Exploring the optimal diet to manage fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is the metabolic form of fatty liver disease, caused by poor diet and physical inactivity. Weight loss through diet and exercise is the only form of treatment – but we don’t yet know what the best diet is for those affected.

Despite NAFLD affecting up to 30% of Western populations, there are no known drug therapies to treat it.

Through her Deakin University Dean’s Postdoctoral Research Fellowship, Dr Elena George aims to get a better understanding of the impacts of diet, lifestyle and body composition on the prevalence and outcomes of this common disease.

In particular, she is investigating the association between a Mediterranean diet and body composition in people with NAFLD. Her three studies will work towards establishing improved recommendations around diet for NAFLD.

One study will examine a large data set for associations between the Mediterranean diet and NAFLD on body composition.

“European guidelines for the management of NAFLD indicate that a Mediterranean diet may be the most beneficial dietary pattern for this condition, but we have very limited studies in non-Mediterranean populations like Australia,” Dr George said.

Dr George’s previous research has shown that the Mediterranean diet has some benefits, such as improvements in visceral fat even without weight loss. But other diets, such as the low-fat diet, which achieve weight loss, actually see greater improvements in liver, metabolic and visceral fat outcomes.

“My fellowship aims to combine the benefits of a Mediterranean diet which include anti-inflammatory and antioxidant effects, as well as being more palatable and sustainable, with weight loss,” she said.

Dr George will conduct a clinical trial to assess the impacts of a low energy Mediterranean diet in Australians with NAFLD.

“This is the first Mediterranean diet intervention in Australia aimed at weight loss so we will assess if it is feasible and the impact on body composition and NAFLD,” she said.

“Our concern is that with weight loss there may be loss of muscle mass which can have detrimental health outcomes in the long term. We think we can mediate this with a Mediterranean diet.”

Dr George hopes the trial will lead to a better understanding about the feasibility of a low energy Mediterranean diet for Australians, and that it will help inform a larger scale trial incorporating exercise.

As part of the fellowship, Dr George is also collecting body composition data on people with liver cancer to better understand the role of NAFLD on liver cancer outcomes.

“Current research indicates that obesity, and in turn NAFLD, are increasingly likely to be risk factors for liver cancer and may impact survival rates,” she said.

“This is concerning given the poor survival rate of people with liver cancer and that NAFLD is increasing in conjunction with the obesity epidemic. I will be focusing on quantifying visceral fat and lean mass in these individuals to determine if there is a link with liver cancer survival.”