Bakhshimoghaddam Farnush, Baez Daniel, Dolatkhah Neda, Sheikh Mahdi, Poustchi Hossein, Hekmatdoost Azita, Dawsey Stanford, Kamangar Farin, Abnet Christian, Malekzadeh Reza, Etemadi Arash, Hashemian Maryam
Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
BMC Nutr. 2024 Nov 28;10(1):153. doi: 10.1186/s40795-024-00961-8.
The global burden of non-alcoholic fatty liver disease (NAFLD) has significantly risen over the past decade. Dietary intake strongly influences its development and should be a component of any prevention and treatment plan strategy. Dietary pattern analysis enables the investigation of the overall diet and permits the consideration of interactions and cumulative effects of dietary components. The current study aimed to systematically review observational studies and intervention trials to determine the associations between various dietary patterns and NAFLD.
The protocol was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and the Cochrane Library. We included studies that reported a priori dietary pattern (i.e., diet quality scores) or a posteriori method, which identified existing eating patterns (i.e., principal component analysis) in adult participants. Two investigators conducted independent screening, extraction, and quality assessment using the Newcastle‒Ottawa or Jadad scale. A third reviewer resolved conflicts.
We identified 27 relevant observational and 16 interventional studies from 16 countries. A Mediterranean or DASH diet might prevent and improve NAFLD, whereas dietary patterns such as Western dietary patterns characterized by high consumption of sweets and animal foods such as red meat and fast food are positively associated with NAFLD. A low-carbohydrate diet effectively prevents and treats NAFLD; however, we need more research on the effects of a low-fat diet and the type of fats.
Healthy dietary patterns, mainly plant-based or adjusted macronutrient distributions, such as the adoption of a low-carbohydrate diet, are linked to a reduced risk of NAFLD and could halt its progression. We proposed recommendations for future studies to fill the gap in knowledge regarding the management of NAFLD via dietary modifications.
在过去十年中，非酒精性脂肪性肝病（NAFLD）的全球负担显著增加。饮食摄入对其发展有强烈影响，应成为任何预防和治疗计划策略的一部分。饮食模式分析能够研究整体饮食情况，并考虑饮食成分之间的相互作用和累积效应。本研究旨在系统回顾观察性研究和干预试验，以确定各种饮食模式与NAFLD之间的关联。
该方案根据系统评价和Meta分析的首选报告项目（PRISMA）指南编写。我们检索了PubMed、Embase和Cochrane图书馆。我们纳入了报告先验饮食模式（即饮食质量评分）或后验方法的研究，后验方法可识别成年参与者中现有的饮食模式（即主成分分析）。两名研究人员使用纽卡斯尔-渥太华或Jadad量表进行独立筛选、提取和质量评估。第三位评审员解决冲突。
我们从16个国家确定了27项相关的观察性研究和16项干预性研究。地中海饮食或得舒饮食可能预防和改善NAFLD，而以高糖摄入以及红肉和快餐等动物性食物为特征的西方饮食模式与NAFLD呈正相关。低碳水化合物饮食可有效预防和治疗NAFLD；然而，我们需要更多关于低脂饮食的影响及脂肪类型的研究。
健康的饮食模式，主要是以植物为基础或调整后的宏量营养素分布，如采用低碳水化合物饮食，与降低NAFLD风险相关，并可能阻止其进展。我们为未来的研究提出了建议，以填补通过饮食调整管理NAFLD方面的知识空白。
