Ad Libitum Mediterranean or Low-Fat Diets as Treatments for Nonalcoholic Fatty Liver Disease?

The 2016 European Society of Cardiology guidelines recommended a total fat intake of ≤30%, of which ≤10% should consist of saturated fats to reduce risk of cardiovascular disease (CVD).(1) These guidelines also suggested decreasing saturated fat intake by substitution with polyunsaturated fatty acids.(1) In June 2017, the American Heart Association’s presidential advisory on dietary fats stated that replacing saturated fat with polyunsaturated vegetable oil reduces the incidence of CVD by ~30%.(2) Importantly, this shift from saturated to unsaturated fats occurs when a Westernized diet containing processed foods is replaced by the Mediterranean diet (MD).(2) Traditionally, the MD contains an abundance of plant foods, including legumes, vegetables, fruits, nuts, grains, and fish.(3) Several observational cohort studies and some randomized clinical