Effect of dietary carbohydrate and lipid modification on clinical and anthropometric parameters in nonalcoholic fatty liver disease: a systematic review and meta-analysis

Abstract

Context Nonalcoholic fatty liver disease (NAFLD) is estimated to affect approximately 25% of the adult population, making it one of the most common chronic liver diseases worldwide and a major public health problem. Still, there is no consensus on the most appropriate nutritional intervention for disease treatment. Objective To systematize and synthesize the results of randomized controlled trials that have evaluated the effect of dietary interventions with different, quantitative, macronutrient compositions on hepatic steatosis attenuation, serum levels of alanine aminotransferase, aspartate aminotransferase, lipid profile, glucose metabolism markers, and anthropometric parameters of adults and the elderly (age ≥ 60 years) with NAFLD. Data Sources MEDLINE databases via PubMed, Embase, Science Direct, LILACS, Web of Science, ClinicalTrials.gov, and Cochrane Library were searched. Randomized controlled trials that compared interventions as diets with values ≤ 45% or 20% of the total daily energy intake from carbohydrates or lipids, respectively, compared with dietary reference intakes, were included. Data Extraction Risk of bias was assessed through the Cochrane Collaboration tool. The meta-analysis was only performed to evaluate the effect of carbohydrate-modified diets on the outcome variables. The number of participants and mean values and respective standard deviations of the outcome variables were extracted and used to calculate weighted mean differences and their respective 95%CIs. Results The search strategy resulted in 21 146 studies, of which 10 were retained for qualitative analysis and 6 were included in the meta-analysis. From the analysis of 10 studies were identified 8 articles in which low-calorie diets were evaluated and 3 interventions that used an isocaloric diet. Only 3 studies were classified as having low risk of bias. Conclusion The observed effects on hepatic steatosis, serum alanine aminotransferase and aspartate aminotransferase levels, parameters of lipid and glucose metabolism, and anthropometric variables were mostly related to a hypocaloric diet. The use of reduced macronutrient interventions had no efficacy. Systematic Review Registration PROSPERO registration no. CRD42018088824.

Role of Intestinal Microbes in Chronic Liver Diseases

“…NAFLD is now considered to be the most common chronic liver disease, affecting approximately 25% of adults worldwide [ 42 ]. Recently, the prevalence of NAFLD has increased dramatically in parallel with the global increase in the number of people with metabolic syndrome, diabetes, and obesity [ 35 ].…”

Diet and exercise in NAFLD/NASH: Beyond the obvious

“…Another more general approach to achieve caloric deficit and consecutive WL is a hypocaloric diet regardless of its dietary composition 34 . Several studies have shown that a total energy deficiency leads to a decrease in BW, transaminase levels, total body fat, visceral fat and IHLC, regardless of how it is achieved 35‐37 .…”

“…Another more general approach to achieve caloric deficit and consecutive WL is a hypocaloric diet regardless of its dietary composition. 34 Several studies have shown that a total energy deficiency leads to a decrease in BW, transaminase levels, total body fat, visceral fat and IHLC, regardless of how it is achieved. 35 , 36 , 37 This is supported by similar long‐term outcomes after 7% WL following a low‐carbohydrate‐diet (LCD) vs a HCD despite short‐term effects in favour of a LCD.…”

Desenvolvimento de questionário de frequência alimentar a partir da avaliação do consumo alimentar habitual de pacientes com Doença Hepática Gordurosa não Alcoólica

“…Assim, devido à relação entre a DHGNA e distúrbios metabólicos, mudanças no estilo de vida e no consumo alimentar Research, Society and Development, v. 10, n. 16, e280101623506, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org /10.33448/rsd-v10i16.23506 3 são fundamentais para o seu tratamento (Chalasani et al, 2018;Arab et al, 2020;Garcêz et al, 2021). Além do excesso da ingestão de calorias e a inadequação de macro e micronutrientes da dieta, a qualidade da alimentação e o consumo de alimentos processados e ultraprocessados, também podem desempenhar um papel importante na patogênese da doença, uma vez que estão associados às complicações metabólicas comuns aos pacientes com esteatose, principalmente aqueles com excesso de peso e obesidade (Rico-Campa et al, 2019;Chen et al, 2020;Mirizzi et al, 2019;Plagiai et al, 2021;Tutunchi et al, 2021).…”