Discipline of Nutrition and Dietetics, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
The University of Sydney, The Concord Health and Ageing Men Project, Camperdown, Australia.
Eur J Nutr. 2023 Jun;62(4):1563-1578. doi: 10.1007/s00394-023-03085-0. Epub 2023 Jan 24.
Non-alcoholic fatty liver disease (NAFLD) is the leading chronic hepatic condition. Low-grade chronic inflammation contributes to disease progression. Diet has protective effects on hepatic health and inflammatory pathways. The purpose of this review is to systematically review and describe the effects of anti-inflammatory dietary patterns on NAFLD.
The Cochrane CENTRAL Library, Cumulative Index of Nursing and Allied Health Literature, Embase, MEDLINE and Web of Science databases were searched. A total of 252 records were identified, 7 of which were included in this review. The revised Cochrane risk-of-bias tool was used to conduct a quality assessment for randomised trials. Certainty of evidence was assessed using the grading of recommendations, assessment, development, and evaluation tool.
Of the 7 included studies, 6 were classified as low risk of bias and studies ranged from high to very low certainty of evidence. In the randomised-controlled studies systematically reviewed, either adherence to the Mediterranean, DASH, or FLiO diet was studied, against usual care or energy matched controls, with a total of 255 participants. Anti-inflammatory dietary pattern adherence significantly reduced the severity of most hepatic and inflammatory markers, and secondary outcomes. A minority of outcomes were improved significantly more than controls.
Anti-inflammatory dietary patterns showed benefits to NAFLD risk factors, severity markers and inflammatory markers compared to the control diet. It is unclear whether reductions in the evaluated parameters are related solely to the anti-inflammatory diet or weight loss resulting from caloric restriction, as improvements in control groups were also evidenced. Current limited body of evidence indicates need for further research including isocaloric dietary patterns, longer interventions, measures of inflammatory markers, and studies including normal-weight subjects to confirm findings at higher certainty.
CRD42021269382.
非酒精性脂肪性肝病（NAFLD）是最常见的慢性肝脏疾病。低度慢性炎症会导致疾病进展。饮食对肝脏健康和炎症途径有保护作用。本综述的目的是系统地回顾和描述抗炎饮食模式对 NAFLD 的影响。
检索了 Cochrane 中心图书馆、护理与联合健康文献累积索引、Embase、MEDLINE 和 Web of Science 数据库。共确定了 252 条记录，其中 7 条被纳入本综述。使用修订后的 Cochrane 偏倚风险工具对随机试验进行质量评估。使用推荐评估、发展和评估工具（GRADE）评估证据的确定性。
在纳入的 7 项研究中，有 6 项被归类为低偏倚风险，研究的证据确定性从高到极低不等。在所系统评价的随机对照研究中，研究了对地中海、DASH 或 FLiO 饮食的依从性，与常规护理或能量匹配的对照组相比，共有 255 名参与者。抗炎饮食模式的依从性显著降低了大多数肝脏和炎症标志物的严重程度，以及次要结局。少数结局的改善明显优于对照组。
与对照饮食相比，抗炎饮食模式对 NAFLD 的危险因素、严重程度标志物和炎症标志物均有获益。尚不清楚评估参数的减少是否仅与抗炎饮食有关，还是与热量限制导致的体重减轻有关，因为对照组也有改善的证据。目前有限的证据表明，需要进一步研究包括等热量饮食模式、更长的干预时间、炎症标志物的测量以及包括正常体重受试者的研究，以在更高的确定性水平上证实这些发现。
PROSPERO 注册号：CRD42021269382。
