As the weight of managing non-alcoholic fatty liver disease (NAFLD) presses down upon the shoulders of our healthcare systems, there is an urgent need for effective and sustainable management strategies. Our understanding what causes and moderates NAFLD has grown considerably over the past two decades, but essentially comes down to two things; 1) energy balance [calories in and out]; and 2) a background of genetic susceptibility. As the latter is relatively fixed (excluding epigenetic effects of course), much attention is being given to exploring how calories in and out influence NAFLD. In general, eat too much and you are more likely to develop NAFLD, eat less and liver fat goes down. If you move too little you are more likely to develop NAFLD, move more and liver fat goes down. But, the devil is in the detail of course! Although there is a clear role of energy in and out in NAFLD, there appears to be a new element to this – doing nothing at all.
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Published online: August 19, 2015See Article, pages 1229–1237
© 2015 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.