Neglected features of lifestyle: Their relevance in non-alcoholic fatty liver disease

Abstract

AIMTo investigated in non-alcoholic-fatty-liver-disease (NAFLD), with ultrasound (US)-detected fatty liver, and in a group of non-alcoholic and otherwise healthy subjects, relationship of neglected features of lifestyle with NAFLD and obesity.METHODSFive hundred and thirty-two NAFLD and 667 non-NAFLD healthy subjects, age 21-60 years were studied. Severity of liver steatosis was assessed by US bright liver score. The adherence to mediterranean diet score (AMDS) was assessed on the basis of a 1-wk recall computerized questionnaire which included a detailed physical activity reports (Baecke questionnaire). The western dietary profile score, as a simplified paradigm of unhealthy diet, a questionnaire quantifying sun exposure score and a sleep habits questionnaires provided a further comprehensive lifestyle assessment.RESULTSBody mass index (BMI), insulin resistance (HOMA), and triglycerides, poorer adherence to a mediterranean diet profile, sedentary habits, minor sun exposure and use of “western diet” foods are greater in NAFLD. Multiple linear regression analysis, weighted by years of age, displays BMI, HOMA and AMDS as the most powerful independent predictors of fatty liver severity; however, also the physical activity score, the western diet habit and the sun exposure score are acting inside the model with significant independent effects.CONCLUSIONArticulated clinical intervention, according to our results, are justified in NAFLD and can be pursued addressing by focused intervention nutritional profile, physical exercise mainly in open-air subsets for enhancing sun exposure and healthier sleep duration and rhythm.

High‐Quality Diets Are Associated With Reduced Risk of Hepatocellular Carcinoma and Chronic Liver Disease: The Multiethnic Cohort

“…Fruit and vegetable intake is associated with higher dietary vitamin E and D, with vitamin E influencing lower levels of liver steatosis and inflammation and vitamin D decreasing inflammation and increasing glucose and lipid metabolism. The inverse association between the Mediterranean diet and NAFLD reported by prior studies and with HCC incidence in the MEC Latinos in the current study is important to note given the high prevalence of NAFLD in Latinos and the large fraction of NALFD‐associated HCC among Latinos …”

The Mediterranean dietary pattern as the diet of choice for non‐alcoholic fatty liver disease: Evidence and plausible mechanisms

“…The concept that the MD is beneficial for NAFLD treatment is relatively new and relays on few observational and interventional studies (summarized in Table ). In observational study, adjusting for body mass index (BMI) and homeostatic model assessment (HOMA), the MD score was one of the most powerful independent predictors of fatty liver severity on ultrasound (US) . Just two small observational studies included liver biopsy.…”

“…In observational study, adjusting for body mass index (BMI) and homeostatic model assessment (HOMA), the MD score was one of the most powerful independent predictors of fatty liver severity on ultrasound (US). 34 Just two small observational studies included liver biopsy. Adherence to the MD was estimated by a score in 73 NAFLD patients, 34 of them had liver biopsies.…”

Mediterranean Diet and Multi-Ingredient-Based Interventions for the Management of Non-Alcoholic Fatty Liver Disease

“…In this sense, an association between the MedDiet and a lower incidence or severity of NAFLD has been found in some observational studies ( Table 1 ). Thus, in a large cohort of subjects with or without NAFLD ( n = 532 and n = 667, respectively), the most powerful independent predictors of hepatic steatosis severity were body mass index (BMI), homeostasis model assessment-estimated insulin resistance (HOMA-IR) and the Adherence to Mediterranean Diet Score (AMDS) [ 40 ]. Similar results were described in two studies with smaller cohorts that used liver biopsy to diagnose NAFLD.…”