Jeznach-Steinhagen Anna, Ostrowska Joanna, Czerwonogrodzka-Senczyna Aneta, Boniecka Iwona, Gronostajska Wioletta
Department of Clinical Nutrition, Medical University od Warsaw, Poland; Institute of Mother and Child, Diabetes Outpatient Clinic, Warsaw, Poland.
Department of Clinical Nutrition, Medical University od Warsaw, Poland.
Pol Merkur Lekarski. 2017 Dec 22;43(258):281-286.
Non-alcoholic Fatty Liver Disease (NAFLD) is currently the most common chronic liver disease in the developed world. Nowadays, in the adult population of Europe it is estimated at 14% to 21%. Its most important risk factors are obesity and metabolic syndrome. Introducing lifestyle changes such as: dietary intervention and increased physical activity are the first-line treatment and are intended to support not only NAFLD but also associated diseases such as obesity, insulin resistance, diabetes and dyslipidemia. Dietary management focuses on weight reduction of overweight or obese people by decreasing energy in diet. It is recommended to limit the intake of saturated fats and trans fatty acids as well as cholesterol. Instead, it is important to increase the proportion of polyunsaturated fatty acid diets, mainly from the n-3 family, which exhibit anti-inflammatory activity. It is also beneficial to eat nuts, despite their high energy value, as a source of alpha linolenic acid, which lowers LDL cholesterol. It is important to increase the share of vegetable protein (eg. soya) and limit the intake of fat meat, milk and the dairy products. A key role in the treatment and prevention of NAFLD is also a reduction of simple sugars and total exclusion of added sugar in the diet. The rise of NAFLD in developed countries is analogous to the increase of fructose consumption, which high intake is directly indicated as the main cause of the disease. Choosing foods with high fiber content, low glycemic index and meals composed with low glycemic load, is conducive to weight reduction. An important role in supporting NAFLD treatment is also attributed to vitamin D, C and E supplementation and some probiotic bacteria, as well as cinnamon and turmeric, which improve insulin sensitivity. Daily physical activity is strongly recommended as the supplement of healthy lifestyle.
非酒精性脂肪性肝病（NAFLD）是目前发达国家最常见的慢性肝病。如今，在欧洲成年人群中，其患病率估计为14%至21%。其最重要的风险因素是肥胖和代谢综合征。引入生活方式的改变，如饮食干预和增加体育活动，是一线治疗方法，不仅旨在支持NAFLD，还包括肥胖、胰岛素抵抗、糖尿病和血脂异常等相关疾病。饮食管理的重点是通过减少饮食中的能量来减轻超重或肥胖人群的体重。建议限制饱和脂肪、反式脂肪酸以及胆固醇的摄入量。相反，增加多不饱和脂肪酸饮食的比例很重要，主要是来自n-3家族的脂肪酸，它们具有抗炎活性。食用坚果也有益处，尽管其能量值较高，但它是α-亚麻酸的来源，可降低低密度脂蛋白胆固醇。增加植物蛋白（如大豆）的比例并限制肥肉、牛奶和乳制品的摄入量也很重要。在NAFLD的治疗和预防中，减少单糖摄入并完全排除饮食中添加的糖也起着关键作用。发达国家NAFLD的增加与果糖消费量的增加类似，高果糖摄入量被直接指出是该疾病的主要原因。选择高纤维含量、低血糖指数以及由低血糖负荷组成的食物，有利于减轻体重。补充维生素D、C和E以及一些益生菌，还有肉桂和姜黄，它们能提高胰岛素敏感性，在支持NAFLD治疗中也起着重要作用。强烈建议日常进行体育活动，作为健康生活方式的补充。
