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Diets to Treat Non-Alcoholic Fatty Liver Disease


Noureddin M, Zelber-Sagi S, Wilkens LR, et al. Diet Associations with Nonalcoholic Fatty Liver Disease in an Ethnically Diverse Population: The Multiethnic Cohort. Hepatology. 2020;71(6):1940-1952. doi:10.1002/hep.30967. PMID: 31553803

Study Summary

A nested case control study of >215,000 patients on the influence of foods on the development of non-alcoholic fatty liver disease (NAFLD). NAFLD is believed to be present in 1 in 3 adults in the U.S. and 1 in 6 children, and its presence increases the risk of metabolic syndrome, type 2 diabetes, and cirrhosis. Characteristics across all groups found the average calorie intake was ~2,100 calories per day, with the mean BMI greater in the NAFLD group compared to the controls. Controls were more commonly exercising ~20 minutes per day and had higher alcohol intake compared to those with NAFLD.

Foods that statistically increased the risk of NAFLD were:

  • • Red meat (OR 1.16; 95% CI: 1.04-1.30)
  • • Processed red meat (OR 1.18, 95% CI: 1.05-1.32)
  • • Poultry (OR 1.16; 95% CI: 1.04-130).

Foods inversely associated with NAFLD were high fiber foods (vegetables and fruits) and soluble fiber (psyllium) supplements (OR 0.84; 95% CI: 0.74-0.95).


For patients with NAFLD, encourage diets that are high in dietary fiber (7-10 servings of non-starchy vegetables per day) and limit red meat, processed red meat, and poultry.

Stats Refresher

A case control study is a retrospective analysis that looks back in time to find the odds between a specific exposure (e.g. secondhand tobacco smoke) and an outcome (e.g. cancer). The goal is to determine the relationship between risk factors and disease or outcome and estimate the odds of an individual getting a disease or experiencing an event.

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Nonalcoholic Fatty Liver Disease (NAFLD)

Contributed by Frank J. Domino, MD, December 4, 2020