Nutrients · 5 authors, 2 centres
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This narrative review synthesizes evidence from observational studies and clinical trials on the effects of Mediterranean, low-fat, DASH, vegetarian, low-carbohydrate ketogenic, and intermittent fasting dietary patterns on NAFLD incidence and progression. Multiple dietary approaches show inverse associations with NAFLD risk or improvements in liver outcomes, though evidence strength varies by diet type.
This narrative review examines the effects of six dietary patterns on NAFLD: Mediterranean, low-fat, DASH, vegetarian, low-carbohydrate ketogenic, and intermittent fasting. Evidence spans observational studies (cross-sectional, prospective cohort) and randomized clinical trials. The DASH diet was associated with a thirty percent reduction in NAFLD risk in observational data, with one small RCT (N=60) showing benefits on liver enzymes, triglycerides, and insulin resistance. Vegetarian diets showed a fifty-seven percent reduction in new-onset fatty liver in one study, and one RCT in seventy-five patients reported NAFLD improvement in sixty-seven percent on a lacto-ovo-vegetarian diet. Intermittent fasting reduced hepatic fat in prospective data (N=697) and controlled trials (N=70). Ketogenic diets reduced hepatic fat but a meta-analysis found no superiority over low-fat diets. Limitations include reliance on observational data for most findings, limited clinical trial evidence, and heterogeneous study populations. The authors note the Mediterranean diet is uniquely endorsed by scientific societies for NAFLD management.
