School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Department of Gastroenterology Tel Aviv Medical Center, Tel Aviv, Israel.
Liver Int. 2022 Aug;42(8):1731-1750. doi: 10.1111/liv.15335. Epub 2022 Jun 21.
Different dietary regimens for weight loss have developed over the years. Since the most evidenced treatment for non-alcoholic fatty liver disease (NAFLD) is weight reduction, it is not surprising that more diets targeting obesity are also utilized for NAFLD treatment. However, beyond the desired weight loss effects, one should not ignore the dietary composition of each diet, which may not necessarily be healthy or safe over the long term for hepatic and extrahepatic outcomes, especially cardiometabolic outcomes. Some of these diets are rich in saturated fat and red meat, are very strict, and require close medical supervision. Some may also be very difficult to adhere to for long periods, thus reducing the patient's motivation. The evidence for a direct benefit to NAFLD by restrictive diets such as very-low-carb, ketogenic, very-low-calorie diets, and intermittent fasting is scarce, and the long-term safety has not been tested. Nowadays, the approach is that the diet should be tailored to the patient's cultural and personal preferences. There is strong evidence for the independent protective association of NAFLD with a diet based on healthy eating patterns of minimally-processed foods, low in sugar and saturated fat, high in polyphenols, and healthy types of fats. This leads to the conclusion that a Mediterranean diet should serve as a basis that can be restructured into other kinds of diets. This review will elaborate on the different diets and their role in NAFLD. It will provide a practical guide to tailor the diet to the patients without compromising its composition and safety.
多年来，已经开发出了不同的减肥饮食方案。由于非酒精性脂肪性肝病 (NAFLD) 的最有效治疗方法是减轻体重，因此针对肥胖的饮食方案也被用于治疗 NAFLD 并不奇怪。然而，除了期望的减肥效果外，人们不应忽视每种饮食的饮食成分，这些成分从长期来看对肝脏和肝脏外结果（尤其是心血管代谢结果）不一定健康或安全。其中一些饮食富含饱和脂肪和红肉，非常严格，需要密切的医疗监督。有些饮食也可能非常难以长期坚持，从而降低患者的积极性。限制饮食（如极低碳水化合物、生酮、极低热量饮食和间歇性禁食）对 NAFLD 的直接益处的证据很少，并且长期安全性尚未得到检验。如今，方法是根据患者的文化和个人喜好来定制饮食。有强有力的证据表明，NAFLD 与基于健康饮食模式的独立保护关联，这种饮食模式的食物加工最少，低糖和饱和脂肪，富含多酚和健康类型的脂肪。这得出结论，地中海饮食应作为基础，可将其重构为其他类型的饮食。这篇综述将详细介绍不同的饮食及其在 NAFLD 中的作用。它将提供一个实用的指南，根据患者的情况调整饮食，而不会影响其组成和安全性。
