Nutritional Strategies for the Individualized Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) Based on the Nutrient-Induced Insulin Output Ratio (NIOR)

Abstract

Nutrients play a fundamental role as regulators of the activity of enzymes involved in liver metabolism. In the general population, the action of nutrients may be affected by gene polymorphisms. Therefore, individualization of a diet for individuals with fatty liver seems to be a fundamental step in nutritional strategies. In this study, we tested the nutrient-induced insulin output ratio (NIOR), which is used to identify the correlation between the variants of genes and insulin resistance. We enrolled 171 patients, Caucasian men (n = 104) and women (n = 67), diagnosed with non-alcoholic fatty liver disease (NAFLD). From the pool of genes sensitive to nutrient content, we selected genes characterized by a strong response to the NIOR. The polymorphisms included Adrenergic receptor (b3AR), Tumor necrosis factor (TNFα), Apolipoprotein C (Apo C III). Uncoupling Protein type I (UCP-1), Peroxisome proliferator activated receptor γ2 (PPAR-2) and Apolipoprotein E (APOEs). We performed three dietary interventions: a diet consistent with the results of genotyping (NIOR (+)); typical dietary recommendations for NAFLD (Cust (+)), and a diet opposite to the genotyping results (NIOR (−) and Cust (−)). We administered the diet for six months. The most beneficial changes were observed among fat-sensitive patients who were treated with the NIOR (+) diet. These changes included improvements in body mass and insulin sensitivity and normalization of blood lipids. In people sensitive to fat, the NIOR seems to be a useful tool for determining specific strategies for the treatment of NAFLD.

Nutrition and Genetics in NAFLD: The Perfect Binomium

“…Another important study investigated the response to diets depending on individual genetic backgrounds by exploiting the nutrient-induced insulin output ratio (NIOR) in order to identify patients phenotypically sensitive to glucose or fat in the diet [89]. In this paper, the authors examined the polymorphisms linked with NIOR according to their impact on the output of insulin after a meal in 171 patients, after which they create a nutritional plan to follow for 6 months.…”

“…In this paper, the authors examined the polymorphisms linked with NIOR according to their impact on the output of insulin after a meal in 171 patients, after which they create a nutritional plan to follow for 6 months. The reduction of total and hepatic fat mass was most effective in the group in which the amount of dietary fat or sugar was adjusted to gene polymorphisms, among which Adrenergic receptor (b3AR), Tumor necrosis factor α (TNFα), Apolipoprotein C3 (Apo C3), Uncoupling Protein type I (UCP-1), Peroxisome proliferator activated receptor (PPAR)γ 2 and Apolipoprotein E (APOE) [89].…”

5-Lipooxygenase Derivatives as Serum Biomarkers of a Successful Dietary Intervention in Patients with NonAlcoholic Fatty Liver Disease

“…This study is a secondary analysis study (in the post-intervention period) based on results and biological material collected in the study described in detail in a previous report [26]. From the group of patients selected based on their weight loss (below and above 7% body mass), we filtered out patients' anthropometric and medical data and frozen plasma samples.…”

“…From the group of patients selected based on their weight loss (below and above 7% body mass), we filtered out patients' anthropometric and medical data and frozen plasma samples. The study, as described in [26], was a six-month single-center study conducted at the Pomeranian Medical University in Szczecin, Poland from October 2010 to October 2013. All the patients who consented to participate in the study were put on a six-month diet, and they were scheduled to four visits, as described in detail previously [26].…”

“…The study, as described in [26], was a six-month single-center study conducted at the Pomeranian Medical University in Szczecin, Poland from October 2010 to October 2013. All the patients who consented to participate in the study were put on a six-month diet, and they were scheduled to four visits, as described in detail previously [26]. In this study, we presented only the data from timepoint 0 (at the beginning of the diet) and timepoint 1 (six months after the diet).…”