Mambrini Sara Paola, Grillo Antonio, Colosimo Santo, Zarpellon Francesco, Pozzi Giorgia, Furlan Davide, Amodeo Gabriele, Bertoli Simona
Nutrition Science Research Lab, Ospedale S. Giuseppe, Istituto Auxologico Italiano IRCCS, Piancavallo, Italy.
Istituto Auxologico Italiano IRCCS, Piancavallo, Italy.
Front Nutr. 2024 Aug 20;11:1426551. doi: 10.3389/fnut.2024.1426551. eCollection 2024.
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has emerged as a prevalent health concern, encompassing a wide spectrum of liver-related disorders. Insulin resistance, a key pathophysiological feature of MASLD, can be effectively ameliorated through dietary interventions. The Mediterranean diet, rich in whole grains, fruits, vegetables, legumes, and healthy fats, has shown promising results in improving insulin sensitivity. Several components of the Mediterranean diet, such as monounsaturated fats and polyphenols, exert anti-inflammatory and antioxidant effects, thereby reducing hepatic steatosis and inflammation. Furthermore, this dietary pattern has been associated with a higher likelihood of achieving MASLD remission. In addition to dietary modifications, physical exercise, particularly resistance exercise, plays a crucial role in enhancing metabolic flexibility. Resistance exercise training promotes the utilization of fatty acids as an energy source. It enhances muscle glucose uptake and glycogen storage, thus reducing the burden on the liver to uptake excess blood glucose. Furthermore, resistance exercise stimulates muscle protein synthesis, contributing to an improved muscle-to-fat ratio and overall metabolic health. When implemented synergistically, the Mediterranean diet and resistance exercise can elicit complementary effects in combating MASLD. Combined interventions have demonstrated additive benefits, including greater improvements in insulin resistance, increased metabolic flexibility, and enhanced potential for MASLD remission. This underscores the importance of adopting a multifaceted approach encompassing dietary modifications and regular physical exercise to effectively manage MASLD. This narrative review explores the biological mechanisms of diet and physical exercise in addressing MASLD by targeting insulin resistance and decreased metabolic flexibility.
代谢功能障碍相关脂肪性肝病（MASLD）已成为一个普遍的健康问题，涵盖了广泛的肝脏相关疾病。胰岛素抵抗是MASLD的一个关键病理生理特征，可通过饮食干预有效改善。富含全谷物、水果、蔬菜、豆类和健康脂肪的地中海饮食，在改善胰岛素敏感性方面已显示出有希望的结果。地中海饮食的几个成分，如单不饱和脂肪和多酚，具有抗炎和抗氧化作用，从而减少肝脏脂肪变性和炎症。此外，这种饮食模式与实现MASLD缓解的可能性更高有关。除了饮食调整外，体育锻炼，特别是抗阻运动，在增强代谢灵活性方面起着关键作用。抗阻运动训练促进脂肪酸作为能量来源的利用。它增强肌肉对葡萄糖的摄取和糖原储存，从而减轻肝脏摄取过量血糖的负担。此外，抗阻运动刺激肌肉蛋白质合成，有助于改善肌肉与脂肪的比例和整体代谢健康。当协同实施时，地中海饮食和抗阻运动在对抗MASLD方面可产生互补作用。联合干预已显示出累加益处，包括胰岛素抵抗的更大改善、代谢灵活性增加以及MASLD缓解的可能性增强。这凸显了采用包括饮食调整和定期体育锻炼的多方面方法来有效管理MASLD的重要性。这篇叙述性综述探讨了饮食和体育锻炼通过针对胰岛素抵抗和代谢灵活性降低来解决MASLD的生物学机制。
