Isocaloric Dietary Changes and Non-Alcoholic Fatty Liver Disease in High Cardiometabolic Risk Individuals

Abstract

Non-alcoholic fatty liver disease (NAFLD) incorporates an extensive spectrum of histologic liver abnormalities, varying from simple triglyceride accumulation in hepatocytes non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), and it is the most frequent chronic liver disease in the industrialized world. Beyond liver related complications such as cirrhosis and hepatocellular carcinoma, NAFLD is also an emerging risk factor for type 2 diabetes and cardiovascular disease. Currently, lifestyle intervention including strategies to reduce body weight and to increase regular physical activity represents the mainstay of NAFLD management. Total caloric intake plays a very important role in both the development and the treatment of NAFLD; however, apart from the caloric restriction alone, modifying the quality of the diet and modulating either the macro- or micronutrient composition can also markedly affect the clinical evolution of NAFLD, offering a more realistic and feasible treatment alternative. The aim of the present review is to summarize currently available evidence from randomized controlled trials on the effects of different nutrients including carbohydrates, lipids, protein and other dietary components, in isocaloric conditions, on NAFLD in people at high cardiometabolic risk. We also describe the plausible mechanisms by which different dietary components could modulate liver fat content.

Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases

“…Insulin resistance (IR) has been defined as a dysmetabolic condition in which the peptide hormone insulin produces a less-than-expected biological effect on peripheral target tissues, leading to hyperinsulinemia, the diagnostic hallmark of IR [1]. IR affects approximately 25%-35% of Westernized populations [2] and is consistently associated with obesity [3] and obesity-related complications, such as type 2 diabetes (T2D) mellitus [4], cardiovascular disease (CVD) [5,6], certain types of cancer [7], infertility [8], non-alcoholic fatty liver disease (NAFLD) [9,10], and cognitive impairment [11]. Although surgical and pharmacological strategies [12] have been shown to be useful, energy reduced diets, as part of a healthy lifestyle, may almost invariably facilitate weight loss and reduce IR in these patients [13].…”

Dietary Factors in Relation to Liver Fat Content: A Cross-sectional Study

“…The main goals in NAFLD management are moderate body weight reduction (7%-10%) and increased physical activity [6], while, despite first promising clinical studies with anti-diabetic and anti-inflammatory drugs [4], no specific medical treatment for NAFLD is approved so far [7]. Several studies have analyzed the relationships between dietary factors and NAFLD in recent years [7][8][9]. Epidemiological studies suggest that coffee consumption may decrease liver fat content [8], but little is known about associations between food consumption and NAFLD so far.…”

“…Several studies have analyzed the relationships between dietary factors and NAFLD in recent years [7][8][9]. Epidemiological studies suggest that coffee consumption may decrease liver fat content [8], but little is known about associations between food consumption and NAFLD so far. As a dietary pattern, the Mediterranean (MED) diet has been recommended as a diet of choice for individuals with NAFLD [6], and observational studies [9], as well as smaller intervention studies [10,11], suggest potential benefits from following the MED diet.…”

Dietary Interventions for the Prevention of Type 2 Diabetes in High-Risk Groups: Current State of Evidence and Future Research Needs

“…Despite claims that low-carbohydrate diets might help lower ectopic fat deposition, the evidence is currently unclear. Marked restriction of carbohydrates to under 30 g/day appears to lower intrahepatic triglyceride in the absence of weight loss, but it is not clear whether this is due to the high protein content of the interventions [ 26 , 27 ], with the type of fat [ 28 ] likely playing an additional role.…”