As alluded to above, the best diet for people with NAFLD is virtually any hypocaloric diet that suits the individual’s preferences and facilitates a weight loss of at least 5%, preferably ≥10%, as more weight loss is associated with improved outcomes.[1] However, significant weight loss is difficult to achieve, which begs the question of whether dietary adjustments can improve liver health independent of changes in body weight.
Several societies recommend the Mediterranean diet for people with NAFLD.[2][3][4] A Mediterranean diet has been consistently shown to improve cardiovascular health.[5] In addition, evidence from mechanistic studies and a couple of randomized controlled trials in humans suggests that a Mediterranean diet may reduce liver fat independent of changes in body weight.[6][7][8]
Other evidence suggests that under eucaloric conditions, a low-fat, low-saturated fat diet (16–25% of energy from fat; 5–7% of energy from saturated fat) may reduce liver fat compared to a high-fat, high-saturated fat diet (45–56% of energy from fat; 25–28% of energy from saturated fat).[9][10]