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We read with interest the work by Alferink et al,1 which reports that intake of animal protein, but not that of monosaccharides and disaccharides, was found to be independently associated with non-alcoholic fatty liver disease (NAFLD). This is a surprising finding from a well-conducted cohort study that facilitated adjustment for metabolic covariates, in addition to sociodemographics and other lifestyle factors. However, we have reservations about the generalisability of these findings to patients with NAFLD or non-alcoholic steatohepatitis (NASH).
The studied population had an average age of 70 years, which is unusual for …
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