Figure 1.

The effects of diverse macronutrients on non-alcoholic fatty liver disease pathophysiology. An unhealthy dietary pattern including saturated fats, trans fats, simple sugars and animal protein (red and processed meat) results in an increased total and visceral fat mass, insulin resistance, increased hepatic de novo lipogenesis and gut dysbiosis. Under these conditions and acting parallel, fat accumulates in the liver causing lipotoxicity, increased oxidative stress and mitochondrial dysfunction adding genetic or environmental predisposition for hepatic lipid accumulation (‘multiple hit hypothesis´). Red arrow: unfavorable/harmful effect; Green arrow: favorable/beneficial effect. NAFLD: non-alcoholic fatty liver disease; PPAR: peroxisome proliferator-activated receptors.