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Dietary Composition and Nonalcoholic Fatty Liver Disease

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is a common and potentially serious form of chronic liver disease that occurs in patients who do not abuse alcohol. Present dietary recommendations for all Americans, including those with NAFLD, endorse a low-calorie, low-fat diet. However, little is known about the effect of diet composition on liver histopathology in patients with NAFLD. The aim of this study was to determine whether overall calorie intake and diet composition are associated with the severity of NAFLD histopathology. Seventy-four consecutive morbidly obese patients presenting for bariatric surgery from January 2001 to March 2002 were retrospectively reviewed. In addition to a standard surgical and psychological evaluation, all patients underwent a preoperative dietary evaluation using a standardized 24-hr food recall. Food intake was evaluated for total calories and macronutrients and compared to liver histopathology from biopsies routinely obtained during surgery. Associations with the severity of steatosis and the presence of inflammation or fibrosis were assessed separately using chi-square for categorical variables and ANOVA for continuous variables. Further, we conducted multiple logistic regression analyses for each histological outcome. There were no significant associations between either total caloric intake or protein intake and either steatosis, fibrosis, or inflammation. However, higher CHO intake was associated with significantly higher odds of inflammation, while higher fat intake was associated with significantly lower odds of inflammation. In conclusion, present dietary recommendations may worsen NAFLD histopathology.

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Authors and Affiliations

  1. Division of Gastroenterology, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland, 21205

    Steven Solga & Jeanne M. Clark

  2. Department of Medicine, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland, 21205

    Amir R. Alkhuraishe

  3. Department of Pathology, Johns Hopkins Hospital, 417 North Carolina, B314, Baltimore, Maryland, 21205

    Mike Torbenson

  4. Department of Clinical Nutrition, Johns Hopkins Bayview, 4940 Eastern Avenue, Baltimore, Maryland, 21224

    Ashli Greenwald

  5. Duke University Medical Center, Box 3256, Durham, NC, 27710

    Anna Mae Diehl

  6. Department of Surgery, Johns Hopkins Bayview, 4940 Eastern Avenue, Baltimore, Maryland, 21224

    Thomas Magnuson

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  1. Steven Solga
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  2. Amir R. Alkhuraishe
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  4. Mike Torbenson
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  7. Thomas Magnuson
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Solga, S., Alkhuraishe, A.R., Clark, J.M. et al. Dietary Composition and Nonalcoholic Fatty Liver Disease. Dig Dis Sci 49, 1578–1583 (2004). https://doi.org/10.1023/B:DDAS.0000043367.69470.b7

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  • DOI: https://doi.org/10.1023/B:DDAS.0000043367.69470.b7

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