Yasutake Kenichiro, Kohjima Motoyuki, Kotoh Kazuhiro, Nakashima Manabu, Nakamuta Makoto, Enjoji Munechika
Kenichiro Yasutake, Department of Health and Nutrition Sciences, Faculty of Health and Social Welfare Sciences, Nishikyushu University, Kanzaki 842-8585, Japan.
World J Gastroenterol. 2014 Feb 21;20(7):1756-67. doi: 10.3748/wjg.v20.i7.1756.
Nonalcoholic fatty liver disease (NAFLD) is one of the most frequent causes of health problems in Western (industrialized) countries. Moreover, the incidence of infantile NAFLD is increasing, with some of these patients progressing to nonalcoholic steatohepatitis. These trends depend on dietary habits and life-style. In particular, overeating and its associated obesity affect the development of NAFLD. Nutritional problems in patients with NAFLD include excess intake of energy, carbohydrates, and lipids, and shortages of polyunsaturated fatty acids, vitamins, and minerals. Although nutritional therapeutic approaches are required for prophylaxis and treatment of NAFLD, continuous nutrition therapy is difficult for many patients because of their dietary habits and lifestyle, and because the motivation for treatment differs among patients. Thus, it is necessary to assess the nutritional background and to identify nutritional problems in each patient with NAFLD. When assessing dietary habits, it is important to individually evaluate those that are consumed excessively or insufficiently, as well as inappropriate eating behaviors. Successful nutrition therapy requires patient education, based on assessments of individual nutrients, and continuing the treatment. In this article, we update knowledge about NAFLD, review the important aspects of nutritional assessment targeting treatment success, and present some concrete nutritional care plans which can be applied generally.
非酒精性脂肪性肝病（NAFLD）是西方（工业化）国家最常见的健康问题之一。此外，婴儿NAFLD的发病率正在上升，其中一些患者会进展为非酒精性脂肪性肝炎。这些趋势取决于饮食习惯和生活方式。特别是，暴饮暴食及其相关的肥胖会影响NAFLD的发展。NAFLD患者的营养问题包括能量、碳水化合物和脂质摄入过多，以及多不饱和脂肪酸、维生素和矿物质短缺。尽管预防和治疗NAFLD需要营养治疗方法，但由于许多患者的饮食习惯和生活方式，以及患者之间的治疗动机不同，持续的营养治疗对他们来说很困难。因此，有必要评估每个NAFLD患者的营养背景并确定其营养问题。在评估饮食习惯时，重要的是要单独评估那些摄入过多或不足的食物，以及不适当的饮食行为。成功的营养治疗需要基于对个体营养素的评估进行患者教育，并持续进行治疗。在本文中，我们更新了关于NAFLD的知识，回顾了以治疗成功为目标的营养评估的重要方面，并提出了一些可普遍应用的具体营养护理计划。
