J Clin Endocrinol Metab. 2023 Jun 8:dgad346. doi: 10.1210/clinem/dgad346. Online ahead of print.

ABSTRACT

CONTEXT: A healthy lifestyle is the cornerstone of management in non-alcoholic fatty liver disease (NAFLD). However, the associations between dietary macronutrient composition and different aspects of NAFLD pathology are unclear and dietary recommendations for NAFLD are lacking.

OBJECTIVE: To evaluate the associations of dietary macronutrient composition with hepatic steatosis, hepatic fibro-inflammation, and NAFLD.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, a total of 12,620 UK Biobank participants who completed both the dietary questionnaire and magnetic resonance imaging (MRI) examination were included in this study.

MAIN OUTCOMES AND MEASURES: Dietary consumption of macronutrient was self-reported and calculated. MRI-determined hepatic fat content, fibro-inflammation, and NAFLD were estimated.

RESULTS: Firstly, we found that saturated fatty acids (SFA) intake was associated with higher hepatic steatosis, fibro-inflammation, and the NAFLD prevalence. In contrast, higher fiber or protein intake was reversely correlated with hepatic steatosis and fibro-inflammation. Interestingly, starch or sugar intake was significantly associated with hepatic fibro-inflammation while monounsaturated fatty acids (MUFA) intake was negatively correlated with hepatic fibro-inflammation. Isocaloric analysis revealed that replacing SFA with sugar, fiber, or protein was significantly associated with a reduction in hepatic steatosis, while replacing starch, sugar, or SFA with protein or MUFA was significantly correlated with a decrease in hepatic fibro-inflammation.

CONCLUSION: Overall, our results demonstrate that specific macronutrients are associated with different aspects of NAFLD, and specific dietary compositions should be recommended for distinct NAFLD-risk populations.

PMID:37290038 | DOI:10.1210/clinem/dgad346