Dietary patterns and fatty liver disease.

PURPOSE OF REVIEW: The association of dietary intake and fatty liver disease (FLD) is of importance for disease prevention. Dietary pattern analysis enables the investigation of overall diet and permits to take interactions and cumulative effects of dietary components into account. This review summarizes recent findings on the association of dietary patterns and FLD. RECENT FINDINGS: A systematic review of articles published from March 2013 to August 2014 identified four relevant observational (n = 116-995) and one interventional study (n = 12). The Healthy Eating Index and Dietary Diversity Scores were not related to nonalcoholic FLD. A Mediterranean diet intervention resulted in a significant decrease in liver fat content over 6 weeks. Exploratory approaches revealed a 'Western pattern' and a pattern having alcohol, meat (poultry) and tea in common with a hypothesis-driven pattern, which were both associated with FLD. SUMMARY: Most studies were limited by a cross-sectional design and small-to-moderate sample sizes. Observational studies applying exploratory approaches and a Mediterranean diet intervention demonstrated most promising results relating dietary patterns to FLD. Prospective studies with measurement of liver fat on a continuous scale at multiple time points in large samples are important requisites to improve our understanding of FLD cause.