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#Gastroenterology #Hepatology #Multispeciality
Liver is a major metabolic organ implicated in the regulation of carbohydrate, fat, and protein metabolism. There is a substantial increase in prevalence of non-alcoholic fatty liver disease (NAFLD) along with increasing rates of obesity. Although the pathogenesis of NAFLD is not yet understood, which is also defined as the hepatic manifestation of the metabolic syndrome, lifestyle factors such as diet plays a crucial role.
Evidence based observations have demonstrated controversial results, some studies suggest that patients with NAFLD consume diets higher in total fat/saturated fatty acids, while other trials observed that intake of carbohydrates/sugars is higher in these patients in contrast to healthy controls. However, constant findings from the limited number of intervention studies divulged that a hypercaloric diet, irrespective of the source of excess calories such as fat, sugar, or both, increases liver fat content whereas a hypocaloric diet reduces liver fat content. Therefore, it can be postulated that total calorie intake, independent of nutrient content, is a key regulator of liver fat content. It has been assumed that these alteration in liver fat content are mediated mainly via a change in body weight and/or substrate availability.
Moreover, researches conducted regarding both hyper- and hypo-caloric feeding provide evidence that macronutrient composition may play a role in regulation of liver fat content. This has been validated by data from isocaloric feeding studies that shows fatty acid composition and/or type or content of carbohydrate affect whether there is accumulation of liver fat or not. Nevertheless, the underlying mechanisms responsible for the changes in liver fat caused by a specific macronutrients, when consumed as part of an isocaloric diet require more evaluation.
Source: Parry SA, Hodson L. Influence of dietary macronutrients on liver fat accumulation and metabolism. Journal of Investigative Medicine. 2017;65:1102-1115.