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Dietary treatment of nonalcoholic steatohepatitis

Perito, Emily R.a; Rodriguez, Luis A.b; Lustig, Robert H.a,c

Current Opinion in Gastroenterology: March 2013 - Volume 29 - Issue 2 - p 170–176
doi: 10.1097/MOG.0b013e32835ca11d
NUTRITION: Edited by David H. Alpers and William F. Stenson

Purpose of review Nonalcoholic steatohepatitis (NASH) is increasing in prevalence, in tandem with the U.S. obesity epidemic, in both children and adults. Identifying specific dietary components that drive NASH is important for successful management of this disease.

Recent findings Weight loss of 5–10% improves NASH. In addition, fructose and trans-fats, two components of the Western ‘fast-food’ diet, have unique metabolic effects that suggest they may be key contributors to NASH. However, further research is needed to clarify the utility of restricting these nutrients in treating NASH.

Summary Overall reductions in body weight, through reduced calorie intake and increased physical activity, are the current mainstays of NASH treatment. Reducing fructose and trans-fat intake, independent of weight loss, may be critical to improving or preventing progression of NASH.

aDepartment of Pediatrics, University of California, San Francisco

bDepartment of Nutrition and Food Services, UCSF Medical Center

cThe Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA

Correspondence to Robert H. Lustig, MD, 513 Parnassus Avenue, Box 0434, San Francisco, CA 94143, USA. Tel: +1 415 502 8672; fax: +1 415 476 8214; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.