Vancells Lujan Pau, Viñas Esmel Esther, Sacanella Meseguer Emilio
Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain.
Department of Internal Medicine, Hospital Clínic de Barcelona, Villarroel 170, 08036 Barcelona, Spain.
Nutrients. 2021 Apr 24;13(5):1442. doi: 10.3390/nu13051442.
NAFLD is the world's most common chronic liver disease, and its increasing prevalence parallels the global rise in diabetes and obesity. It is characterised by fat accumulation in the liver evolving to non-alcoholic steatohepatitis (NASH), an inflammatory subtype that can lead to liver fibrosis and cirrhosis. Currently, there is no effective pharmacotherapeutic treatment for NAFLD. Treatment is therefore based on lifestyle modifications including changes to diet and exercise, although it is unclear what the most effective form of intervention is. The aim of this review, then, is to discuss the role of specific nutrients and the effects of different dietary interventions on NAFLD. It is well established that an unhealthy diet rich in calories, sugars, and saturated fats and low in polyunsaturated fatty acids, fibre, and micronutrients plays a critical role in the development and progression of this disease. However, few clinical trials have evaluated the effects of nutrition interventions on NAFLD. We, therefore, summarise what is currently known about the effects of macronutrients, foods, and dietary patterns on NAFLD prevention and treatment. Most current guidelines recommend low-calorie, plant-based diets, such as the Mediterranean diet, as the most effective dietary pattern to treat NAFLD. More clinical trials are required, however, to identify the best evidence-based dietary treatment approach.
非酒精性脂肪性肝病（NAFLD）是全球最常见的慢性肝病，其患病率的上升与全球糖尿病和肥胖症发病率的增加同步。它的特点是肝脏中脂肪堆积，进而发展为非酒精性脂肪性肝炎（NASH），这是一种炎症亚型，可导致肝纤维化和肝硬化。目前，对于NAFLD尚无有效的药物治疗方法。因此，治疗主要基于生活方式的改变，包括饮食和运动的调整，尽管尚不清楚最有效的干预形式是什么。那么，本综述的目的是讨论特定营养素的作用以及不同饮食干预措施对NAFLD的影响。众所周知，富含热量、糖和饱和脂肪且多不饱和脂肪酸、纤维和微量营养素含量低的不健康饮食在该疾病的发生和发展中起关键作用。然而，很少有临床试验评估营养干预对NAFLD的影响。因此，我们总结了目前关于常量营养素、食物和饮食模式对NAFLD预防和治疗影响的已知情况。目前大多数指南推荐低热量、以植物为基础的饮食，如地中海饮食，作为治疗NAFLD最有效的饮食模式。然而，需要更多的临床试验来确定最佳的循证饮食治疗方法。
