What is the Optimal Dietary Composition for NAFLD

Purpose of Review: Non-alcoholic fatty liver disease (NAFLD) is a complex condition with multi-organ considerations. Weight reduction effectively reduces steatosis in the short term; however, the effects of dietary composition in the absence of weight loss on hepatic and metabolic measures remain unclear. This review sought to update the evidence for whole of diet approaches and interventions in human studies of NAFLD. Recent Findings: Assessing dietary composition in NAFLD is complex and requires consideration of food patterns across decades of life. Dietary composition aligned with mostly plant-based, high fibre, unprocessed foods, such as the Mediterranean Diet, can produce hepatic and metabolic benefits in NAFLD irrespective of weight loss. High fructose-sweetened beverages are associated with more severe steatosis, and short-term avoidance has demonstrated rapid improvements in liver health. Regular coffee drinking may have a protective effect against fibrosis in those with established NASH. Summary: Changing focus from single nutrient to dietary patterns may offer greater translation capability to research findings. Investment in whole food dietary education approaches to engage lifelong health behaviours targeted at culturally appropriate healthy food and lifestyle choices are needed.