Microbial management of nonalcoholic fatty acid liver diseases

Nonalcoholic fatty acid liver disease (NAFLD) is a chronic liver disease occurring in people due to excessive fat deposition in the liver. NAFLD is an asymptomatic disease and is usually diagnosed based on the abnormal activity of the liver enzymes. Liver biopsies are the most accurate criteria to diagnose NAFLD. The primary causes of NAFLD are obesity, type 2 diabetes, dyslipidemia, and nutritional issues such as total parenteral nutrition (TPN). The gut microbes play a significant role in NAFLD. Specific microbial signatures were found associated with NAFLD. Microbiota-based therapeutics including fecal microbiota transplantation (FMT), probiotics, prebiotics, and synbiotics have a significant impact on the maintenance of gut microbiota equilibrium. FMT has a therapeutic role and can be an effective treatment method, yet large-scale and well-designed randomized clinical trials are needed to validate the therapeutic benefits of this method in NAFLD. Dietary modulations can also be effective in its treatment. A Mediterranean diet including whole grains, fruits, vegetables, and legumes was found beneficial in the management of NAFLD. Other dietary modulations such as introducing unsaturated fatty acids, omega-3 fatty acids, and low-fat dairy products in the diet while excluding refined carbohydrates and sugars can also be beneficial for disease treatment. This will reduce calorie intake for weight loss, which helps in the management of the disease.