Fatty liver — can diet reverse it?

Aim of the study: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease without pharmacological treatment yet. There is also a lack of specific dietary recommendations and strategies to treat the negative health impacts derived from NAFLD. This scoping review aimed to compile dietary patterns, foods, and nutrients to ameliorate NAFLD.

Results: Several guidelines are available through the literature. Hypocaloric Mediterranean diet is the most accepted dietary pattern to tackle NAFLD. Coffee consumption (sugar free) may have a protective effect for NAFLD. Microbiota also plays a role in NAFLD; hence, fibre intake should be guaranteed. A high-quality diet could improve liver steatosis. Weight loss through hypocaloric diet together with physical activity and limited sugar intake are good strategies for managing NAFLD. Specific dietary recommendations and a Mediterranean plate have been proposed to ameliorate NAFLD.

Aim of the study: This study aimed to investigate the effects of the typical Mediterranean diet (TMD), low-carbohydrate Mediterranean diet (LCMD), and low-fat Mediterranean diet (LFMD) on biochemical findings, fatty liver index (FLI), anthropometric measurements, and body composition in individuals with obesity with non-alcoholic fatty liver disease (NAFLD) and insulin resistance.

Results: This study included 63 participants with obesity with insulin resistance diagnosed with NAFLD by ultrasonography to investigate the effects of an 8-week energy-restricted TMD, LCMD, and LFMD on biochemical findings, FLI, fibrosis-4 index (FIB-4), anthropometric measurements, and body composition. Patients were randomized into three groups and were interviewed face-to-face every week. According to the food consumption records (baseline end), the difference in the amount of sucrose and total fat consumed in the TMD group; the difference in energy intake from sucrose, monounsaturated fatty acids, and oleic acid in the LCMD group; and the difference in energy intake from fiber, sucrose, monounsaturated and polyunsaturated fatty acids, and cholesterol in the LFMD group showed significant correlations with liver enzymes and FLI (p < 0.05).

Aim of the study: γ-Aminobutyric acid (GABA)-rich fermented rice bran (GFRB) is a multi-component fermented food matrix with potential metabolic benefits, but its effects on high-fat diet (HFD)-induced liver injury and associated gut microbial and metabolic changes remain unclear. In this study, we characterized the metabolite profile of GFRB and evaluated its effects in rats with HFD-induced liver injury.

Results: GFRB supplementation attenuated these hepatic alterations, as reflected by a reduced NAFLD activity score in the low-dose GFRB group and decreased hepatic interleukin-6 levels in the high-dose GFRB group. Exploratory analyses also identified alterations in gut microbiota composition and fecal metabolite profiles, particularly in amino acid- and nitrogen-related metabolic pathways. Overall, these findings suggest that GFRB may attenuate early HFD-induced liver injury, potentially through modulation of hepatic inflammation. The accompanying gut microbiota and metabolomic changes should be considered exploratory observations that warrant further mechanistic investigation.

Aim of the study: Diet quality plays a pivotal role in the prevention of non-alcoholic fatty liver disease (NAFLD). However, evidence on the associations between the Cardiovascular Health Diet Index (CHDI) and the Concise Healthy Diet Score (CHDS) and NAFLD remains limited, particularly in Middle Eastern populations. In this study, we investigated this association.

Results: Among the NAFLD cases, the mean CHDI score was 55.9 ± 10.3, and the median CHDS score was 2.00 (IQR: 1.00-3.00). Among the controls, the mean CHDI score was 62.2 ± 10.9, and median CHDS score was 2.00 (IQR: 2.00-3.00). In multivariable adjusted model, participants in the highest tertile of the CHDI had an 84% lower odds of NAFLD compared with those in the lowest tertile (OR = 0.16; 95%CI:0.08-0.32; P for trend < 0.001). Similarly, for the CHDS, participants in the highest category had 69% lower odds of NAFLD compared with the lowest category (OR = 0.31;95%CI:0.17-0.60; P for trend = 0.001). These inverse associations were also observed per one‑unit increase in each score, with an 8% reduction for CHDI (OR = 0.92;95%CI:0.90-0.95, P < 0.001) and a 36% reduction for CHDS (OR = 0.64;95%CI:0.49-0.85, P = 0.002).