Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
Nutrients. 2017 Sep 26;9(10):1065. doi: 10.3390/nu9101065.
Non-alcoholic fatty liver disease (NAFLD) incorporates an extensive spectrum of histologic liver abnormalities, varying from simple triglyceride accumulation in hepatocytes non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), and it is the most frequent chronic liver disease in the industrialized world. Beyond liver related complications such as cirrhosis and hepatocellular carcinoma, NAFLD is also an emerging risk factor for type 2 diabetes and cardiovascular disease. Currently, lifestyle intervention including strategies to reduce body weight and to increase regular physical activity represents the mainstay of NAFLD management. Total caloric intake plays a very important role in both the development and the treatment of NAFLD; however, apart from the caloric restriction alone, modifying the quality of the diet and modulating either the macro- or micronutrient composition can also markedly affect the clinical evolution of NAFLD, offering a more realistic and feasible treatment alternative. The aim of the present review is to summarize currently available evidence from randomized controlled trials on the effects of different nutrients including carbohydrates, lipids, protein and other dietary components, in isocaloric conditions, on NAFLD in people at high cardiometabolic risk. We also describe the plausible mechanisms by which different dietary components could modulate liver fat content.
非酒精性脂肪性肝病（NAFLD）包含广泛的组织学肝脏异常，从单纯的肝细胞内甘油三酯积聚（非酒精性脂肪肝，NAFL）到非酒精性脂肪性肝炎（NASH）不等，它是工业化世界最常见的慢性肝病。除了与肝脏相关的并发症，如肝硬化和肝细胞癌外，NAFLD也是 2 型糖尿病和心血管疾病的新兴危险因素。目前，生活方式干预包括减少体重和增加有规律的身体活动的策略，是 NAFLD 管理的主要方法。总热量摄入在 NAFLD 的发生和治疗中起着非常重要的作用；然而，除了单独的热量限制外，改变饮食的质量并调节宏量或微量营养素的组成也可以显著影响 NAFLD 的临床演变，提供更现实和可行的治疗选择。本综述的目的是总结目前在高心血管代谢风险人群中，等热量条件下，不同营养素（包括碳水化合物、脂肪、蛋白质和其他膳食成分）对 NAFLD 的随机对照试验的证据。我们还描述了不同的膳食成分如何通过可能的机制来调节肝内脂肪含量。
