component of any treatment plan. It is crucial to standardize diet recommendations in an evidence-based manner.

Calorie restriction per se seems beneficial regardless of macronutrients composition. However, fat consumption, mainly cholesterol and saturated fatty acids are particularly steatogenic. There is increasing evidence that fructose, mainly consumed as soft drinks, is highly deleterious to the liver. Controversial results regarding modest alcohol consumption, suggest that although alcohol should not be advised, it should not be strictly forbidden. Recent studies suggest beneficial effects of coffee and tea in NAFLD.

Patients with NAFLD should have an individualized diet recommendation, in order to lose at least 7% of their weight if overweight, reducing caloric intake, mainly at cost of cholesterol and saturated fatty acids. Simple sugars should be avoided, and soft drinks discouraged.