Liver Disease

The Impact of Diet on Liver-Related Mortality in Patients With NAFLD

Chronic liver disease is increasingly a cause of morbidity and mortality, but the burden of the disease varies significantly based on etiology. In a recent study, researchers investigated the burden of disability based on the presence of various complications and the various potential etiologies in order to better understand trends in disability associated with viral hepatitis, nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), and other liver diseases.1

Consultant360 reached out to corresponding author Zobair Younossi, MD, MPH, from the Betty and Guy Beatty Center for Integrated Research at Inova Fairfax Medical Campus and the Center for Liver Diseases at Inova Fairfax Hospital in Falls Church, Virginia, about the study and its results.2

Consultant360: How did you decide on the focus of your study?

Zobair Younossi: NAFLD is becoming the most common cause of liver disease worldwide. NAFLD is considered the liver complication of central obesity and type 2 diabetes. Given that NAFLD is a complex disease, it is influenced by genetic and environmental factors. In this context, dietary habits will be the most important environmental factor that can impact not only the burden of NAFLD but also mortality, morbidity and cost associated with this disease. Our goal was to look at this important factor on the mortality associated with NAFLD across different regions of the world.

C360: How do your results impact clinical practice?

ZY: Our results emphasize the importance of a healthy diet to address the issue of NAFLD burden in the community. This information should inform patients, providers and policy makers to emphasize strategies to promote healthy eating habits in all regions of the world.

C360: What other knowledge gaps exist in this area?

ZY: There are a number of challenges in the field of NAFLD. First, there is a substantial gap in awareness about NAFLD among patients, providers (primary care and subspecialists) and policy makers. Additionally, identifying patients with NAFLD who are at risk for adverse risk using non-invasive tests is still very suboptimal. Finally, treatment is limited. Although lifestyle modification with diet and exercise may be helpful, its implementation is limited. Currently, there are no treatment regimens approved for NAFLD

C360: What is the next step in this research?

ZY: Better understanding of the clinical burden of NAFLD and how public health and policy changes can change the trajectory of this important liver disease.

C360: Overall, what did your review of the 2017 Global Burden of Disease report tell you?

ZY: In general, there Global Burden of Liver Disease is driven by cirrhosis and liver cancer. The burden of liver disease related to viral hepatitis is relatively stable or for HBV may be decreasing, the burden related to NAFLD is increasing. 


  1. Paik JM, Golabi P, Younossi ZM, et al. The growing burden of disability related to nonalcoholic fatty liver disease: data from the global burden of disease 2007‐2017. Hepatol Comm.
  2. Paik J. Dietary risks for liver related mortality among nonalcoholic fatty liver disease (NAFLD): data from the global burden of disease (GBD) 2017. Talk presented at: American Association for the Study of Liver Diseases: The Liver Meeting 2020; November 13-16, 2020; Virtual.