Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 28, 2015; 7(24): 2522-2534
Published online Oct 28, 2015. doi: 10.4254/wjh.v7.i24.2522
Dietary approach in the treatment of nonalcoholic fatty liver disease
Silvia Marinho Ferolla, Luciana Costa Silva, Maria de Lourdes Abreu Ferrari, Aloísio Sales da Cunha, Flaviano dos Santos Martins, Cláudia Alves Couto, Teresa Cristina Abreu Ferrari
Silvia Marinho Ferolla, Maria de Lourdes Abreu Ferrari, Aloísio Sales da Cunha, Cláudia Alves Couto, Teresa Cristina Abreu Ferrari, Departamento de Clínica Médica, Centro de Pós-Graduação, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
Luciana Costa Silva, Departamento de Propedêutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
Flaviano dos Santos Martins, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
Author contributions: Ferolla SM, Couto CA, Ferrari TCA and Martins FS performed search; Ferolla SM, Silva LC, Ferrari MLA and da Cunha AS analyzed the data and made critical revisions; Ferolla SM and Ferrari TCA wrote the paper; all the authors approved the final version of the manuscript.
Supported by The Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG).
Conflict-of-interest statement: None of the authors have any potential financial conflict of interest related to this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Teresa Cristina Abreu Ferrari, Professor, Departamento de Clínica Médica, Centro de Pós-Graduação, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena 190, Belo Horizonte 30130-100, Minas Gerais, Brazil. tferrari@medicina.ufmg.br
Telephone: +55-31-34099746 Fax: +55-31-34099664
Received: April 20, 2015
Peer-review started: April 21, 2015
First decision: August 10, 2015
Revised: September 2, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: October 28, 2015
Abstract

Nonalcoholic fatty liver disease (NAFLD) has been identified as one of the most prevalent chronic liver disease in adults and children populations. NAFLD is usually associated with the metabolic syndrome (MS), which is chiefly related to insulin resistance and its consequences. Insulin resistance has a crucial role in the pathogenesis of hepatic steatosis and potentially nonalcoholic steatohepatitis (NASH). Because of the contemporary epidemics of MS and obesity, the burden of NAFLD is also expected to rise. Unhealthy diets, such as the so-called western diet, are enriched in fructose, trans-fatty acids and saturated fat and seem to be associated with the development of NAFLD. In human studies, certain dietary sugars, particularly fructose, are used as a substrate for lipogenesis leading to hepatic fatty infiltration, inflammation, and possibly fibrosis. Other investigations have shown that fat consumption especially cholesterol and trans/saturated fatty acids are also steatogenic and seem to increase visceral adiposity. The identification of specific dietary components that favor the development of NASH could be important for the management of this disorder. This review focuses on the effects of different dietary approaches to prevent and treat NAFLD emphasizing the macronutrients and energy composition.

Keywords: Fatty liver, Dietary carbohydrates, Dietary fats, Dietary fructose, Energy intake

Core tip: Nonalcoholic fatty liver disease (NAFLD) has been identified as one of the most prevalent chronic liver disease. Its pathogenesis is not fully elucidated, and until now there is no effective treatment for this condition. Evidence supports that dietary pattern may be related to the development of NAFLD. Furthermore, dietary intervention could be beneficial in NAFLD treatment. However, there is no consensus regarding the best dietary intervention to treat NAFLD. In this context, we conducted a systematic review about recent advances in the effects of different diets in the development of NAFLD in humans, and also in the dietary treatment approach of this disorder.