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Systematic Review and Meta-analysis: The Role of Diet in the Development of Nonalcoholic Fatty Liver Disease

Tsompanaki, E; Thanapirom, K; Papatheodoridi, M; Parikh, P; Chotai de Lima, Y; Tsochatzis, EA; (2021) Systematic Review and Meta-analysis: The Role of Diet in the Development of Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology 10.1016/j.cgh.2021.11.026. (In press). Green open access

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Abstract

BACKGROUND & AIMS: The association of nonalcoholic fatty liver disease (NAFLD) with dietary factors is well established but not thoroughly investigated. This systematic review and meta-analysis synthesizes available evidence regarding the effect of nutrition on the presence and severity of NAFLD. METHODS: A literature search was conducted identifying studies published between January 1985 and May 2021. We included studies with a dietary assessment and anthropometry based on validated tools, performed by a qualified dietitian or a trained health professional. We examined differences between patients with NAFLD and healthy controls as well as patients with NAFLD and nonalcoholic steatohepatitis (NASH). Risk of bias was assessed with the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. RESULTS: There were 60 eligible studies with 100,621 patients. The risk of bias was moderate for the majority of studies (41/60; 68%). According to meta-analyses, total caloric intake was higher in patients with NAFLD compared with controls (mean difference, 78.08; 95% confidence interval, 41.03-115.13). Macronutrient (protein, fat, and carbohydrate) consumption as proportion of total caloric intake and daily intake of fiber and vitamins E, A, and C did not significantly differ between patients with NAFLD and controls. Soft drink consumption had a trend towards association with the presence of NAFLD. However, the odds ratio was 4.4 and the confidence intervals very wide. Finally, there was no significant difference in any comparison between patients with NAFLD and NASH; however, the number of patients was relatively small. All meta-analyses had significant heterogeneity. CONCLUSIONS: Overall, despite high heterogeneity among studies, this meta-analysis demonstrated that higher caloric intake is positively associated with NAFLD, whereas diet composition in macronutrients was not associated with the presence or severity of disease.

Type: Article
Title: Systematic Review and Meta-analysis: The Role of Diet in the Development of Nonalcoholic Fatty Liver Disease
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.cgh.2021.11.026
Publisher version: https://doi.org/10.1016/j.cgh.2021.11.026
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Carbohydrates, Fatty Acids, Fructose, Metabolic Syndrome, Obesity, Protein
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10141825
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