How much fat does one need to eat to get a fatty liver? A dietary view of NAFLD

Abstract

The prevalence of nonalcoholic fatty liver disease is increasing worldwide, and dietary habits have an important role in the epidemics of disease. High-fat diets are likely to contribute to hepatic triglyceride accumulation, and reducing dietary fat intake is recommended to prevent metabolic liver disease and liver disease progression to nonalcoholic steatohepatitis. However, also a diet rich in refined carbohydrates, i.e., simple sugars, and poor in dietary fibers may increase liver fat deposition, even more than dietary fats, through de novo lipogenesis. In conclusion, a hypercaloric diet, independently of macronutrient composition, drives hepatic fat accumulation, whereas a few fat sources, in particular monounsaturated fatty acids and polyunsaturated fatty acids present in olive oil and fish, may reduce the risk of steatosis or even cure fatty liver. Adherence to a Mediterranean dietary style, thanks to its high-fiber and antioxidant content, and lower fat intake remains the most favorable dietary intervention for the prevention and treatment of nonalcoholic fatty liver disease, mainly when coupled with habitual physical activity.