What’s New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD)

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a serious health problem due to its high incidence and consequences. In view of the existing controversies, new therapeutic options for NAFLD are still being sought. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. We searched for articles in the PubMed database using appropriate terms, including “non-alcoholic fatty liver disease”, “nonalcoholic fatty liver disease”, “NAFLD”, “diet”, “treatment”, “physical activity”, “supplementation”, “surgery”, “overture” and “guidelines”. One hundred forty-eight randomized clinical trials published from January 2020 to November 2022 were used for the final analysis. The results show significant benefits of NAFLD therapy associated with the use of not only the Mediterranean but also other types of diet (including low-calorie ketogenic, high-protein, anti-inflammatory and whole-grain diets), as well as enrichment with selected food products or supplements. Significant benefits in this group of patients are also associated with moderate aerobic physical training. The available therapeutic options indicate, above all, the usefulness of drugs related to weight reduction, as well as the reduction in insulin resistance or lipids level and drugs with anti-inflammatory or antioxidant properties. The usefulness of therapy with dulaglutide and the combination of tofogliflozin with pioglitazone should be emphasized. Based on the results of the latest research, the authors of this article suggest a revision of the therapeutic recommendations for NAFLD patients.

The Influence of Diet and Its Components on the Development and Prevention of Hepatocellular Carcinoma (HCC)

“…Deficiencies in these nutrients can disrupt the metabolic and detoxification functions of the organ, leading to chronic diseases [ 46 ]. To prevent a deficiency in essential components, supplementation is necessary in certain cases [ 47 , 48 ].…”

Understanding the Burden of Nonalcoholic Fatty Liver Disease: Time for Action

“…For some people, benefits can be realized from other diets (e.g., low-calorie ketogenic, high-protein, anti-inflammatory, and/or whole-grain diets), as long as the principles of healthy eating are followed ( 79 – 82 ). Avoidance of advanced glycation end products, which are generated from high-fat and high-sugar foods, high heat–processed food and beverages, and processed and well-done red meat, is also encouraged ( 80 – 82 ). The consumption of three or more cups of coffee is also recommended because of its antifibrotic and antioxidant properties in the liver, while avoiding sugar-sweetened beverages, fructose-laden products, and ultra-processed foods (e.g., foods that contain hydrolyzed proteins, fructose, high-fructose corn syrup, hydrogenated oil, and cosmetic additives such as flavorings, coloring agents, and emulsifiers) ( 83 – 86 ).…”

Exploring the Impact of Nutrition on Non-Alcoholic Fatty Liver Disease Management: Unveiling the Roles of Various Foods, Food Components, and Compounds

“…It is worth emphasizing that it is effective in reducing liver fat amounts even when weight loss is not observed. A beneficial impact on the NAFLD state achieved by physical activity is seen through improvements in the intestinal microbiota, weight loss, and impacts on epigenetic factors [ 13 ]. A short graphic presentation of the NAFLD pathogenesis mechanism and the risk factors leading to it is presented in Figure 1 .…”