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NUTRITION IN NONALCOHOLIC FATTY LIVER DISEASE (NASH)

Metin Basaranoglu

Accumulation of triglycerides (TG) in liver, in the absence of significant alcohol consumption is nonalcoholic fatty liver dis­ease (NAFLD). NAFLD is a significant risk factor for develop­ing cirrhosis and an independent predictor of cardiovascular disease. High fructose corn syrup (HFCS)-containing beverages were associated with metabolic abnormalities, and contributed to the development of NAFLD in human trials. Ingested car­bohydrates are a major stimulus for hepatic de novo lipogenesis (DNL) and are more likely to directly contribute to NAFLD than dietary fat. Substrates used for the synthesis of newly made fatty acids by DNL are primarily glucose, fructose, and amino acids. Epidemiological studies linked HFCS consump­tion to the severity of fibrosis in patients with NAFLD. New animal studies provided additional evidence on the role of car­bohydrate-induced DNL and the gut microbiome in NAFLD.