Coffee, fiber and the Mediterranean diet are key players in the fight against non-alcoholic fatty liver disease

In a recent review published in the Nutrients Journal, researchers examined existing evidence on dietary habits, foods, and nutrients to improve nonalcoholic fatty liver disease (NAFLD).

Study: Dietary Patterns, Foods, and Nutrients to Improve Nonalcoholic Fatty Liver Disease: A Scoping Review. Image Credit: Sweet Marshmallow/


Although it is the most common cause of chronic liver disease worldwide, NAFLD lacks pharmaceutical therapy and dietary recommendations to address its serious health consequences.

NASH aggravates cirrhosis and hepatocellular carcinoma, leading to higher medical costs, financial losses, and poorer quality of life.

Dietary adjustments, lifestyle changes, and lifestyle modifications are examples of treatment options. Metabolic syndrome, obesity, cardiovascular disease, hypertension, diabetes, and chronic kidney disease have all been associated with NAFLD.

About the exam

In the current review, researchers described dietary approaches to manage NAFLD. Databases such as MEDLINE, Web of Science, Google Scholar, and Scopus were searched between January and July 2023 for relevant documents published in English or Spanish.

Diets, dietary guidelines, gut microbiome and NAFLD

The Mediterranean diet (MedDiet) is a plant-based diet, high in monounsaturated fatty acids (MUFA) and low in red meat. According to research, those who eat a high-fat Western diet are more likely to get NAFLD and have it worsen.

The Mediterranean diet, on the other hand, has been associated with improved liver steatosis and a decreased risk of NAFLD.

Low carb intake, refined carbohydrates and low sugars, with olive oil providing the most added fat, sets MedDiet apart from other diets. MedDiet is linked to decreased levels of NAFLD and reduced weight gain, insulin resistance, and NAFLD.

The MedDiet, thanks to its low carbohydrate consumption and plant-rich food composition, offers a viable alternative to Western diets.

NAFLD, or non-alcoholic fatty liver disease, is associated with insulin resistance and a lack of phospholipid metabolism. Consumption of processed meat, red meat, soda, cookies, and cakes has been associated with insulin resistance and NAFLD.

Saturated fat interferes with phospholipid metabolism, causing mitochondrial dysfunction, increased production of reactive oxygen species (ROS), and apoptosis. High animal protein consumption has also been linked to NAFLD in obese people.

Diet has a direct impact on de novo lipogenesis, the process by which hepatocytes convert excess carbohydrates, particularly fructose, into fatty acids. Regular consumption of fructose is linked to an increase in fibrosis, mainly due to industrial fructose.

High-fructose diets including sucrose, fructose, and high-fructose corn syrup have been associated with an increased risk of developing steatosis and NASH, particularly in overweight and obese individuals.

Genetics, Foods, and NAFLD Improvement

Diet is important in the development of NAFLD because it affects deoxyribonucleic acid (DNA) homeostasis and telomere biology. DNA production and repair requires folate, calcium, retinol, vitamin E and nicotinic acid, but trans fats can damage DNA.

Telomere shortening is detected in NAFLD, although it is prevented by fiber, omega-3 fatty acids and vegetables. High-glycemic carbs, processed meat, and saturated fats promote telomere shortening.

PNPLA3 (patatin-like phospholipase domain-containing 3) is a key regulator of liver fat accumulation and the development of NAFLD. Diets high in carbohydrates and fatty acids can cause the mutant gene to code for proteins. Diet can alter hepatic lipid utilization, insulin resistance, oxidative stress, and mitochondrial function by modulating epigenetic changes.

Deficiencies of betaine, choline, betaine, folate, and vitamin B12 can promote DNA methylation, thereby increasing hepatic triglyceride production. Eating nuts, seeds, seafood, and a diet high in fiber significantly reduces the risk of developing NAFLD in men.

Walnuts improve lipid profiles, liver disease, and inflammation, potentially effectively treating NAFLD.

Fish can generate omega-3 fatty acids from marine plants, which can help reduce liver fat and avoid NAFLD, nonalcoholic steatohepatitis (NASH), and fibrosis.

Diets high in fiber and whole grains may impact the composition of the gut microbiota, potentially influencing the hepatic intestinal axis in the development of NAFLD. A diet rich in legumes (peas, lentils, and beans) is strongly associated with a decreased risk of NAFLD.

The mechanism underlying the protective benefits of vegetables and fruits on the risk of NAFLD is not fully understood. However, their lower energy density has been explained after their addition to the diet and the antioxidant activity of polyphenols and carotenoids contained in vegetables and fruits.

Consumption of non-starchy vegetables has been associated with better metabolic outcomes, such as decreased visceral and hepatic fat and higher insulin sensitivity.

Dairy products, particularly yogurts containing Lactobacillus acidophilus A5 and Bifidobacterium lactis Bb12, have been associated with a lower risk of NAFLD due to their high whey protein content, which helps reduce weight and fat mass.

Probiotics, such as Bifidobacterium And Lactobacilli These strains have been shown to reduce oxidative and inflammatory liver injury while also decreasing hepatic triglycerides (TG) and fatty liver.

Prebiotics, such as unsweetened filtered coffee, can influence the composition of the intestinal microbiota, which is involved in the development of NAFLD. Choline is an important B group vitamin derived from dietary intake and endogenous production. It is mainly digested and stored in the liver.

Micronutrients implicated in NAFLD include zinc, copper, iron, selenium, magnesium, vitamins A, C, D, and E, as well as carotenoids, with antioxidant, antifibrotic, immunomodulatory, and lipoprotective properties reported as mechanisms. of action.

Based on these findings, the MedDiet, which focuses on reducing oxidative stress and inflammation, may help control NAFLD.

A high-quality diet, frequent exercise, and limiting sugar intake are important tactics, and getting enough fiber and coffee can help guard against gut bacteria.

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