Animal protein intake and hepatic steatosis in the elderly: authors' response

We would like to thank Tang and Mann for their interest in our study in which we showed that animal protein intake was independently associated with higher prevalence of non-alcoholic fatty liver disease (NAFLD) in an overweight, predominantly aged Caucasian population.1 2

Rightfully so, the authors express their concerns regarding the generalisability of our findings towards younger patients with clinically significant non-alcoholic steatohepatitis (NASH).1 Indeed, our results only pertain to our study population, consisting of an elderly and presumably healthy population in which the vast majority will have NAFLD, not NASH. Nonetheless, we believe that aiming for a healthy lifestyle, such as adherence to a healthy diet, is key across the entire spectrum of NAFLD and is not reserved for advanced disease only.3 Also, Tang and Mann question the clinical significance of NAFLD as a liver disease at the age of 70 years, but patients...

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