Elsevier

Advances in Nutrition

Volume 9, Issue 1, January 2018, Pages 30-40
Advances in Nutrition

Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. In the absence of effective pharmacotherapies, clinical guidelines focus primarily on weight loss to treat this condition. Established consensus, evidence-based, and clinical dietary recommendations for NAFLD are currently lacking. The aim of this paper is to provide evidence-based practical dietary recommendations for the prevention and management of NAFLD in adults. A literature review focusing on established principles for the development of clinical practice recommendations was employed using the following criteria: based on substantial evidence, ensures risk minimization, is flexible for an individual patient approach, and is open to further modification as evidence emerges. The Practice-based Evidence in Nutrition classification system was used to grade these principles. Five key dietary recommendations were developed: 1) follow traditional dietary patterns, such as the Mediterranean diet; 2) limit excess fructose consumption and avoid processed foods and beverages with added fructose; 3) PUFAs, especially long-chain omega-3 rich foods and MUFAs, should replace SFAs in the diet; 4) replace processed food, fast food, commercial bakery goods, and sweets with unprocessed foods high in fiber, including whole grains, vegetables, fruits, legumes, nuts, and seeds; and 5) avoid excess alcohol consumption. Improving diet quality may reduce the incidence and progression of NAFLD and associated risk factors. Many of the benefits are likely to result from the collective effect of dietary patterns. High-quality research—in particular, randomized clinical trials assessing dietary interventions that focus on liver-specific endpoints—are needed as a priority.

nonalcoholic fatty liver disease
nonalcoholic steatohepatitis
diet
dietary recommendations
clinical guidelines

Abbreviations used

MetS
metabolic syndrome
NAFLD
nonalcoholic fatty liver disease
NASH
nonalcoholic steatohepatitis
RCT
randomized controlled trial

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Author disclosures: ESG, AF, CI, AJN, MR, SS, SKR, and ACT, no conflicts of interest.

1

ESG was supported by an Australian Government Research Training Program Scholarship.