Low-Carbohydrate and Low-Fat Diet with Metabolic-Dysfunction-Associated Fatty Liver Disease

Abstract

Background: This observational cross-sectional study was designed to explore the effects of a low-carbohydrate diet (LCD) and a low-fat diet (LFD) on metabolic-dysfunction-associated fatty liver disease (MAFLD).

Methods: This study involved 3961 adults. The associations between LCD/LFD scores and MAFLD were evaluated utilizing a multivariable logistic regression model. Additionally, a leave-one-out model was applied to assess the effect of isocaloric substitution of specific macronutrients.

Results: Participants within the highest tertile of healthy LCD scores (0.63; 95% confidence interval [CI], 0.45-0.89) or with a healthy LFD score (0.64; 95%CI, 0.48-0.86) faced a lower MAFLD risk. Furthermore, compared with tertile 1, individuals with unhealthy LFD scores in terile 2 or tertile 3 had 49% (95%CI, 1.17-1.90) and 77% (95%CI, 1.19-2.63) higher risk levels for MAFLD, respectively.

Conclusions: Healthy LCD and healthy LFD are protective against MAFLD, while unhealthy LFD can increase the risk of MAFLD. Both the quantity and quality of macronutrients might have significant influences on MAFLD.

Keywords: low-carbohydrate diet; low-fat diet; metabolic-dysfunction-associated fatty liver disease; quality of macronutrients; severe fibrosis.

Figure 1

The association between replacing 3% of energy from carbohydrates with specific macronutrients and MAFLD in NHANES (2017–2018). MAFLD, metabolic-dysfunction-associated fatty liver disease. Adjusted for age (continuous), gender (male/female), race/ethnicity (non-Hispanic White/other), educational level (high school or below/college or above), marital status (married or living with partner/other), PIR (<1.85/≥1.85), current smoker (yes/no), current drinker (yes/no), recommended physical activity (yes/no), and total energy intake (continuous).