Abstract: | OBJECTIVES AND METHODS: Most definitions of nonalcoholic fatty liver disease (NAFLD) allow some intake of alcohol but little attention has been paid to the possible contribution of alcohol-derived calories in the overall daily intake. The aim of the present study was to determine whether, in a group of 144 patients referred to liver outpatients with NAFLD, a more structured questioning of dietary habits and alcohol consumption would provide better information on alcohol-derived and dietary-derived calorie intake and the relationship with the BMI. RESULTS: Both food intake and calories resulting from alcohol ingestion were frequently underestimated as was the percentage of patients who were drinking excessively (>30 U a week), which was surprisingly high at 40%. The substantial calorie intake resulting from alcohol consumption in this group was associated with a reduction in dietary calorie intake, so that the total daily calorie intake remained similar to those with low-to-moderate or no alcohol consumption. The findings also showed that the BMI, although still elevated, was significantly reduced in those drinking heavily compared with low and nondrinkers. CONCLUSION: Patients with NAFLD can have substantially higher levels of alcohol consumption than usually recognized. The additional calorie intake resulting from this is to some extent balanced by a reduction in dietary calorie intake with less elevation in BMI, and a clear distinction from an alcohol-induced steatosis may be difficult. |