Dietary Approaches for Management of Non-Alcoholic Fatty Liver Disease: A Clinician’s Guide

Aboubakr, Aiya; Stroud, Andrea; Kumar, Sonal; Newberry, Carolyn

doi:10.1007/s11894-021-00827-0

Cited by 9 publications

(9 citation statements)

References 59 publications

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“…Most likely, nutrition and exercise are effective in maximizing the extent of the weight loss response to pharmacologic interventions and ensuring the sustainability of that response. Also, critically, as in “common” obesity, nutrition and exercise likely play a large role in preventing or mitigating metabolic sequelae of hypothalamic obesity, including fatty liver disease and type 2 diabetes mellitus ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

et al. 2022

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ContextIndividuals treated for pediatric craniopharyngioma, a rare, grade 1 brain tumor, frequently develop hypothalamic obesity, a complication often recalcitrant to intervention. Although hypothalamic obesity is known to adversely impact quality of life, less is known about how caregivers and patients experience this condition.ObjectiveOur goal was to examine the approaches that families take towards weight management and the impact on social function in individuals with craniopharyngioma and obesity. Individuals with craniopharyngioma without obesity were included as a comparison.Subjects and MethodsAdult caregivers of children <18y with craniopharyngioma completed a web-based survey posted by a patient advocacy organization between February and July 2020. Questions related to the child’s diagnosis, medications, lifestyle modifications, and social function along with research priorities. Descriptive statistics were generated. Linear regression was used to assess the independent effects of obesity and other covariates on social function.ResultsOf 106 respondents, 60 (57%) reported their child had obesity at the time of survey completion. In contrast, only 6 (5.7%) had obesity prior to craniopharyngioma diagnosis. A majority (92%) of those with obesity had tried limiting calories or carbohydrates; 31% and 69% found these helpful, respectively. Thirty-eight percent had tried weight loss medications (stimulants, metformin, GLP1R-agonists, and topiramate) and 48% found at least one helpful. Both stimulant and anti-depressant use were reported more frequently with obesity. An index (T-score) reflecting social function was lower in the cohort than a population reference, 41 (SD 11) vs. 50 (SD 10), p<0.001. In a linear model, both older age and obesity were independently associated with greater social impairment. Ninety-four percent of respondents caring for a child with obesity (and 79% of all respondents) identified “improving treatments and prevention for hypothalamic obesity” as a key research priority.ConclusionsOnly a minority of individuals with hypothalamic obesity had trialed medication, even though many reported that lifestyle modification was inadequate. Furthermore, social function was significantly impaired overall in survivors compared to a reference cohort, and even more so in individuals with obesity. These findings highlight the opportunity to improve social functioning as an additional potential benefit of improved treatments for hypothalamic obesity.

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Section: Discussionmentioning

confidence: 99%

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

et al. 2022

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“…A long‐term GFD has been associated with metabolic dysregulation and cardiovascular complications, possibly through a reduced intake of whole grains 123 or higher intake of refined carbohydrates or saturated fats 124 . Coeliac patients with metabolic dysfunction‐associated fatty liver disease need strict counselling regarding increasing physical activity and optimising their diet to reduce caloric intake, enrich unprocessed, naturally gluten‐free foods and minimise highly refined carbohydrates and saturated fat 125 . Ultrasound elastography can assess for liver fibrosis.…”

Section: Monitoring For Complicationsmentioning

confidence: 99%

“…124 Coeliac patients with metabolic dysfunction-associated fatty liver disease need strict counselling regarding increasing physical activity and optimising their diet to reduce caloric intake, enrich unprocessed, naturally gluten-free foods and minimise highly refined carbohydrates and saturated fat. 125 Ultrasound elastography can assess for liver fibrosis.…”

Section: Liver Diseasementioning

confidence: 99%

Review article: Follow‐up of coeliac disease

Tye–Din

2022

Aliment Pharmacol Ther

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Coeliac disease is a lifelong immune-mediated enteropathy associated with important systemic manifestations. 1,2 A strict gluten-free diet (GFD) is the cornerstone of management but does not resolve the underlying immune cause of coeliac disease. 3 The GFD imparts a substantial treatment burden, 4 and many patients fail to achieve complete symptom or mucosal remission. As coeliac disease is associated with increased morbidity and modestly increased mortality, periodic medical follow-up is considered a crucial component of patient care [5][6][7][8] but this is compromised by the paucity of evidence to inform best-practice approaches. 9,10 As a result, real-world follow-up is often inconsistent or absent altogether. [11][12][13] For many chronic illnesses, such as type 1 diabetes, the importance of maintaining long-term follow-up to assess disease status, treatment efficacy and monitor for complications is well established in the medical community, however, for coeliac disease, this is typically not the case, even though the monitoring goals are the same. 5,6,7,8,14 For patients, the key goals of treatment are to resolve symptoms, reduce the risk of complications and achieve optimal quality of life, and for clinicians, disease remission also encompasses healing of the enteropathy. Effective models of care that leverage local medical and allied health expertise, ideally involving a gastroenterologist, dietitian and primary care provider, will support these goals but willThe Handling Editor for this article was Professor Peter Gibson, and it was accepted for publication after full peer-review.

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“…One of the main goals of dietary interventions in patients with NAFLD is reduction in overall weight and central adiposity, the presence of which have a strong correlation to the degree and progression of disease. Several approaches to dietary modification have been analyzed, including a reduction in total calories consumed (ie, hypocaloric diet) and a manipulation of these calories in terms of macronutrient and micronutrient ratios and additive components 16 . Recommendations should be personalized based on patient need and comorbidities as well as ease of following a specific dietary plan.…”

Section: Dietary Interventionsmentioning

confidence: 99%

Dietary and nutrition considerations in caring for patients with nonalcoholic fatty liver disease: Updates for the practicing clinician

Newberry

Kumar

2022

Nut in Clin Prac

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Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide, affecting up to one-third of the global population. The disease is defined by excess fat deposition in the liver and has a strong correlation with metabolic syndrome, which, in turn, is also a risk factor for disease progression, including the development of steatohepatitis, advanced fibrosis, cirrhosis, and hepatocellular carcinoma. Although a number of medications are being explored for disease mitigation, nothing is currently approved, and the mainstay of therapy remains dietary and lifestyle intervention that promotes weight loss as well as management of comorbid conditions. The landscape that guides care for patients with NAFLD continues to evolve. Clinicians caring for these patients need to consider underlying disease state and nutrition risk in addition to concurrent related diagnoses, such as insulin resistance and hyperlipidemia, when formulating treatment plans. The following is a comprehensive review of the current dietary and nutrition considerations in the management of patients with NAFLD, with a special emphasis on implications for the practicing clinician.

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Dietary Approaches for Management of Non-Alcoholic Fatty Liver Disease: A Clinician’s Guide

Cited by 9 publications

References 59 publications

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

A Survey of Patient-Relevant Outcomes in Pediatric Craniopharyngioma: Focus on Hypothalamic Obesity

Review article: Follow‐up of coeliac disease

Dietary and nutrition considerations in caring for patients with nonalcoholic fatty liver disease: Updates for the practicing clinician

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