Dietary intake of vitamin E and C protects from NAFLD-related liver damage

Israel: Dietary intake of antioxidants vitamin E and C may provide protection against liver damage caused by nonalcoholic fatty liver disease, according to a recent study published in the journal Digestive and Liver Disease.

Nonalcoholic fatty liver disease affects about 25% of the adult population globally and is strongly associated with metabolic syndrome, affecting most patients who have dyslipidemia, obesity, or type 2 diabetes. Long-standing NAFLD and NASH can result in cirrhosis and its complications, including hepatocellular carcinoma.

Antioxidants are known to play a protective role in nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH). But the role of dietary intake of antioxidants on NAFLD and NASH is not widely studied. Dana Ivancovsky-Wajcman, School of Public Health, University of Haifa, Haifa, Israel, and colleagues determined the association between the intake of vitamin E, vitamin C and NAFL, NASH and fibrosis markers in this cross-sectional study of subjects undergoing colonoscopy.

The study sample consisted of 789 participants, and 714 had reliable FibroMax. The presence of NAFLD was evaluated by ultrasonography. The level of steatosis was defined using SteatoTest, moderate-severe NASH using new quantitative NashTest and borderline-significant fibrosis ≥ F1–F2 using FibroTest. Nutritional intake was measured by food frequency questionnaire (FFQ).

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Key findings of the study include:

• Adjusting for BMI, dietary and lifestyle factors, the upper tertile of vitamin E intake/1000 Kcal was associated with lower odds of NASH.


• There was an inverse association between reaching the recommended vitamin E intake and NASH.


• The upper tertile of vitamin C intake/1000 Kcal was associated with lower odds of NAFLD and NASH.


• Both vitamins were related to the level of steatosis according to SteatoTest.