Bogl LH, et al. - Researchers designed the current co-twin control study of monozygotic (MZ) twin pairs to identify potential nutritional factors involved in non-alcoholic fatty liver disease (NAFLD) pathogenesis. A cross-sectional study of 50 MZ twin pairs (age range: 23-36 years), ten pairs of which were discordant for liver fat as determined by magnetic resonance spectroscopy. Nutrient consumption from 3-day food reports were estimated. Investigators found that the n-6: n-3 ratio was significantly higher in the twins with higher liver as compared with their co-twins with lower liver fat among the ten liver fat-discordant twin pairs. A higher n-6: n-3 ratio was significantly linked to a higher liver fat percentage within MZ twin pairs after adjustment for BMI, energy intake and other covariates in multiple regression analysis of within-pair differences including all 50 twin pairs. For the prevention and treatment of NAFLD, the n-6: n-3 ratio is a promising dietary agent. To order to better understand causal relationships and appropriate doses, clinical trials are needed.