Journal List > Korean J Gastroenterol > v.61(5) > 1007082

Korean J Gastroenterol. 2013 May;61(5):243-251. Korean.
Published online May 21, 2013.
Copyright © 2013 The Korean Society of Gastroenterology
The Role of Diet in Non-alcoholic Fatty Liver Disease
Dae Won Jun
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Correspondence to: Dae Won Jun, Department of Gastroenterology, Hanyang University Medical Center, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea. Tel: +82-2-2290-8304, Fax: +82-2-2298-9183, Email:

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Prevalence of non-alcoholic fatty liver disease (NAFLD) is about 20-25% in Korean adults population. Obesity is strongly associated with NAFLD and the prevention of obesity is a major public issue. Unfortunately, pharmacological treatment of obesity and NAFLD remains uncertain. Only weight loss by dietary changes been shown to lead to histological improvement in fatty liver. So the nutrition therapy is a cornerstone of treatment for NAFLD. Epidemiologic studies show that saturated fat, trans-fatty acid, carbohydrate, and simple sugar have strong correlation with intrahepatic fat accumulation. But, true associations with specific nutrients still remain unclear. Recently, fructose consumption has been rising in many countries and several epidemiologic studies show that fructose consumption has strong correlation with metabolic diseases. The consumption of excessively added sugar in the pathogenesis of steatohepatitis has received attention. Most clinicians agree with lifestyle modification are effective in histologic improvement. Total energy intake restriction is the most important action to reduce intrahepatic fat accumulation. Macronutrient composition may also have correlation with the development of NAFLD. To reduce the incidence of NAFLD, public statements on optimal dietary education program have been issused. Various specific dietary programs are suggested. Among them low fat diet and low carbohydrate diet are suggested in patients with NAFLD. However, there is no ideal diet to obtain the histological improvement in NAFLD. Further randomised controlled studies about specific diet are needed to determine the long-term benefit and histological improvement by ideal diet. Tailoring diet therapy to a patient's lifestyle is more important than universal specific dietary program.

Keywords: Non-alcoholic fatty liver disease; Carbohydrates; Fructose


Fig. 1
Effects of fructose on pathogenesis of non-alcoholic fatty liver disease. PPAR-α, peroxisome proliferator-activated receptors-alpha; NASH, non-alcoholic steatohepatitis.
Click for larger image


Financial support: None.

Conflict of interest: None.

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