Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic Serbia, Belgrade PO Box 102, Serbia.
Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Poznań 60-624, Poland.
World J Gastroenterol. 2022 Jul 21;28(27):3314-3333. doi: 10.3748/wjg.v28.i27.3314.
The prevalence of nonalcoholic fatty liver disease (NAFLD) is rising worldwide, paralleling the epidemic of obesity. The liver is a key organ for the metabolism of proteins, fats and carbohydrates. Various types of fats and carbohydrates in isocaloric diets differently influence fat accumulation in the liver parenchyma. Therefore, nutrition can manage hepatic and cardiometabolic complications of NAFLD. Even moderately reduced caloric intake, which leads to a weight loss of 5%-10% of initial body weight, is effective in improving liver steatosis and surrogate markers of liver disease status. Among dietary patterns, the Mediterranean diet mostly prevents the onset of NAFLD. Furthermore, this diet is also the most recommended for the treatment of NAFLD patients. However, clinical trials based on the dietary interventions in NAFLD patients are sparse. Since there are only a few studies examining dietary interventions in clinically advanced stages of NAFLD, such as active and fibrotic steatohepatitis, the optimal diet for patients in these stages of the disease must still be determined. In this narrative review, we aimed to critically summarize the associations between different dietary patterns, obesity and prevention/risk for NAFLD, to describe specific dietary interventions' impacts on liver steatosis in adults with NAFLD and to provide an updated overview of dietary recommendations that clinicians potentially need to apply in their daily practice.
非酒精性脂肪性肝病（NAFLD）的患病率在全球范围内呈上升趋势，与肥胖症的流行相吻合。肝脏是蛋白质、脂肪和碳水化合物代谢的关键器官。等热量饮食中的各种类型的脂肪和碳水化合物对肝实质脂肪堆积的影响不同。因此，营养可以管理 NAFLD 的肝和心脏代谢并发症。即使是适度减少热量摄入，导致初始体重减轻 5%-10%，也能有效改善肝脂肪变性和肝脏疾病状态的替代标志物。在饮食模式中，地中海饮食最能预防 NAFLD 的发生。此外，这种饮食也是治疗 NAFLD 患者的最推荐饮食。然而，基于 NAFLD 患者饮食干预的临床试验很少。由于只有少数研究检查了 NAFLD 患者临床进展阶段（如活跃和纤维化性脂肪性肝炎）的饮食干预，因此仍必须确定这些阶段患者的最佳饮食。在本叙述性综述中，我们旨在批判性地总结不同饮食模式、肥胖症与 NAFLD 的预防/风险之间的关联，描述特定饮食干预对成人 NAFLD 患者肝脂肪变性的影响，并提供饮食建议的最新概述，临床医生可能需要在日常实践中应用这些建议。
