Dietary Patterns and Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of hepatic conditions characterised by excessive lipid accumulation in the liver in the absence of significant alcohol consumption. It is closely linked to obesity, insulin resistance and components of the metabolic syndrome, and its progression from simple steatosis to steatohepatitis, fibrosis and cirrhosis presents a growing public health challenge worldwide. Dietary patterns exert substantial influence on hepatic lipid homeostasis through modulation of caloric balance, macronutrient composition, gut microbiota and systemic inflammation. Diets high in saturated fats, refined carbohydrates and added sugars—typified by Western eating habits—promote hepatic fat accumulation and dysregulated lipid metabolism. Conversely, dietary regimes rich in polyunsaturated fatty acids, whole grains, fibre, antioxidants and plant-based foods, such as the Mediterranean or other predominantly plant-centric patterns, are associated with reduced hepatic steatosis and improved metabolic profiles. Recent epidemiological and mechanistic studies have explored the interplay between diet quality, genetic predisposition and metabolic biomarkers, underscoring opportunities for targeted nutritional interventions to prevent and manage NAFLD at the population level.

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Dietary Patterns and Non-Alcoholic Fatty Liver Disease publication trend

The graph below shows the total number of articles in dietary patterns and non-alcoholic fatty liver disease across all publications each year (not limited to Nature Index journals).

Technical terms

Non-alcoholic fatty liver disease (NAFLD): accumulation of excess lipid in hepatocytes in the absence of significant alcohol intake.

Metabolic dysfunction-associated steatotic liver disease (MASLD): term emphasising metabolic drivers of liver fat accumulation beyond alcohol.

Plant-based diet indexes (PDI, hPDI, uPDI): scores quantifying overall, healthful and unhealthful plant-based food intake.

EAT-Lancet diet index: composite measure of adherence to a sustainable, predominantly plant-centric dietary pattern.

Metabolomic signature: profile of small-molecule metabolites reflecting the physiological response to specific diets.

Polygenic risk score (PRS): aggregated genetic susceptibility estimate based on multiple single-nucleotide polymorphisms.

Magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF): quantitative imaging biomarker of hepatic fat content.

Fatty Liver Index (FLI): algorithm combining clinical and biochemical parameters to estimate the likelihood of hepatic steatosis.

References

1. Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease. BMC Medicine (2023).
2. Dietary pattern modifies the risk of MASLD through metabolomic signature. JHEP Reports (2024).
3. Sugar-sweetened beverages, low/no-calorie beverages, fruit juice and non-alcoholic fatty liver disease defined by fatty liver index: the SWEET project. Nutrition & Diabetes (2023).