Nonalcoholic fatty liver disease and low-carbohydrate diets

Annu Rev Nutr. 2009;29:365-79. doi: 10.1146/annurev-nutr-070208-114232.


Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, obesity, and other features of metabolic syndrome and is known to be the most common cause for abnormal liver enzymes. The recent surge in the number of patients with NAFLD has been accompanied by an increase in research on potential treatment options, particularly weight loss and dietary interventions. Given the growing interest on the role of carbohydrates in the prevention and treatment of NAFLD, this review discusses the relationship between the amount of carbohydrates in the diet and effects on NAFLD, with special emphasis on a low-carbohydrate diet. We discuss the role of insulin resistance in the pathophysiology of NAFLD and provide an overview of various popular diets and their role as a treatment option for NAFLD. Additional large, longer-duration trials studying the efficacy of a low-carbohydrate diet in the treatment and prevention of NAFLD are eagerly awaited.

Publication types

  • Review

MeSH terms

  • Diet, Carbohydrate-Restricted*
  • Diet, Reducing
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Carbohydrates / metabolism
  • Dose-Response Relationship, Drug
  • Fatty Liver / diet therapy*
  • Glycemic Index
  • Humans
  • Insulin Resistance
  • Obesity / complications
  • Obesity / diet therapy
  • Weight Loss / physiology*


  • Dietary Carbohydrates