Clinical practice advice on lifestyle modification in the management of nonalcoholic fatty liver disease in Japan: an expert review

Kamada, Y.; Takahashi, Hirokazu; Shimizu, Masahito; Kawaguchi, Takumi; Sumida, Yoshio; Fujii, Hideki; Seko, Yuya; Fukunishi, Shinya; Tokushige, Katsutoshi; Nakajima, Atsushi; Okanoue, Takeshi

doi:10.1007/s00535-021-01833-9

Cited by 27 publications

(30 citation statements)

References 147 publications

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“…Not only has the consumption of refined sugar and fructose increased in recent times, but also unhealthy dietary habits, including frequent and irregular patterns of eating (≥6 times daily), have increased rapidly [4,28]. Preliminary studies have suggested that these behaviors are associated with a spectrum of liver injury in non-obese patients, including non-alcoholic fatty liver (NAFL), NASH, cirrhosis, and hepatocellular carcinoma [4]. The possible underlying mechanisms contributing to the development and progression of NAFLD in nonobese individuals include increased hepatic de novo lipogenesis (DNL), inhibition of fat oxidation, greater insulin resistance (IR), circadian rhythm disorders, and intestinal dysbiosis.…”

Section: Healthy Eating In the Treatment Of Non-obese Nafldmentioning

confidence: 99%

“…Therefore, resistance exercise, utilizing muscle strength mass and bone density, may be preferable for many patients with NAFLD and seems to produce metabolic benefits with less energy consumption [67]. Thus, subgroups such as the elderly who have sarcopenia, arthritis, or poor cardiorespiratory fitness, may prefer exercise with a low intensity exercise volume [4]. Until now, a beneficial exercise program has not been elucidated for patients with non-obese NAFLD.…”

Section: Physical Activity In the Treatment Of Non-obese Nafldmentioning

confidence: 99%

“…It has been reported that non-obese NAFLD prevalence is highest in Hispanic and Asian (35.1% and 35.6%, respectively) ethnic groups, followed by White (30.0%) and Black (11.6%; P<0.001) ethnic groups [3]. Non-obese NAFLD is influenced by an unhealthy diet and a sedentary lifestyle and these factors are also affected by host genetics, metabolism, endocrinology, and other factors such as gut microbiota [4][5][6][7][8][9][10]. The medical burden of non-obese NAFLD is aggravated by the fact that individuals with nonobese NAFLD may develop long-term liver-related complications and multiple extra-hepatic comorbidities, such as cardiovascular disease and chronic kidney disease [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Lifestyle Interventions for Non-Obese Patients Both with, and at Risk, of Non-Alcoholic Fatty Liver Disease

et al. 2022

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Non-alcoholic fatty liver disease occurring in non-obese subjects (the so-called non-obese NAFLD) is a highly prevalent but neglected liver condition, which is closely associated with metabolic disorders and suboptimal lifestyles. Landmark studies have shown that lifestyle interventions are potentially beneficial in decreasing the risk of developing non-obese NAFLD and in ameliorating NAFLD in non-obese individuals with pre-existing NAFLD. Lifestyle interventions usually refer to changes in eating habits and physical activity, both of which have a powerful effect on non-obese NAFLD and on risk factors for non-obese NAFLD. However, to date, patients and health-care professionals have a poor awareness and understanding of non-obese NAFLD and the beneficial effects of lifestyle interventions in this patient population. The aim of this narrative review is to briefly discuss the evidence for the effects of lifestyle changes and what changes are needed amongst medical personnel and other stakeholders in order to raise awareness of non-obese NAFLD.

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Section: Healthy Eating In the Treatment Of Non-obese Nafldmentioning

confidence: 99%

Section: Physical Activity In the Treatment Of Non-obese Nafldmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lifestyle Interventions for Non-Obese Patients Both with, and at Risk, of Non-Alcoholic Fatty Liver Disease

et al. 2022

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“…At present, NAFLD patients are mainly treated with lifestyle interventions, such as diet and exercise ( Kamada et al, 2021 ). However, it is extremely difficult for many NAFLD patients to adhere to these therapies for a long time.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of Chinese patent medicines for non-alcoholic fatty liver disease: A network meta-analysis

Zhang

Liu²,

Gu³

et al. 2023

Front. Pharmacol.

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Background: The incidence of Non-alcoholic fatty liver disease (NAFLD) is increasing year by year. Researches showed that Chinese patent medicines (CPMs) had achieved good efficacy in the treatment of Non-alcoholic fatty liver disease. However, the debate on optimum Chinese patent medicine (CPM) persists. Therefore, we conducted a network meta-analysis to objectively compare the efficacy of different Chinese patent medicines in the treatment of Non-alcoholic fatty liver disease.Methods: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, and Chinese Biomedical Literature Database were used as databases for RCT researches retrieval. The retrieval time was from establishment of the database to July 2022. After effective data was extracted, Review Manager 5.4 and Cochrane Collaboration System Evaluator’s Manual were used to assess bias risk. STATA 16.0 based on frequency theory was used for the network meta-analysis.Results: Totally 39 studies were included, involving 13 Chinese patent medicines, including 4049 patients, of which 42 patients were lost. In terms of improving clinical efficiency rate, Zhibitai capsule was most likely the best choice of Chinese patent medicine for Non-alcoholic fatty liver disease. Liuwei Wuling tablet had the best effect in reducing serum ALT and AST; Gandan Shukang capsule had the best effect in reducing serum GGT; Qianggan capsule had the best effect in reducing serum TG; Dangfei Liganning capsule had the best effect in reducing serum TC. None of the included studies had serious adverse reactions.Conclusion: For patients with Non-alcoholic fatty liver disease in this NMA, Zhibitai capsule, Liuwei Wuling tablet, Gandan Shukang capsule, Qianggan capsule, Dangfei Liganning capsule might be noteworthy. Due to the uclear risk bias, better designed double-blind, multi center and large sample RCTs are needed which resolve the problems of blinding, selective reporting and allocation concealment.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42022341240.

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“…Furthermore, antioxidant intake is considered to be beneficial for preventing the progression of NASH, and the Mediterranean diet is recommended as a potential therapy for patients with NAFLD in European countries [12,13]. A few Japanese cross-sectional studies have examined dietary patterns related to abdominal obesity or NAFLD prevalence, and the traditional Japanese dietary pattern is recommended for management of NAFLD [14]. When assessing actual targets relevant to participants' habitual diets and providing advice aimed at ameliorating health problems quickly in the clinical practice of personal nutrition education, time-consuming diet surveys are not practical.…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Pilot Study on Food Intake Patterns Identified from Very Short FFQ and Metabolic Factors Including Liver Function in Healthy Japanese Adults

et al. 2022

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Non-alcoholic fatty liver disease is a growing health problem, and rapid diet assessment is required for personal nutrition education. This pilot study aimed to clarify associations between current food intake patterns identified from the short food frequency questionnaire (FFQ) and metabolic parameters, including liver function. We conducted a cross-sectional study on Japanese non-alcoholic residents of Tokyo and surrounding districts, 20 to 49 years of age. Anthropometric measurements, fasting blood samples, three-day dietary records, and FFQ with 21 items were collected. In all 198 participants, the proportions with obesity were 21% in men and 6% in women. Hypertriglyceridemia was significant only in men, affecting 26%. The traditional Japanese (TJ) pattern (greater intakes of green and yellow vegetables, other vegetables, seaweed/mushrooms/konjac, dairy, fruits, fish, salty, and soybeans/soy products) and the Westernized pattern (greater intakes of saturated-fat-rich foods, oily, egg/fish-eggs/liver, and sweets) were identified. The TJ pattern score showed an inverse relationship with body mass index, triglyceride, alkaline-phosphatase, leucine-aminopeptidase, and fatty liver index. The TJ pattern identified from the short FFQ was suggested to be associated with body fat storage. Further large-scale studies are needed to clarify the associations between this dietary pattern and metabolic parameters, including liver function.

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Clinical practice advice on lifestyle modification in the management of nonalcoholic fatty liver disease in Japan: an expert review

Cited by 27 publications

References 147 publications

Lifestyle Interventions for Non-Obese Patients Both with, and at Risk, of Non-Alcoholic Fatty Liver Disease

Lifestyle Interventions for Non-Obese Patients Both with, and at Risk, of Non-Alcoholic Fatty Liver Disease

Comparative efficacy of Chinese patent medicines for non-alcoholic fatty liver disease: A network meta-analysis

A Cross-Sectional Pilot Study on Food Intake Patterns Identified from Very Short FFQ and Metabolic Factors Including Liver Function in Healthy Japanese Adults

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