Nutritional management of insulin resistance in nonalcoholic fatty liver disease (NAFLD)

Abstract

Nonalcoholic fatty liver disease (NAFLD) is an emerging global health concern. It is the most common form of chronic liver disease in Western countries, affecting both adults and children. NAFLD encompasses a broad spectrum of fatty liver disease, ranging from simple steatosis (NAFL) to nonalcoholic steatohepatitis (NASH), and is strongly associated with obesity, insulin resistance, and dyslipidemia. First-line therapy for NAFLD includes weight loss achieved through diet and physical activity. However, there is a lack of evidenced-based dietary recommendations. The American Diabetes Association's (ADA) recommendations that aim to reduce the risk of diabetes and cardiovascular disease may also be applicable to the NAFLD population. The objectives of this review are to: (1) provide an overview of NAFLD in the context of insulin resistance, and (2) provide a rationale for applying relevant aspects of the ADA recommendations to the nutritional management of NAFLD.

Figure 1

Nonalcoholic Fatty Liver Disease (NAFLD) is histologically categorized into Nonalcoholic Fatty Liver (NAFL) and Nonalcoholic Steatohepatitis (NASH) [1,7,11].

Figure 2

The two-hit hypothesis of NAFLD progression [34]. Reproduced from [35] (Copyright © 2008 Novo et al.; licensee BioMed Central Ltd.).