Department of Internal Medicine, Weill Cornell Medical Center, 1320 York Avenue, Suite HT-621, New York, NY, 10021, USA.
Division of Bariatric Surgery, Oregon Health & Science University, 3485 S. Bond Avenue, Portland, OR, 97239, USA.
Curr Gastroenterol Rep. 2021 Oct 15;23(12):21. doi: 10.1007/s11894-021-00827-0.
Non-alcoholic fatty liver disease (NAFLD) is closely associated with obesity, insulin resistance, and hyperlipidemia. There is strong clinical evidence that reduction in at least 5-7% total body weight is associated with improvement in hepatic steatosis and regression of fibrosis, with weight loss representing the primary approach to treatment. This guide reviews recent data on dietary approaches studied in NAFLD management. The strongest evidence currently supports a hypocaloric diet to induce weight loss and subsequent improvement in liver enzymes and histology, as well as a Mediterranean diet, which can lead to improvement in steatosis even in the absence of weight reduction. The purpose of this paper is to provide clinicians with tools to engage patients in conversations about nutrition in the setting of NAFLD, ultimately guiding suitable personalized dietary recommendations.
非酒精性脂肪性肝病（NAFLD）与肥胖、胰岛素抵抗和血脂异常密切相关。有强有力的临床证据表明，至少减少 5-7%的总体体重与肝脂肪变性的改善和纤维化的消退相关，体重减轻是治疗的主要方法。本指南回顾了在 NAFLD 管理中研究的饮食方法的最新数据。目前最强有力的证据支持低热量饮食以诱导体重减轻和随后改善肝酶和组织学，以及地中海饮食，即使在没有体重减轻的情况下，也可以导致脂肪变性的改善。本文的目的是为临床医生提供工具，使他们能够在 NAFLD 背景下与患者进行关于营养的对话，最终指导合适的个性化饮食建议。
