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Hathagoda W, Rajindrajith S, Niriella MA. Gaps and challenges in the management of pediatric steatotic liver diseases: a narrative review. World J Pediatr 2025; 21:352-360. [PMID: 40252149 DOI: 10.1007/s12519-025-00902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2024] [Revised: 03/17/2025] [Accepted: 03/18/2025] [Indexed: 04/21/2025]
Abstract
BACKGROUND Given the rising prevalence of pediatric steatotic liver disease (SLD), it is imperative to identify and address common challenges in clinical practice. This article aims to examine key issues in managing pediatric SLD and attempts to propose evidence-based recommendations. DATA SOURCES We reviewed published literature on steatotic liver diseases in children focusing on overweight and obesity, including original research, systematic reviews, meta-analyses, consensus statements, and position papers. Databases searched were PubMed/MEDLINE, Cochrane Library, Web of Science, and Scopus. Search terms included: "non-alcoholic fatty liver disease", "NAFLD", "steatohepatitis", "NASH", "steatotic liver disease", "fatty liver", "children", "adolescents", "pediatric", "obesity", and "overweight". RESULTS Critical issues include an over-reliance on liver biochemistry, which may fail to capture the broader spectrum of SLD [e.g., metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction associated with steatohepatitis (MASH)], and delays in recognizing metabolic comorbidities. Dietary and lifestyle recommendations are often generalized, overlooking individual patient needs, while psychological factors, such as stress and mental health, are frequently neglected despite their role in disease progression. Advanced fibrosis cases are under-referred, long-term risks like cirrhosis are underestimated, and insufficient follow-up, coupled with limited family involvement in education, further compromises care. CONCLUSIONS Addressing these deficiencies through a multidisciplinary approach that incorporates early diagnosis, personalized treatment strategies, structured monitoring, and comprehensive family involvement is imperative for optimizing outcomes and mitigating the long-term impact of pediatric SLD.
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Affiliation(s)
- Wathsala Hathagoda
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Kynsey Road Colombo 8, Colombo, 00800, Sri Lanka
- University Paediatric Unit, Lady Ridgeway Hospital for Children, Danister de Silva Road, Colombo 08, Colombo, 00800, Sri Lanka
| | - Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Kynsey Road Colombo 8, Colombo, 00800, Sri Lanka
- University Paediatric Unit, Lady Ridgeway Hospital for Children, Danister de Silva Road, Colombo 08, Colombo, 00800, Sri Lanka
| | - Madunil Anuk Niriella
- Colombo North Centre for Liver Diseases, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, 11010, Sri Lanka.
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Saslow LR, Krinock J, O'Brien A, Raymond K, Bayandorian H, Moskowitz JT, Daubenmier J, Oliveri A, Marriott DJ, Griauzde DH, Speliotes EK. A Very Low-Carbohydrate Program in Adults With Metabolic Dysfunction-Associated Steatotic Liver Disease and Phospholipase Domain-Containing Protein 3 Risk Genotype: Pre-Post Intervention Study. JMIR Form Res 2025; 9:e60051. [PMID: 39801107 PMCID: PMC11740387 DOI: 10.2196/60051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 09/24/2024] [Accepted: 10/10/2024] [Indexed: 01/30/2025] Open
Abstract
Background Insulin resistance and the G allele of rs738409 interact to create a greater risk of metabolic dysfunction-associated steatotic liver disease. Objective This study aims to confirm that one promising way to reduce insulin resistance is by following a very low-carbohydrate (VLC) dietary pattern. Methods Adults with rs738409-GG or -CG with liver steatosis and elevated liver function tests, were taught an ad libitum VLC diet, positive affect and mindful eating skills, goal setting, and self-monitoring and given feedback and coaching for 4 months. We measured liver steatosis, anthropometric, serum metabolic diet adherence, and quality of life measures. Results In this small pilot trial, of the 11 participants enrolled, 9 (82%) participants completed outcomes. All 11 participants viewed at least 1 session of the intervention, and 8 (73%) participants viewed at least half of the sessions. Among the 9 participants who provided 4-month self-report information, intervention satisfaction was high (mean 6.22, 95% CI 5.58-6.85), with 5 (56%) participants rating the intervention the top score, and 4 (44%) participants reporting they did not plan to stop following the VLC diet. Across participants with a 4-month hepatic liver fat percent measurement, the percent change in liver fat was -33.17% (95% CI -86.48 to 20.14), and in only the participants who were adherent to the eating pattern, the percent change in liver fat was -53.12% (95% CI -71.25 to -34.99). Amongst participants with a 4-month hepatic liver fat percent measurement, 6 out of 8 (75%) participants were considered responders, with a relative decline in liver fat ≥30%, and of the 9 participants with a 4-month body weight, 9 (100%) participants lost ≥5% of their body weight. There were no serious adverse events. Conclusions Results suggest the feasibility, acceptability, and preliminary efficacy of the VLC intervention in adults with higher genetic risk for metabolic dysfunction-associated steatotic liver disease, although there is a need for further studies given the small sample size and the high risk of substantial biases in this small pilot study.
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Affiliation(s)
- Laura R Saslow
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Jamie Krinock
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Alison O'Brien
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Kaitlyn Raymond
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Hovig Bayandorian
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute of Holistic Health Studies, San Francisco State University, San Francisco, CA, United States
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Medical Sciences Building II, Room 4741, Ann Arbor, MI, 48109, United States, 1 734-647-2964
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
- Gilbert S Omenn Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jennifer Daubenmier
- Institute of Holistic Health Studies, San Francisco State University, San Francisco, CA, United States
| | - Antonino Oliveri
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Medical Sciences Building II, Room 4741, Ann Arbor, MI, 48109, United States, 1 734-647-2964
| | - Deanna J Marriott
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Dina H Griauzde
- VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Elizabeth K Speliotes
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Medical Sciences Building II, Room 4741, Ann Arbor, MI, 48109, United States, 1 734-647-2964
- Gilbert S Omenn Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, United States
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Lundsgaard AM, Bojsen-Møller KN, Kiens B. Dietary Regulation of Hepatic Triacylglycerol Content-the Role of Eucaloric Carbohydrate Restriction with Fat or Protein Replacement. Adv Nutr 2023; 14:1359-1373. [PMID: 37591342 PMCID: PMC10721463 DOI: 10.1016/j.advnut.2023.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 07/21/2023] [Accepted: 08/07/2023] [Indexed: 08/19/2023] Open
Abstract
Accumulation of hepatic triacylglycerol (TG) is highly associated with impaired whole-body insulin-glucose homeostasis and dyslipidemia. The summarized findings from human intervention studies investigating the effect of reduced dietary carbohydrate and increased fat intake (and in studies also increased protein) while maintaining energy intake at eucaloric requirements reveal a beneficial effect of carbohydrate reduction on hepatic TG content in obese individuals with steatosis and indices of insulin resistance. Evidence suggests that the reduction of hepatic TG content after reduced intake of carbohydrates and increased fat/protein intake in humans, results from regulation of fatty acid (FA) metabolism within the liver, with an increase in hepatic FA oxidation and ketogenesis, together with a concomitant downregulation of FA synthesis from de novo lipogenesis. The adaptations in hepatic metabolism may result from reduced intrahepatic monosaccharide and insulin availability, reduced glycolysis and increased FA availability when carbohydrate intake is reduced.
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Affiliation(s)
- Anne-Marie Lundsgaard
- Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | | | - Bente Kiens
- Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Song K, Yang J, Lee HS, Oh JS, Kim S, Lee M, Suh J, Kwon A, Kim HS, Chae HW. Parental metabolic syndrome and elevated liver transaminases are risk factors for offspring, even in children and adolescents with a normal body mass index. Front Nutr 2023; 10:1166244. [PMID: 37941769 PMCID: PMC10627857 DOI: 10.3389/fnut.2023.1166244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 10/12/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction The parent-child correlation in metabolic syndrome (MetS) and elevated transaminases is sparsely researched. We assessed the correlation of parental MetS and elevated transaminase status with these conditions in their children. Methods Data of 4,167 youths aged 10-18 years were analyzed in a population-based survey, and the parental characteristics were stratified by the presence or absence of MetS or alanine aminotransferase (ALT) elevation in their children. The prevalence of these conditions in children was analyzed according to their parents' status. Logistic regression analyses were performed with MetS and ALT elevation in youth as the dependent variables. Results The proportions of MetS and ALT elevation were higher in parents of children with MetS and ALT elevation than in those without, even among youths without obesity. In logistic regression analyses, age, body mass index-standard deviation score (BMI-SDS), and ALT elevation were positively associated with MetS, whereas age, male sex, BMI-SDS, protein intake, and MetS were positively associated with ALT elevation. Higher protein intake was related to ALT elevation, whereas metabolic components and nutritional factors were closely related in parents and their children. Odds ratios (OR) of ALT elevation for MetS was 8.96 even after adjusting nutritional factors in the children. The OR was higher for ALT elevation in the children of parents with MetS and ALT elevation compared to those without. ORs for MetS and ALT elevation in the children of parents with MetS were higher than those of children of parents without MetS, even after adjusting for nutritional intake. ORs for ALT elevation were higher in the children of parents with ALT elevation than those without, even after adjusting for nutritional intake and BMI of parents as well as the nutritional intake, age, sex, and BMI-SDS of the children. Conclusion MetS and elevated liver transaminase statuses in children were associated with those of their parents even after adjusting for nutritional factors, and the relationships were more prominent in the youth without obesity.
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Affiliation(s)
- Kyungchul Song
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun Suk Oh
- Department of Pediatrics, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Sujin Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeongseob Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junghwan Suh
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ahreum Kwon
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
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A Chagas L, Torloni MR, Sanchez VHS, Pititto BA, Dualib PM, Mattar R. Dietary intake of pregnant women with non-alcoholic fatty liver disease: A case-control study. Clin Nutr ESPEN 2023; 57:630-636. [PMID: 37739716 DOI: 10.1016/j.clnesp.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/20/2023] [Accepted: 08/16/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND AIMS Findings on the role of diet in non-alcoholic fatty liver disease (NAFLD) pathogenesis are inconsistent. There are few studies on the dietary habits of pregnant women with NAFLD. Our primary aim was to compare the dietary intakes of pregnant women with and without NAFLD. METHODS This case-control study recruited 60 women (26-34 weeks' gestation) with recently diagnosed gestational diabetes (GDM) before any treatment was implemented. At recruitment, all participants underwent B-mode hepatic ultrasound. We included 30 women with sonographic NAFLD (cases) and 30 women without NAFLD (controls) matched for age, skin color, and pre-pregnancy body mass index. We assessed participants' dietary intakes in the last six months using a validated food frequency questionnaire. Mann-Whitney´s test was used to compare differences in median macro and micronutrient intakes between cases and controls. RESULTS Total median daily energy (1965.1 × 1949.2 calories) and lipid (25.1% × 28.3%) intakes were similar in women with and without NAFLD and fell within recommended ranges. Participants with NAFLD reported significantly higher median daily intakes of carbohydrates (59.4% × 53.1% p = 0.003), and significantly lower protein (15.6% × 17.0% p = 0.005), fiber (10.7 × 13.3 g/day p = 0.010), and vitamin C (151.8 × 192.6 mg/day p = 0.008) intakes than those without NAFLD. CONCLUSIONS Pregnant women with NAFLD ingest more carbohydrates and less protein, fiber, and vitamin C than those without NAFLD. Our findings contribute to understanding the role of diet in the development of NAFLD in pregnant women.
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Affiliation(s)
- Lucas A Chagas
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo - SP, 04024-002, Brazil
| | - Maria R Torloni
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo - SP, 04024-002, Brazil; Evidence Based Health Care Post-Graduate Program, Department of Medicine, São Paulo Federal University, Rua Botucatu 740, 3º andar, São Paulo - SP, 04023-900, Brazil.
| | - Victor H S Sanchez
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo - SP, 04024-002, Brazil
| | - Bianca A Pititto
- Department of Endocrinology, São Paulo Federal University, Rua Borges de Lagoa, 800, São Paulo - SP, 04038-001, São Paulo, Brazil
| | - Patrícia M Dualib
- Department of Endocrinology, São Paulo Federal University, Rua Borges de Lagoa, 800, São Paulo - SP, 04038-001, São Paulo, Brazil
| | - Rosiane Mattar
- Department of Obstetrics, São Paulo Federal University, Rua Napoleão de Barros, 875, São Paulo - SP, 04024-002, Brazil
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Khazaei Y, Dehghanseresht N, Ebrahimi Mousavi S, Nazari M, Salamat S, Asbaghi O, Mansoori A. Association Between Protein Intake From Different Animal and Plant Origins and the Risk of Non-Alcoholic Fatty Liver Disease: A Case-Control Study. Clin Nutr Res 2023; 12:29-39. [PMID: 36793780 PMCID: PMC9900076 DOI: 10.7762/cnr.2023.12.1.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Previous studies have frequently reviewed how different macronutrients affect liver health. Still, no study centered around protein intake and the non-alcoholic fatty liver disease (NAFLD) risk relationship. This study aimed to examine the association between the consumption of total and different sources of protein and NAFLD risk. We allocated 243 eligible subjects to the case and control groups, including 121 incidence cases of NAFLD, and 122 healthy controls. Two groups were matched in age, body mass index, and sex. We evaluated the usual food intake of participants using FFQ. Binary logistic regression was conducted to estimate the risk of NAFLD in relation to different sources of protein intake. The age of participants was 42.7 years on average, and 53.1% were male. We found Higher intake of protein in total (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.11-0.52) was significantly associated with a lower risk of NAFLD, despite adjusting for multiple confounders. in detail, higher tendency to the vegetables (OR, 0.28; 95% CI, 0.13-0.59), grains (OR, 0.24; 95% CI, 0.11-0.52), and nuts (OR, 0.25; 95% CI, 0.12-0.52) as the main sources of protein, were remarkably correlated with lower NAFLD risk. In contrary, increased intake of meat protein (OR, 3.15; 95% CI, 1.46-6.81) was positively associated with a higher risk. Totally, more calorie intake from proteins was inversely associated with lower NAFLD risk. This was more likely when the protein sources were selected less from meats and more from plants. Accordingly, increasing the consumption of proteins, particularly from plants, may be a good recommendation to manage and prevent NAFLD.
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Affiliation(s)
- Yasaman Khazaei
- Department of Nutrition, School of Public Health, Iran University of Medical Science, Tehran 1134845764, Iran
| | - Narges Dehghanseresht
- Department of Nutrition, Faculty of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 1579461357, Iran
| | - Sara Ebrahimi Mousavi
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran 1416643931, Iran.,Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 1416643931, Iran
| | - Matin Nazari
- Department of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran
| | - Shekoufeh Salamat
- Department of Nutrition, Faculty of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 1579461357, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran
| | - Anahita Mansoori
- Department of Nutrition, Faculty of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 1579461357, Iran
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Thangavel H, Lizardo K, Dhanyalayam D, De Assis S, Nagajyothi JF. Diets Differently Regulate Tumorigenesis in Young E0771 Syngeneic Breast Cancer Mouse Model. J Clin Med 2023; 12:413. [PMID: 36675341 PMCID: PMC9862441 DOI: 10.3390/jcm12020413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/25/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023] Open
Abstract
Breast cancer (BC) is the most diagnosed cancer type, accounting for one in eight cancer diagnoses worldwide. Epidemiological studies have shown that obesity is associated with increased risk of BC in post-menopausal women, whereas adiposity reduces the risk of BC in premenopausal women. The mechanistic link between obesity and BC has been examined by combining murine BC models with high-fat diet (HFD) induced obesity. However, the effect of adiposity (not obesity) induced by a short period of HFD consumption on BC pathogenesis is not well understood. In the current study, we examined the effects of different diet compositions on BC pathogenesis using a young E0771 syngeneic BC mouse model fed on either an HFD or regular diet (RD: a low-fat high-carbohydrate diet) for a short period (4 weeks) before implanting mammary tumors in mice. We analyzed the effect of diet composition on the onset of tumor growth, metastasis, and metabolic and immune status in the tumor microenvironment (TME) using various methods including in vivo bioluminescence imaging and immunoblotting analyses. We showed for the first time that a short-term HFD delays the onset of tumorigenesis by altering the immune and metabolic signaling and energy mechanism in the TME. However, RD may increase the risk of tumorigenesis and metastasis by increasing pro-inflammatory factors in the TME in young mice. Our data suggest that diet composition, adipogenesis, and loss of body fat likely regulate the pathogenesis of BC in a manner that differs between young and post-menopausal subjects.
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Affiliation(s)
- Hariprasad Thangavel
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Kezia Lizardo
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Dhanya Dhanyalayam
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Sonia De Assis
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Jyothi F. Nagajyothi
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
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Alfadda NA, Aljuraiban GS, Awwad HM, Khaleel MS, Almaghamsi AM, Sherbeeni SM, Alqutub AN, Aldosary AS, Alfadda AA. Higher carbohydrate intake in relation to non-alcoholic fatty liver disease in patients with type 2 diabetes. Front Nutr 2022; 9:996004. [PMID: 36570126 PMCID: PMC9773196 DOI: 10.3389/fnut.2022.996004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is an overlooked complication of type 2 diabetes (T2D). Current recommendations for the management of NAFLD are mainly focused on weight reduction, overlooking the role of macronutrient composition. Although dietary carbohydrates play a major role in intrahepatic fat synthesis, their association with the progression of liver steatosis has not been fully investigated in patients with T2D. Aim To investigate the association between higher carbohydrate intake and the presence of liver steatosis in patients with T2D. Methods This cross-sectional study included men and women aged 18-60 years diagnosed with T2D. Anthropometric measurements, hepatic steatosis assessment using the controlled attenuation parameter (CAP), blood samples, and dietary data were analyzed. Participants were divided into two groups: NAFLD and NAFLD-free. A two-sample t-test was used to evaluate the differences between the two groups. Stepwise multiple linear regression models adjusted for potential confounders were used to determine the association between CAP values and higher carbohydrate intake. Results In total, 358 participants were included. NAFLD was present in 79.3% of the participants. Body mass index, waist circumference, ALT, HbA1c, and triglycerides showed direct, while HDL-Cholesterol revealed inverse associations with CAP values. No significant relationship was found between carbohydrate intake and steatosis in the total study sample; however, multiple linear regression analysis revealed a significant relationship between carbohydrate intake and CAP values in patients aged ≤50 years. Conclusion In patients with T2D, higher carbohydrate intake was associated with liver steatosis in those aged 50 years and below. Further studies are required to confirm the causality between carbohydrate intake and liver steatosis.
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Affiliation(s)
- Nora A. Alfadda
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Hadeel M. Awwad
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad S. Khaleel
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Adel N. Alqutub
- Department of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah S. Aldosary
- Department of Medical Imaging Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Assim A. Alfadda
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia,*Correspondence: Assim A. Alfadda,
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Yaghoubi F, Darand M, Vasmehjani AA, Darabi Z, Talenezhad N, Mirzavandi F, Hosseinzadeh M. Adherence to low carbohydrate diets and non-alcoholic fatty liver disease: a case control study. BMC Nutr 2022; 8:140. [PMID: 36447244 PMCID: PMC9706826 DOI: 10.1186/s40795-022-00625-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/26/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is defined as the excessive accumulation of fat in the liver cells of people who do not drink alcohol. The aim of study is investigated the association between low carbohydrate diets (LCDs) and NAFLD. METHODS This age and gender-matched case-control study was conducted on 120 patients newly diagnosed with NAFLD and 120 adults without NAFLD. Diagnosis of NAFLD based on laboratory tests and abdominal ultrasound. Low carbohydrate diets score calculated on the percentage of energy as carbohydrate, fat, and protein. Participants in the highest rank intake of fat and protein and lowest intake of carbohydrate received 10 points. Multivariable logistic odds ratio was used for examine the relation between LCDs and NAFLD. RESULTS This study showed subjects in the highest tertile of LCD has more intake of zinc and vitamin B12 compare to lowest. Also, intake of protein (p = 0.02) carbohydrate (p < 0.02) and cholesterol (p = 0.02) were significantly higher in patient with NAFLD compare to control subjects. There was no significant association between LCD and risk of NAFLD (OR: 1.36; 95% CI: 0.97-1.92; P-trend = 0.13) in crude and adjusted (OR: 1.31; 95% CI: 0.84-2.04; P-trend = 0.23) model. CONCLUSION However, we showed that intake of protein, carbohydrate and cholesterol are higher in NAFLD, but our results of study showed that LCDs with higher proportion intakes of protein and fat was not associated with NAFLD. Further prospective studies are required for confirm these associations.
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Affiliation(s)
- Fatemeh Yaghoubi
- grid.412505.70000 0004 0612 5912Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mina Darand
- grid.411036.10000 0001 1498 685XDepartment of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aazam Ahmadi Vasmehjani
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,Department of Nutrition, School of Public Health, Shahid Sadughi University of Medical Sciences, Yazd, Iran
| | - Zahra Darabi
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,Department of Nutrition, School of Public Health, Shahid Sadughi University of Medical Sciences, Yazd, Iran
| | - Nasir Talenezhad
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,Department of Nutrition, School of Public Health, Shahid Sadughi University of Medical Sciences, Yazd, Iran
| | - Farhang Mirzavandi
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,Department of Nutrition, School of Public Health, Shahid Sadughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Hosseinzadeh
- grid.412505.70000 0004 0612 5912Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,Department of Nutrition, School of Public Health, Shahid Sadughi University of Medical Sciences, Yazd, Iran
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10
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El-Kassas M, Cabezas J, Coz PI, Zheng MH, Arab JP, Awad A. Nonalcoholic Fatty Liver Disease: Current Global Burden. Semin Liver Dis 2022; 42:401-412. [PMID: 35617968 DOI: 10.1055/a-1862-9088] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The map and global disease burden of chronic liver diseases are markedly changing, with nonalcoholic fatty liver disease (NAFLD) becoming the most common cause of liver diseases coinciding with the current epidemics of obesity, type 2 diabetes, and metabolic syndrome. Understanding the incidence and prevalence of NAFLD is critical because of its linkage to a significant economic burden of hospitalization and changing patterns in consequences, such as liver transplantation. Moreover, the long-term average health care expenses of NAFLD patients have exceeded those of other liver diseases. To lessen the imminent burden of NAFLD, immediate actions to raise worldwide awareness and address metabolic risk factors are required. This review summarizes key data about the global disease burden of NAFLD, modifiable and nonmodifiable risk factors, and current preventive approaches.
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Affiliation(s)
- Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Joaquín Cabezas
- Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Santander, Spain
- Department of Gastroenterology and Hepatology, Research Institute Valdecilla (IDIVAL), Santander, Spain
| | - Paula Iruzubieta Coz
- Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Santander, Spain
- Department of Gastroenterology and Hepatology, Research Institute Valdecilla (IDIVAL), Santander, Spain
| | - Ming-Hua Zheng
- NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
| | - Abeer Awad
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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11
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Vijay A, Al-Awadi A, Chalmers J, Balakumaran L, Grove JI, Valdes AM, Taylor MA, Shenoy KT, Aithal GP. Development of Food Group Tree-Based Analysis and Its Association with Non-Alcoholic Fatty Liver Disease (NAFLD) and Co-Morbidities in a South Indian Population: A Large Case-Control Study. Nutrients 2022; 14:nu14142808. [PMID: 35889764 PMCID: PMC9322963 DOI: 10.3390/nu14142808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a global problem growing in parallel to the epidemics of obesity and diabetes, with South Asians being particularly susceptible. Nutrition and behaviour are important modifiers of the disease; however, studies to date have only described dietary patterns and nutrients associated with susceptibility to NAFLD. METHODS This cross-sectional case-control study included 993 NAFLD patients and 973 healthy controls from Trivandrum (India). Dietary data was collected using a locally validated food frequency questionnaire. A tree-based classification categorised 2165 ingredients into three levels (food groups, sub-types, and cooking methods) and intakes were associated with clinical outcomes. RESULTS NAFLD patients had significantly higher consumption of refined rice, animal fat, red meat, refined sugar, and fried foods, and had lower consumption of vegetables, pulses, nuts, seeds, and milk compared to controls. The consumption of red meat, animal fat, nuts, and refined rice was positively associated with NAFLD diagnosis and the presence of fibrosis, whereas consumption of leafy vegetables, fruits, and dried pulses was negatively associated. Fried food consumption was positively associated with NAFLD, whilst boiled food consumption had a negative association. Increased consumption of animal fats was associated with diabetes, hypertension, and cardiovascular outcomes among those with NAFLD, whereas consumption of wholegrain rice was negatively associated with these clinical-related outcomes. CONCLUSIONS The tree-based approach provides the first comprehensive method of classifying food intakes to enable the identification of specific dietary factors associated with NAFLD and related clinical outcomes. This could inform culturally sensitive dietary guidelines to reduce risk of NAFLD development and/or its progression.
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Affiliation(s)
- Amrita Vijay
- Inflammation, Injury and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (A.V.); (A.M.V.)
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; (A.A.-A.); (J.C.); (J.I.G.)
| | - Amina Al-Awadi
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; (A.A.-A.); (J.C.); (J.I.G.)
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Jane Chalmers
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; (A.A.-A.); (J.C.); (J.I.G.)
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Leena Balakumaran
- Population Health Research Institute (PHRI), Trivandrum, Kerala 695011, India; (L.B.); (K.T.S.)
| | - Jane I. Grove
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; (A.A.-A.); (J.C.); (J.I.G.)
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Ana M. Valdes
- Inflammation, Injury and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (A.V.); (A.M.V.)
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; (A.A.-A.); (J.C.); (J.I.G.)
| | - Moira A. Taylor
- School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Kotacherry T. Shenoy
- Population Health Research Institute (PHRI), Trivandrum, Kerala 695011, India; (L.B.); (K.T.S.)
| | - Guruprasad P. Aithal
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; (A.A.-A.); (J.C.); (J.I.G.)
- Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- Correspondence: ; Tel.: +44-01158231149
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12
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Sayegh NF, Heraoui GNHA, Younes H, Sayegh LN, Boulos C, Sayegh R. Relation of Dietary Patterns and Nutritional Profile to Hepatic Fibrosis in a Sample of Lebanese Non-Alcoholic Fatty Liver Disease Patients. Nutrients 2022; 14:nu14122554. [PMID: 35745284 PMCID: PMC9229197 DOI: 10.3390/nu14122554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is considered the most common liver injury worldwide. NAFLD can evolve into non-alcoholic steatohepatitis (NASH) with or without fibrosis. The objectives of this study were to determine the nutritional profile and dietary patterns of NAFLD Lebanese patients and to report the type of diet-related to the presence of hepatic fibrosis. We hypothesized that the traditional pattern was related to a low risk of fibrosis. This cross-sectional study included 320 eligible Lebanese NAFLD patients. Three dietary patterns were identified: the Traditional diet, the High Fruit diet, and the Westernized diet. Multivariate analysis showed a significant relationship between high adherence to the traditional diet and absence of hepatic fibrosis with a decreased risk of 82%, p = 0.031 after adjusting for its covariables. Fruits were absent from this dietary pattern. Although our results pointed to a possible relationship between fibrosis in NAFLD patients and fruit intake, experimental studies are needed to show whether this is a causal relationship. However, the results obtained in this study may contribute to the planning of dietary interventions and recommendations and enable a better follow-up for NAFLD patients with fibrosis.
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Affiliation(s)
- Nicole Fakhoury Sayegh
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Damascus Road, Riad el Solh, Beirut P.O. Box 11-5076, Lebanon; (G.N.H.A.H.); (C.B.)
- Correspondence: or
| | - Gessica N. H. A. Heraoui
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Damascus Road, Riad el Solh, Beirut P.O. Box 11-5076, Lebanon; (G.N.H.A.H.); (C.B.)
| | - Hassan Younes
- College Health, équipe PANASH-ULR 7519, Institut Polytechnique UniLaSalle, 19, Rue Pierre Waguet, CEDEX, 60026 Beauvais, France;
| | - Lea Nicole Sayegh
- Faculty of Medicine, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon;
| | - Christa Boulos
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Damascus Road, Riad el Solh, Beirut P.O. Box 11-5076, Lebanon; (G.N.H.A.H.); (C.B.)
| | - Raymond Sayegh
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Saint Joseph University, Damascus Road, Riad el Solh, Beirut P.O. Box 11-5076, Lebanon;
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13
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Barrea L, Caprio M, Watanabe M, Cammarata G, Feraco A, Muscogiuri G, Verde L, Colao A, Savastano S. Could very low-calorie ketogenic diets turn off low grade inflammation in obesity? Emerging evidence. Crit Rev Food Sci Nutr 2022; 63:8320-8336. [PMID: 35373658 DOI: 10.1080/10408398.2022.2054935] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Obesity is an emerging non-communicable disease associated with chronic low-grade inflammation and oxidative stress, compounded by the development of many obesity-related diseases, such as cardiovascular disease, type 2 diabetes mellitus, and a range of cancers. Originally developed for the treatment of epilepsy in drug non-responder children, the ketogenic diet (KD) is being increasingly used in the treatment of many diseases, including obesity and obesity-related conditions. The KD is a dietary pattern characterized by high fat intake, moderate to low protein consumption, and very low carbohydrate intake (<50 g) that has proved to be an effective and weight-loss tool. In addition, it also appears to be a dietary intervention capable of improving the inflammatory state and oxidative stress in individuals with obesity by means of several mechanisms. The main activity of the KD has been linked to improving mitochondrial function and decreasing oxidative stress. β-hydroxybutyrate, the most studied ketone body, has been shown to reduce the production of reactive oxygen species, improving mitochondrial respiration. In addition, KDs exert anti-inflammatory activity through several mechanisms, e.g., by inhibiting activation of the nuclear factor kappa-light-chain-enhancer of activated B cells, and the inflammatory nucleotide-binding, leucine-rich-containing family, pyrin domain-containing-3, and inhibiting histone deacetylases. Given the rising interest in the topic, this review looks at the underlying anti-inflammatory and antioxidant mechanisms of KDs and their possible recruitment in the treatment of obesity and obesity-related disorders.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Napoli, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Cammarata
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI) and Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - Alessandra Feraco
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Silvia Savastano
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
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14
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Burra P, Bizzaro D, Gonta A, Shalaby S, Gambato M, Morelli MC, Trapani S, Floreani A, Marra F, Brunetto MR, Taliani G, Villa E. Clinical impact of sexual dimorphism in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Liver Int 2021; 41:1713-1733. [PMID: 33982400 DOI: 10.1111/liv.14943] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022]
Abstract
NAFLD/NASH is a sex-dimorphic disease, with a general higher prevalence in men. Women are at reduced risk of NAFLD compared to men in fertile age, whereas after menopause women have a comparable prevalence of NAFLD as men. Indeed, sexual category, sex hormones and gender habits interact with numerous NAFLD factors including cytokines, stress and environmental factors and alter the risk profiles and phenotypes of NAFLD. In the present review, we summarized the last findings about the influence of sex on epidemiology, pathogenesis, progression in cirrhosis, indication for liver transplantation and alternative therapies, including lifestyle modification and pharmacological strategies. We are confident that an appropriate consideration of sex, age, hormonal status and sociocultural gender differences will lead to a better understanding of sex differences in NAFLD risk, therapeutic targets and treatment responses and will aid in achieving sex-specific personalized therapies.
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Affiliation(s)
- Patrizia Burra
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Debora Bizzaro
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Anna Gonta
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Sarah Shalaby
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Martina Gambato
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | | | - Silvia Trapani
- Italian National Transplant Center, Italian National Institute of Health, Rome, Italy
| | - Annarosa Floreani
- University of Padova, Padua, Italy.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Fabio Marra
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maurizia Rossana Brunetto
- Hepatology and Liver Physiopathology Laboratory and Internal Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Taliani
- Infectious Diseases Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Erica Villa
- Gastroenterology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy
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15
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Legault M, Leblanc V, Marchand GB, Iceta S, Drolet-Labelle V, Lemieux S, Lamarche B, Michaud A. Evaluation of Dietary Assessment Tools Used in Bariatric Population. Nutrients 2021; 13:nu13072250. [PMID: 34210110 PMCID: PMC8308448 DOI: 10.3390/nu13072250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 01/23/2023] Open
Abstract
Severe obesity is associated with major health issues and bariatric surgery is still the only treatment to offer significant and durable weight loss. Assessment of dietary intakes is an important component of the bariatric surgery process. Objective: To document the dietary assessment tools that have been used with patients targeted for bariatric surgery and patients who had bariatric surgery and explore the extent to which these tools have been validated. Methods: A literature search was conducted to identify studies that used a dietary assessment tool with patients targeted for bariatric surgery or who had bariatric surgery. Results: 108 studies were included. Among all studies included, 27 used a dietary assessment tool that had been validated either as part of the study per se (n = 11) or in a previous study (n = 16). Every tool validated per se in the cited studies was validated among a bariatric population, while none of the tools validated in previous studies were validated in this population. Conclusion: Few studies in bariatric populations used a dietary assessment tool that had been validated in this population. Additional studies are needed to develop valid and robust dietary assessment tools to improve the quality of nutritional studies among bariatric patients.
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Affiliation(s)
- Marianne Legault
- Quebec Heart and Lung Institute Research Centre, Université Laval, Québec City, QC G1V 4G5, Canada; (M.L.); (S.I.); (V.D.-L.)
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Vicky Leblanc
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Geneviève B. Marchand
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Sylvain Iceta
- Quebec Heart and Lung Institute Research Centre, Université Laval, Québec City, QC G1V 4G5, Canada; (M.L.); (S.I.); (V.D.-L.)
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Virginie Drolet-Labelle
- Quebec Heart and Lung Institute Research Centre, Université Laval, Québec City, QC G1V 4G5, Canada; (M.L.); (S.I.); (V.D.-L.)
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Simone Lemieux
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Benoît Lamarche
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
| | - Andréanne Michaud
- Quebec Heart and Lung Institute Research Centre, Université Laval, Québec City, QC G1V 4G5, Canada; (M.L.); (S.I.); (V.D.-L.)
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec City, QC G1V 0A6, Canada; (V.L.); (G.B.M.); (S.L.); (B.L.)
- Correspondence:
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16
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Naghibeiranvand M, Visskaramian A, Mehrabirad F, Mohammadi Z. Comparison of Body Mass Index, Smoking, Vitamin E and Type of Oil Consumed Between Patients Suffering from Non-alcoholic Fatty Liver Disease Versus Non-affected Patients: A Case-Control Study. JUNDISHAPUR JOURNAL OF CHRONIC DISEASE CARE 2021; 10. [DOI: 10.5812/jjcdc.108713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) has an increasing trend in the world and can lead to liver failure and death if left untreated. Lifestyle modification is very important in the treatment of this disease. Objectives: This study aimed to determine the comparison of body mass index (BMI), smoking, vitamin E consumption, and type of oil consumed by patients with NAFLD with non-alcoholic patients. Methods: The present study was a retrospective case-control study that was performed on 120 patients referred to the ultrasound unit of Shohaday Ashayer Hospital in Khorramabad. The participants were divided into two groups, including case (61 people) and control (59 people). The questionnaire consisted of three parts: (1) the first part was related to demographic information; (2) the second part was related to liver ultrasound results; (3) and the third part was related to height, weight, BMI, weekly vitamin E intake, daily smoking status, and type of oil consumed. Data were analyzed using SPSS-23 software and descriptive and inferential statistical methods. Results: Most of the participants in the study were 69 (55.8%) and 92 (76.66%) were married. The mean BMI of patients with NAFLD was significantly higher than non-alcoholic patients (P = 0.003). There was no statistically significant difference in daily smoking and weekly intake of vitamin E in patients with and without non-alcoholic fatty liver disease (P < 0.05). According to Fisher's exact test, it was found that there was a statistically significant difference in the frequency by patients with NAFLD and non-alcoholic (P = 0.014). Also, a statistically significant difference was observed in the frequency of the type of oil consumed by patients with NAFLD (P = 0.014). Conclusions: Consumption of olive and sesame oil along with weight loss is recommended. Smoking as a risk factor, as well as the use of vitamin E to prevent and treat NAFLD, require further studies with a larger sample size.
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17
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Maj M, Harbottle B, Thomas PA, Hernandez GV, Smith VA, Edwards MS, Fanter RK, Glanz HS, Immoos C, Burrin DG, Santiago-Rodriguez TM, La Frano MR, Manjarín R. Consumption of High-Fructose Corn Syrup Compared with Sucrose Promotes Adiposity and Increased Triglyceridemia but Comparable NAFLD Severity in Juvenile Iberian Pigs. J Nutr 2021; 151:1139-1149. [PMID: 33693900 PMCID: PMC8112773 DOI: 10.1093/jn/nxaa441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/11/2020] [Accepted: 12/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fructose consumption has been linked to nonalcoholic fatty liver disease (NAFLD) in children. However, the effect of high-fructose corn syrup (HFCS) compared with sucrose in pediatric NAFLD has not been investigated. OBJECTIVES We tested whether the isocaloric substitution of dietary sucrose by HFCS would increase the severity of NAFLD in juvenile pigs, and whether this effect would be associated with changes in gut histology, SCFA production, and microbial diversity. METHODS Iberian pigs, 53-d-old and pair-housed in pens balanced for weight and sex, were randomly assigned to receive a mash diet top-dressed with increasing amounts of sucrose (SUC; n = 3 pens; 281.6-486.8 g/kg diet) or HFCS (n = 4; 444.3-724.8 g/kg diet) during 16 wk. Diets exceeded the animal's energy requirements by providing sugars in excess, but met the requirements for all other nutrients. Animals were killed at 165 d of age after blood sampling, and liver, muscle, and gut were collected for histology, metabolome, and microbiome analyses. Data were analyzed by multivariate and univariate statistics. RESULTS Compared with SUC, HFCS increased subcutaneous fat, triacylglycerides in plasma, and butyrate in colon (P ≤ 0.05). In addition, HFCS decreased UMP and short-chain acyl carnitines in liver, and urea nitrogen and creatinine in serum (P ≤ 0.05). Microbiome analysis showed a 24.8% average dissimilarity between HFCS and SUC associated with changes in SCFA-producing bacteria. Body weight gain, intramuscular fat, histological and serum markers of liver injury, and circulating hormones, glucose, and proinflammatory cytokines did not differ between diets. CONCLUSIONS Fructose consumption derived from HFCS promoted butyrate synthesis, triglyceridemia, and subcutaneous lipid deposition in juvenile Iberian pigs, but did not increase serum and histological markers of NAFLD compared with a sucrose-enriched diet. Longer studies could be needed to observe differences in liver injury among sugar types.
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Affiliation(s)
- Magdalena Maj
- Biological Sciences Department, California Polytechnic State University, San Luis Obispo, CA, USA,Center for Applications in Biotechnology, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Brooke Harbottle
- Animal Science Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Payton A Thomas
- Animal Science Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Gabriella V Hernandez
- Animal Science Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Victoria A Smith
- Animal Science Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Mark S Edwards
- Animal Science Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Rob K Fanter
- College of Agriculture, Food and Environmental Sciences, California Polytechnic State University, San Luis Obispo, CA, USA,Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Hunter S Glanz
- Statistics Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Chad Immoos
- Chemistry and Biochemistry Department, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Douglas G Burrin
- United States Department of Agriculture-Agricultural Research Services, Children's Nutrition Research Center, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | | | - Michael R La Frano
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA,Food Science and Nutrition Department, California Polytechnic State University, San Luis Obispo, CA, USA
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18
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Park JY, Jang MG, Oh JM, Ko HC, Hur SP, Kim JW, Baek S, Kim SJ. Sasa quelpaertensis Leaf Extract Ameliorates Dyslipidemia, Insulin Resistance, and Hepatic Lipid Accumulation in High-Fructose-Diet-Fed Rats. Nutrients 2020; 12:nu12123762. [PMID: 33297496 PMCID: PMC7762336 DOI: 10.3390/nu12123762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Increased dietary fructose consumption is closely associated with lipid and glucose metabolic disorders. Sasa quelpaertensis Nakai possesses various health-promoting properties, but there has been no research on its protective effect against fructose-induced metabolic dysfunction. In this study, we investigated the effects of S. quelpaertensis leaf extract (SQE) on metabolic dysfunction in high-fructose-diet-fed rats. Methods: Animals were fed a 46% carbohydrate diet, a 60% high-fructose diet, or a 60% high-fructose diet with SQE (500 mg/kg of body weight (BW)/day) in drinking water for 16 weeks. Serum biochemical parameters were measured and the effects of SQE on hepatic histology, protein expression, and transcriptome profiles were investigated. Results: SQE improved dyslipidemia and insulin resistance induced in high-fructose-diet-fed rats. SQE ameliorated the lipid accumulation and inflammatory response in liver tissues by modulating the expressions of key proteins related to lipid metabolism and antioxidant response. SQE significantly enriched the genes related to the metabolic pathway, namely, the tumor necrosis factor (TNF) signaling pathway and the PI3K-Akt signaling pathway. Conclusions: SQE could effectively prevent dyslipidemia, insulin resistance, and hepatic lipid accumulation by regulation of metabolism-related gene expressions, suggesting its role as a functional ingredient to prevent lifestyle-related metabolic disorders.
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Affiliation(s)
- Jeong Yong Park
- Department of Biology, Jeju National University, Jeju 63243, Korea; (J.Y.P.); (M.G.J.); (J.M.O.)
| | - Mi Gyeong Jang
- Department of Biology, Jeju National University, Jeju 63243, Korea; (J.Y.P.); (M.G.J.); (J.M.O.)
| | - Jung Min Oh
- Department of Biology, Jeju National University, Jeju 63243, Korea; (J.Y.P.); (M.G.J.); (J.M.O.)
| | - Hee Chul Ko
- Biotech Regional Innovation Center, Jeju Nation University, Jeju 63423, Korea; (H.C.K.); (J.-W.K.); (S.B.)
| | - Sung-Pyo Hur
- Jeju International Marine Science Research & Logistics Center, Korea Institute of Ocean Science & Technology, Gujwa, Jeju 63349, Korea;
| | - Jae-Won Kim
- Biotech Regional Innovation Center, Jeju Nation University, Jeju 63423, Korea; (H.C.K.); (J.-W.K.); (S.B.)
| | - Songyee Baek
- Biotech Regional Innovation Center, Jeju Nation University, Jeju 63423, Korea; (H.C.K.); (J.-W.K.); (S.B.)
| | - Se-Jae Kim
- Department of Biology, Jeju National University, Jeju 63243, Korea; (J.Y.P.); (M.G.J.); (J.M.O.)
- Biotech Regional Innovation Center, Jeju Nation University, Jeju 63423, Korea; (H.C.K.); (J.-W.K.); (S.B.)
- Correspondence: ; Tel.: +82-64-754-3529
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19
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Farokh Nezhad R, Nourbakhsh M, Razzaghy-Azar M, Sharifi R, Yaghmaei P. The effect of trans-palmitoleic acid on cell viability and sirtuin 1 gene expression in hepatocytes and the activity of peroxisome-proliferator-activated receptor-alpha. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2020; 25:105. [PMID: 33824670 PMCID: PMC8019128 DOI: 10.4103/jrms.jrms_16_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/05/2020] [Accepted: 07/09/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Accumulation of fatty acids in liver causes lipotoxicity which is followed by nonalcoholic fatty liver disease. The association between intakes of trans-fatty acids with metabolic diseases is still controversial. Accordingly, the objective of this study was to investigate the in vitro effects of trans-palmitoleic acid (tPA) and palmitic acid (PA) on lipid accumulation in hepatocytes, focusing on the gene expression of sirtuin 1 (SIRT1) as well as the transcriptional activity of peroxisome proliferator-activated receptor alpha (PPARα). MATERIALS AND METHODS In this experimental study, hepatocellular carcinoma (HepG2) cells were cultured and treated with various concentrations of tPA and PA (C16:0). The accumulation of triglyceride in the cells was measured by enzymatic method. Gene expression was evaluated by real-time polymerase chain reaction. The activity of PPARα was assessed by luciferase reporter assay after transfection of human embryonic kidney 293T cells by a vector containing the PPAR response element. RESULTS While concentration >1 mM for PA and cis-PA (cPA) reduced the viability of hepatocytes, tPA revealed an opposite effect and increased cell survival. Lipid accumulation in HepG2 cells after treatment with tPA was significantly lower than that in cells treated with PA. In addition, tPA at physiological concentration had no effect on the expression of SIRT1 while at high concentration significantly augmented its expression. There was a modest increase in PPARα activity at low concentration of tPA. CONCLUSION tPA causes less lipid accumulation in hepatocytes with no detrimental effect on cell viability and might be beneficial for liver cells by the activation of SIRT1 and induction of PPARα activity.
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Affiliation(s)
- Ramesh Farokh Nezhad
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mitra Nourbakhsh
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Razzaghy-Azar
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- H. Aliasghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Sharifi
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Parichehreh Yaghmaei
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
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20
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Egea MB, Santos DCD, Oliveira Filho JGD, Ores JDC, Takeuchi KP, Lemes AC. A review of nondairy kefir products: their characteristics and potential human health benefits. Crit Rev Food Sci Nutr 2020; 62:1536-1552. [PMID: 33153292 DOI: 10.1080/10408398.2020.1844140] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Functional foods are foods that, in addition to having nutrients, contain in their composition ingredients that act specifically on body functions associated with the control and reduction of the risk of developing some diseases. In this sense, kefir, a group of microorganisms in symbiosis, mainly yeasts and lactic acid bacteria, stands out. The trend of ingesting kefir has been focused on the development of products that serve specific consumers, such as those who are lactose-intolerant, vegans and vegetarians, and consumers in general who seek to combine the consumption of functional products with the improvement of their health and lifestyle. This overview provides an insight into kefir, presenting the technological process to produce a nondairy beverage and evidence of the benefits of its use to reduce the risk of disease. We also discuss regulatory aspects of products fermented using kefir. Until now, the use of kefir (isolated microorganism, kefiran, or fermented product) has demonstrated the potential to promote an increase in the number of bifidobacteria in the colon and an increase in the glycemic control while reducing the blood cholesterol and balancing the intestinal microbiota, which helps in reducing constipation and diarrhea, improving intestinal permeability, and stimulating and balancing the immune system. However, the literature still has gaps that need to be clarified, such as the consumption dose of kefir or its products to cause some health benefit.
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Affiliation(s)
- Mariana Buranelo Egea
- Goiano Federal Institute of Education, Science, and Technology, Campus Rio Verde, Rio Verde, Brazil
| | - Daiane Costa Dos Santos
- Goiano Federal Institute of Education, Science, and Technology, Campus Rio Verde, Rio Verde, Brazil
| | | | - Joana da Costa Ores
- Goiano Federal Institute of Education, Science, and Technology, Campus Rio Verde, Rio Verde, Brazil
| | - Katiuchia Pereira Takeuchi
- Goiano Federal Institute of Education, Science, and Technology, Campus Rio Verde, Rio Verde, Brazil.,Faculty of Nutrition, Department of Food and Nutrition, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Ailton Cesar Lemes
- School of Chemistry, Department of Biochemical Engineering, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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21
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Kechagias S, Nasr P, Blomdahl J, Ekstedt M. Established and emerging factors affecting the progression of nonalcoholic fatty liver disease. Metabolism 2020; 111S:154183. [PMID: 32061907 DOI: 10.1016/j.metabol.2020.154183] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease affecting approximately 25% of the global population. Although a majority of NAFLD patients will never experience liver-related symptoms it is estimated that 5-10% will develop cirrhosis-related complications with risk of death or need for liver transplantation. NAFLD is closely associated with cardiovascular disease and components of the metabolic syndrome. However, NAFLD is not uncommon in lean individuals and may in these subjects represent a different entity with separate pathophysiological mechanisms involved implying a higher risk for development of end-stage liver disease. There is considerable fluctuation in the histopathological course of NAFLD that may partly be attributed to lifestyle factors and dietary composition. Nutrients such as fructose, monounsaturated fatty acids, and trans-fatty acids may aggravate NAFLD. Presence of type 2 diabetes mellitus seems to be the most important clinical predictor of liver-related morbidity and mortality in NAFLD. Apart from severity of the metabolic syndrome, genetic polymorphisms and environmental factors, such as moderate alcohol consumption, may explain the variation in histopathological and clinical outcome among NAFLD patients.
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Affiliation(s)
- Stergios Kechagias
- Department of Gastroenterology and Hepatology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Patrik Nasr
- Department of Gastroenterology and Hepatology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Julia Blomdahl
- Department of Gastroenterology and Hepatology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Mattias Ekstedt
- Department of Gastroenterology and Hepatology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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22
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Tahir F, Majid Z, Majid B, Ahmed J, Zaman A, Tariq M, Imtiaz F, Tahir SA. Anthropometric Measurements and Lifestyle Characteristics of Individuals with Non-alcoholic Fatty Liver Disease. Cureus 2020; 12:e7016. [PMID: 32211252 PMCID: PMC7081744 DOI: 10.7759/cureus.7016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is a common liver disorder caused by the deposition of lipids and fats in the hepatocytes, in individuals who consume little or no alcohol, which eventually progresses to cirrhosis and carcinoma. Apart from the known risk factors like obesity, metabolic syndrome (MS), and lack of physical activity (PA), diet also plays a major role in the development of NAFLD. A high body mass index (BMI) and waist circumference (WC) have positive associations with NAFLD. The aim of this study was to find the prevalence of risk factors of hepatic steatosis in NAFLD population and to raise public awareness about the condition. Method We conducted a cross-sectional study from October to December 2019 with a sample size of 98 subjects determined by using a confidence interval (CI) of 99.9%. Patients presenting to Essa Laboratory, Karachi for abdominal ultrasound (US) were scanned for fatty changes in the liver, after obtaining consent, and were then assessed for risk factors by administering a 20-item questionnaire along with registering their BMI and WC measurement. The collected data was analyzed using the Statistical Package for Social Sciences (SPSS), version 22 (IBM, Armonk, NY). The independent sample t-test was applied for the exploration of variables and a p-value <0.05 was considered significant. Result Our study included 96 participants, of which 49 (51%) were male and 47 (49%) female. Mean BMI in females was slightly greater (30.58) than in males (27.98), whereas WC (in inches) was almost equal in males (40.796) and females (40.383). Among the people that had any comorbidities (n = 60, 62.5%), hypertension (HTN) was the most common one (n = 37, 38.5%) followed by diabetes mellitus (DM) type 2 (n = 26, 27.1%). A significant majority (n = 63, 65.5%) never consumed any fruits or vegetables in their meal nor did they perform any sort of physical exercise (n = 46, 47.9%). Conclusion Obesity (high BMI), lack of PA, lower consumption of fruits and vegetables along with a carbohydrate- and fat-rich diet play a vital role in the development of hepatic steatosis. Moreover, HTN and DM, as components of MS, exhibit a significant association with NAFLD. Screening and counseling sessions should be considered for individuals with these anthropometric measurements and lifestyle characteristics.
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Affiliation(s)
- Faryal Tahir
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Zainab Majid
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Bushra Majid
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Jawad Ahmed
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Arbaz Zaman
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Moeez Tariq
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Fouzia Imtiaz
- Genetics, Dow University of Health Sciences, Karachi, PAK
| | - Syeda Anjala Tahir
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK.,Internal Medicine, Civil Hospital, Karachi, PAK
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23
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Critical appraisal for low-carbohydrate diet in nonalcoholic fatty liver disease: Review and meta-analyses. Clin Nutr 2019; 38:2023-2030. [DOI: 10.1016/j.clnu.2018.09.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 09/14/2018] [Accepted: 09/16/2018] [Indexed: 01/02/2023]
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24
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Tayyem RF, Al-Dayyat HM, Rayyan YM. Relationship between lifestyle factors and nutritional status and non-alcoholic fatty liver disease among a group of adult Jordanians. Arab J Gastroenterol 2019; 20:44-49. [PMID: 30872135 DOI: 10.1016/j.ajg.2019.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 12/02/2018] [Accepted: 01/26/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND STUDY AIMS Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. NAFLD may progress from simple steatosis to nonalcoholic steatohepatitis, cirrhosis and finally decompensated liver failure. This study aims at assessing the relationship between lifestyle factors and nutrients intake and the development of non-alcoholic fatty liver disease (NAFLD) in a group of Jordanian adults 30-60 years of age. PATIENTS AND METHODS In this case-control study, a total of 120 Jordanian adults 30-60 years of age were recruited. Sixty NAFLD patients and 60 control subjects were enrolled. The diagnosis of NAFLD was made based on the basis of ultrasonography. Weight, height and waist circumference (WC) were measured and body mass index (BMI) was calculated. Nutrients intake and physical activity level were assessed using validated questionnaires. RESULTS The results showed that patients with NAFLD had a higher significant difference in BMI, WC, and weight compared to controls (p = 0.001). Physical activity level was significantly higher in control subjects than in cases (p = 0.001). The metabolic parameters were significantly different both groups. The mean daily intakes of macronutrients were significantly higher in cases than in control subjects (p = 0.001). A significant difference was detected in the daily intake of some vitamins and minerals among cases compared to control subjects (p < 0.05). CONCLUSION The present study supports the findings of the presence of a relationship between macro- and micronutrients intake and some anthropometric and biochemical variables and NAFLD.
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Affiliation(s)
- Reema Fayez Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan.
| | - Hanaa Mahmoud Al-Dayyat
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan
| | - Yaser Mohammed Rayyan
- Department of Gastroenterology & Hepatology, School of Medicine, University of Jordan, Amman, Jordan
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25
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Schwenger KJP, Bolzon CM, Li C, Allard JP. Non-alcoholic fatty liver disease and obesity: the role of the gut bacteria. Eur J Nutr 2018; 58:1771-1784. [PMID: 30306296 DOI: 10.1007/s00394-018-1844-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/05/2018] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty-liver disease (NAFLD) is now considered one of the leading causes of liver disease worldwide and is associated with metabolic syndrome and obesity. There are several factors contributing to the disease state. Recent research suggests that the intestinal microbiota (IM) and bacterial products may play a role through several mechanisms which include increased energy uptake, intestinal permeability and chronic inflammation. In addition to diet and exercise, treatment options targeting the IM are being investigated and include the use of pre-, pro- and synbiotics as well as the possibility of fecal microbial transfers. This literature review explores the relationship between NAFLD and the IM as well as highlight new IM treatment options that may become available in the near future.
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Affiliation(s)
- Katherine J P Schwenger
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Toronto General Hospital, University Health Network, 585 University Avenue, 9-973, Toronto, ON, M5G 2C4, Canada
| | - Colin M Bolzon
- Toronto General Hospital, University Health Network, 585 University Avenue, 9-973, Toronto, ON, M5G 2C4, Canada
| | - Carrie Li
- Toronto General Hospital, University Health Network, 585 University Avenue, 9-973, Toronto, ON, M5G 2C4, Canada
| | - Johane P Allard
- Toronto General Hospital, University Health Network, 585 University Avenue, 9-973, Toronto, ON, M5G 2C4, Canada. .,Department of Medicine, University of Toronto, Toronto, Canada. .,Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
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26
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Mirtschink P, Jang C, Arany Z, Krek W. Fructose metabolism, cardiometabolic risk, and the epidemic of coronary artery disease. Eur Heart J 2018; 39:2497-2505. [PMID: 29020416 PMCID: PMC6037111 DOI: 10.1093/eurheartj/ehx518] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 07/16/2017] [Accepted: 08/15/2017] [Indexed: 02/06/2023] Open
Abstract
Despite strong indications that increased consumption of added sugars correlates with greater risks of developing cardiometabolic syndrome (CMS) and cardiovascular disease (CVD), independent of the caloric intake, the worldwide sugar consumption remains high. In considering the negative health impact of overconsumption of dietary sugars, increased attention is recently being given to the role of the fructose component of high-sugar foods in driving CMS. The primary organs capable of metabolizing fructose include liver, small intestine, and kidneys. In these organs, fructose metabolism is initiated by ketohexokinase (KHK) isoform C of the central fructose-metabolizing enzyme KHK. Emerging data suggest that this tissue restriction of fructose metabolism can be rescinded in oxygen-deprived environments. In this review, we highlight recent progress in understanding how fructose metabolism contributes to the development of major systemic pathologies that cooperatively promote CMS and CVD, reference recent insights into microenvironmental control of fructose metabolism under stress conditions and discuss how this understanding is shaping preventive actions and therapeutic approaches.
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Affiliation(s)
- Peter Mirtschink
- Department of Biology, Institute of Molecular Health Sciences, ETH Zurich, Otto-Stern-Weg 7, Zurich, Switzerland
- Department of Clinical Pathobiochemistry, Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Dresden, Fetscherstr. 74, Dresden, Germany
| | - Cholsoon Jang
- Department of Medicine, Cardiovascular Institute and Institute Diabetes Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania, 11th floor, Civic Blvd, Philadelphia, 19104 PA, USA
| | - Zoltan Arany
- Department of Medicine, Cardiovascular Institute and Institute Diabetes Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania, 11th floor, Civic Blvd, Philadelphia, 19104 PA, USA
| | - Wilhelm Krek
- Department of Biology, Institute of Molecular Health Sciences, ETH Zurich, Otto-Stern-Weg 7, Zurich, Switzerland
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27
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Al-Dayyat HM, Rayyan YM, Tayyem RF. Non-alcoholic fatty liver disease and associated dietary and lifestyle risk factors. Diabetes Metab Syndr 2018; 12:569-575. [PMID: 29571977 DOI: 10.1016/j.dsx.2018.03.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/16/2018] [Indexed: 12/11/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease worldwide with a reported prevalence ranging 20-30% depending on the studied populations. The high prevalence of NAFLD is probably due to the contemporary epidemics of obesity, unhealthy dietary pattern, and sedentary lifestyle. NAFLD patients are at increased risk of cardiovascular and liver related mortality. The cornerstone of any treatment regimen for patients with NAFLD is lifestyle modification focused on weight loss, exercise, and improving insulin sensitivity. The purpose of this review is to outline the effect of diet and lifestyle factors on developing NAFLD.
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Affiliation(s)
- Hana'a Mahmoud Al-Dayyat
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan
| | - Yaser Mohammed Rayyan
- Department of Gastroenterology & Hepatology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Reema Fayez Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan.
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28
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Mardinoglu A, Wu H, Bjornson E, Zhang C, Hakkarainen A, Räsänen SM, Lee S, Mancina RM, Bergentall M, Pietiläinen KH, Söderlund S, Matikainen N, Ståhlman M, Bergh PO, Adiels M, Piening BD, Granér M, Lundbom N, Williams KJ, Romeo S, Nielsen J, Snyder M, Uhlén M, Bergström G, Perkins R, Marschall HU, Bäckhed F, Taskinen MR, Borén J. An Integrated Understanding of the Rapid Metabolic Benefits of a Carbohydrate-Restricted Diet on Hepatic Steatosis in Humans. Cell Metab 2018; 27:559-571.e5. [PMID: 29456073 PMCID: PMC6706084 DOI: 10.1016/j.cmet.2018.01.005] [Citation(s) in RCA: 332] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/06/2017] [Accepted: 01/10/2018] [Indexed: 02/07/2023]
Abstract
A carbohydrate-restricted diet is a widely recommended intervention for non-alcoholic fatty liver disease (NAFLD), but a systematic perspective on the multiple benefits of this diet is lacking. Here, we performed a short-term intervention with an isocaloric low-carbohydrate diet with increased protein content in obese subjects with NAFLD and characterized the resulting alterations in metabolism and the gut microbiota using a multi-omics approach. We observed rapid and dramatic reductions of liver fat and other cardiometabolic risk factors paralleled by (1) marked decreases in hepatic de novo lipogenesis; (2) large increases in serum β-hydroxybutyrate concentrations, reflecting increased mitochondrial β-oxidation; and (3) rapid increases in folate-producing Streptococcus and serum folate concentrations. Liver transcriptomic analysis on biopsy samples from a second cohort revealed downregulation of the fatty acid synthesis pathway and upregulation of folate-mediated one-carbon metabolism and fatty acid oxidation pathways. Our results highlight the potential of exploring diet-microbiota interactions for treating NAFLD.
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Affiliation(s)
- Adil Mardinoglu
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden; Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Hao Wu
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elias Bjornson
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cheng Zhang
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Antti Hakkarainen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sari M Räsänen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Sunjae Lee
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Rosellina M Mancina
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mattias Bergentall
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kirsi H Pietiläinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Sanni Söderlund
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Niina Matikainen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland; Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Marcus Ståhlman
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per-Olof Bergh
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Brian D Piening
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Marit Granér
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Nina Lundbom
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kevin J Williams
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Michael Snyder
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Mathias Uhlén
- Science for Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Rosie Perkins
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fredrik Bäckhed
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Marja-Riitta Taskinen
- Research Programs Unit, Diabetes and Obesity, University of Helsinki and Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
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Federico A, Dallio M, Caprio GG, Gravina AG, Picascia D, Masarone M, Persico M, Loguercio C. Qualitative and Quantitative Evaluation of Dietary Intake in Patients with Non-Alcoholic Steatohepatitis. Nutrients 2017; 9:1074. [PMID: 28956816 PMCID: PMC5691691 DOI: 10.3390/nu9101074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/23/2017] [Accepted: 09/26/2017] [Indexed: 02/07/2023] Open
Abstract
There are very few reports about the intake of nutrients for the development or progression of non-alcoholic steatohepatitis (NASH). The aim of this study was to identify the dietary habits and the nutrient intake in patients with NASH, in comparison to chronic hepatitis C (HCV)-related patients. We prospectively evaluated the intake of macronutrients and micronutrients in 124 NAFLD and 162 HCV patients, compared to 2326 subjects as a control group. We noticed major differences in macro- and micronutrients intakes in NASH and HCV patients compared to controls. Proteins, carbohydrate (glucose, fructose, sucrose, maltose and amide), saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), folic acid, vitamin A and C (p < 0.0001), and thiamine (p < 0.0003) ingestion was found to be higher in patients with NASH, while total lipids, polyunsaturated fatty acid (PUFA), riboflavin and vitamin B6 daily intake were lower compared to controls (p < 0.0001). Similarly, NASH patients had significantly reduced carbohydrate intake (p < 0.0001) and an increased intake of calcium (p < 0.0001) compared to HCV positive patients. Finally, we showed in NASH males an increase in the intake of SFA, PUFA, soluble carbohydrates (p < 0.0001) and a decrease in the amount of fiber (p < 0.0001) compared to control males. In NASH female population, we showed an increase of daily total calories, SFA, MUFA, soluble carbohydrates, starch and vitamin D ingested (p < 0.0001) with a reduction of fibers and calcium (p < 0.0001) compared to control females. This study showed how NASH patients' diets, in both male and females, is affected by a profound alteration in macro- and micronutrients intake.
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Affiliation(s)
- Alessandro Federico
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Via Pansini 5 80131 Naples, Italy.
| | - Marcello Dallio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Via Pansini 5 80131 Naples, Italy.
| | - Giuseppe Gerardo Caprio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Via Pansini 5 80131 Naples, Italy.
| | - Antonietta Gerarda Gravina
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Via Pansini 5 80131 Naples, Italy.
| | - Desiree Picascia
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Via Pansini 5 80131 Naples, Italy.
| | - Mario Masarone
- Department of Medicine and Surgery, University of Salerno, Via Salvador Allende 84081 Baronissi, Salerno, Italy.
| | - Marcello Persico
- Department of Medicine and Surgery, University of Salerno, Via Salvador Allende 84081 Baronissi, Salerno, Italy.
| | - Carmela Loguercio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Via Pansini 5 80131 Naples, Italy.
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Mokhtari Z, Poustchi H, Eslamparast T, Hekmatdoost A. Egg consumption and risk of non-alcoholic fatty liver disease. World J Hepatol 2017; 9:503-509. [PMID: 28443155 PMCID: PMC5387362 DOI: 10.4254/wjh.v9.i10.503] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 01/04/2017] [Accepted: 03/14/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the association between egg consumption and risk of non-alcoholic fatty liver disease (NAFLD) development. METHODS This case-control study was conducted on individuals who were referred to two hepatology clinics in Tehran, Iran in 2015. The study included 169 patients with NAFLD and 782 controls. Egg consumption was estimated using a validated food frequency questionnaire. The participants were categorized according to the frequency of their egg consumption during the previous year: Less than two eggs per week, two to three eggs per week, and four or more eggs per week. RESULTS In the crude model, participants who consumed 2 to 3 eggs per week, were 3.56 times more likely to have NAFLD in comparison to those who consumed less than 2 eggs per week (OR: 3.56; 95%CI: 2.35-5.31). Adjustment for known risk factors of NAFLD strengthened this significant association so that individuals have consumed two to three eggs per week had 3.71 times higher risk of NAFLD than those who have eaten less than two eggs per week (OR: 3.71; 95%CI: 1.91, 7.75). CONCLUSION Our data indicate that higher egg consumption in common amount of usage is associated with higher risk of NAFLD.
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Affiliation(s)
- Zeinab Mokhtari
- Zeinab Mokhtari, Tannaz Eslamparast, Azita Hekmatdoost, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran
| | - Hossein Poustchi
- Zeinab Mokhtari, Tannaz Eslamparast, Azita Hekmatdoost, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran
| | - Tannaz Eslamparast
- Zeinab Mokhtari, Tannaz Eslamparast, Azita Hekmatdoost, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran
| | - Azita Hekmatdoost
- Zeinab Mokhtari, Tannaz Eslamparast, Azita Hekmatdoost, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran
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Semiane N, Foufelle F, Ferré P, Hainault I, Ameddah S, Mallek A, Khalkhal A, Dahmani Y. High carbohydrate diet induces nonalcoholic steato-hepatitis (NASH) in a desert gerbil. C R Biol 2017; 340:25-36. [DOI: 10.1016/j.crvi.2016.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 02/07/2023]
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Chon YE, Kim KJ, Jung KS, Kim SU, Park JY, Kim DY, Ahn SH, Chon CY, Chung JB, Park KH, Bae JC, Han KH. The Relationship between Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease Measured by Controlled Attenuation Parameter. Yonsei Med J 2016; 57:885-892. [PMID: 27189281 PMCID: PMC4951464 DOI: 10.3349/ymj.2016.57.4.885] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 09/21/2015] [Accepted: 10/17/2015] [Indexed: 01/02/2023] Open
Abstract
PURPOSE The severity of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) population compared with that in normal glucose tolerance (NGT) individuals has not yet been quantitatively assessed. We investigated the prevalence and the severity of NAFLD in a T2DM population using controlled attenuation parameter (CAP). MATERIALS AND METHODS Subjects who underwent testing for biomarkers related to T2DM and CAP using Fibroscan® during a regular health check-up were enrolled. CAP values of 250 dB/m and 300 dB/m were selected as the cutoffs for the presence of NAFLD and for moderate to severe NAFLD, respectively. Biomarkers related to T2DM included fasting glucose/insulin, fasting C-peptide, hemoglobin A1c (HbA1c), glycoalbumin, and homeostasis model assessment of insulin resistance of insulin resistance (HOMA-IR). RESULTS Among 340 study participants (T2DM, n=66; pre-diabetes, n=202; NGT, n=72), the proportion of subjects with NAFLD increased according to the glucose tolerance status (31.9% in NGT; 47.0% in pre-diabetes; 57.6% in T2DM). The median CAP value was significantly higher in subjects with T2DM (265 dB/m) than in those with pre-diabetes (245 dB/m) or NGT (231 dB/m) (all p<0.05). Logistic regression analysis showed that subjects with moderate to severe NAFLD had a 2.8-fold (odds ratio) higher risk of having T2DM than those without NAFLD (p=0.02; 95% confidence interval, 1.21-6.64), and positive correlations between the CAP value and HOMA-IR (ρ0.407) or fasting C-peptide (ρ0.402) were demonstrated. CONCLUSION Subjects with T2DM had a higher prevalence of severe NAFLD than those with NGT. Increased hepatic steatosis was significantly associated with the presence of T2DM, and insulin resistance induced by hepatic fat may be an important mechanistic connection.
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Affiliation(s)
- Young Eun Chon
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Kwang Joon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Executive Healthcare Clinic, Severance Hospital, Yonsei Health System, Seoul, Korea
| | - Kyu Sik Jung
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Seung Up Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Jun Yong Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Do Young Kim
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Sang Hoon Ahn
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Chae Yoon Chon
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Jae Bock Chung
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
- Executive Healthcare Clinic, Severance Hospital, Yonsei Health System, Seoul, Korea
| | - Kyeong Hye Park
- Executive Healthcare Clinic, Severance Hospital, Yonsei Health System, Seoul, Korea
| | - Ji Cheol Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Hyub Han
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea.
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Abbasalizad Farhangi M, Mohseni F, Farajnia S, Jafarabadi MA. Major components of metabolic syndrome and nutritional intakes in different genotype of UCP2 -866G/A gene polymorphisms in patients with NAFLD. J Transl Med 2016; 14:177. [PMID: 27301474 PMCID: PMC4908770 DOI: 10.1186/s12967-016-0936-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/02/2016] [Indexed: 01/09/2023] Open
Abstract
Background It has been suggested that dietary modifications in combination with genetic predisposition play an important role in the pathogenesis of NAFLD. In the current study we aimed to investigate the major components of metabolic syndrome in patients with non-alcoholic fatty liver disease (NAFLD) and nutritional intakes according to different genotype of uncoupling protein-2 (UCP2) −866G/A gene polymorphism in these patients. Methods In this study 151 participants including 75 patients with NAFLD and 76 healthy individuals were enrolled. Dietary intakes were assessed using a semi-quantitative food-frequency questionnaire. Physical activity was obtained by metabolic equivalent questionnaire. Anthropometric assessments were conducted by a trained researcher and body mass index and waist to hip ratio were calculated. Body composition was measured by bioelectrical impedance analysis and biochemical assays including fasting serum glucose, liver enzymes and lipid profiles were measured. Polymorphisms of −866G/A UCP2 gene was determined using polymerase chain reaction-restriction fragment length polymorphism method. Results Serum triglyceride concentrations in 53.3 % of NAFLD patients compared with 35.5 % of control group was more than 150 mg/dl (P = 0.034). A significantly higher prevalence of low serum high density lipoprotein cholesterol concentrations was also observed in female NAFLD patients (P < 0.001). Dietary intakes in NAFLD group were not significantly different compared with control group (P > 0.05). However, according to genotypes patients with AG genotype had significantly higher protein consumption compared with control group (P < 0.05). Significantly higher consumption of dietary iron and copper in NAFLD patients with AG genotype was only observed among patients with NAFLD. However, the comparison of macro and micronutrient intakes in control group sound for stronger differences for AA genotype although these differences did not achieve significant threshold. Conclusions A high prevalence of metabolic abnormalities was reported among NAFLD patients. Additionally, among NAFLD group, patients with AG genotype significantly consumed more protein, iron and copper in their usual diet.
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Affiliation(s)
- Mahdieh Abbasalizad Farhangi
- Nutrition Research Center, Department of Community Nutrition, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Fatemeh Mohseni
- Drug Applied Research Center (DARC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Safar Farajnia
- Drug Applied Research Center (DARC), Tabriz University of Medical Sciences, Tabriz, Iran
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Softic S, Cohen DE, Kahn CR. Role of Dietary Fructose and Hepatic De Novo Lipogenesis in Fatty Liver Disease. Dig Dis Sci 2016; 61:1282-93. [PMID: 26856717 PMCID: PMC4838515 DOI: 10.1007/s10620-016-4054-0] [Citation(s) in RCA: 471] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/21/2016] [Indexed: 12/11/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a liver manifestation of metabolic syndrome. Overconsumption of high-fat diet (HFD) and increased intake of sugar-sweetened beverages are major risk factors for development of NAFLD. Today the most commonly consumed sugar is high fructose corn syrup. Hepatic lipids may be derived from dietary intake, esterification of plasma free fatty acids (FFA) or hepatic de novo lipogenesis (DNL). A central abnormality in NAFLD is enhanced DNL. Hepatic DNL is increased in individuals with NAFLD, while the contribution of dietary fat and plasma FFA to hepatic lipids is not significantly altered. The importance of DNL in NAFLD is further established in mouse studies with knockout of genes involved in this process. Dietary fructose increases levels of enzymes involved in DNL even more strongly than HFD. Several properties of fructose metabolism make it particularly lipogenic. Fructose is absorbed via portal vein and delivered to the liver in much higher concentrations as compared to other tissues. Fructose increases protein levels of all DNL enzymes during its conversion into triglycerides. Additionally, fructose supports lipogenesis in the setting of insulin resistance as fructose does not require insulin for its metabolism, and it directly stimulates SREBP1c, a major transcriptional regulator of DNL. Fructose also leads to ATP depletion and suppression of mitochondrial fatty acid oxidation, resulting in increased production of reactive oxygen species. Furthermore, fructose promotes ER stress and uric acid formation, additional insulin independent pathways leading to DNL. In summary, fructose metabolism supports DNL more strongly than HFD and hepatic DNL is a central abnormality in NAFLD. Disrupting fructose metabolism in the liver may provide a new therapeutic option for the treatment of NAFLD.
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Affiliation(s)
- Samir Softic
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA
- Department of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - David E Cohen
- Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - C Ronald Kahn
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, One Joslin Place, Boston, MA, 02215, USA.
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Harbury CM, Verbruggen EE, Callister R, Collins CE. What do individuals with morbid obesity report as a usual dietary intake? A narrative review of available evidence. Clin Nutr ESPEN 2016; 13:e15-e22. [PMID: 28531563 DOI: 10.1016/j.clnesp.2016.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 02/05/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND In several developed countries, as obesity prevalence doubles it has quadrupled for morbid obesity (BMI ≥ 40 kgm-2). As more individuals with morbid obesity present for weight loss treatment there is a greater need to understand their dietary habits. No reviews were found in the literature, therefore this systematic review aims to identify and describe the existing evidence on the usual dietary intake of individuals with morbid obesity including those from a general population and those seeking treatment such as weight loss surgery. METHODS A literature search of ten databases from 1980 to June 2014 was conducted to identify original research of adults with morbid obesity (aged 18-60 years) that reported a usual dietary intake. RESULTS Ten studies met all inclusion criteria and reported energy intake, most reported macronutrient composition, two assessed micronutrient intake, and one reported food-based outcomes. Other dietary outcomes were related to surgical intervention. The most plausible energy intake data suggest high intakes, >4000 Kcal/day for those weight stable at the highest levels of morbid obesity (up to BMI 97 kgm-2). Fat intakes are also high, around 40% of energy intake and up to 57% for some individuals. Suboptimal intakes of iron and calcium are reported. CONCLUSION This review draws attention to a limited evidence base, offers preliminary insight suggesting individuals with morbid obesity are prone to consuming poor quality diets similar to those reported for obese populations, and highlights challenges for future research.
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Affiliation(s)
- Cathy M Harbury
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia; Nutrition and Dietetic Department, John Hunter Hospital, Lookout Road, New Lambton, New South Wales, Australia.
| | - Elisabeth E Verbruggen
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Robin Callister
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia.
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Elshaghabee FMF, Bockelmann W, Meske D, de Vrese M, Walte HG, Schrezenmeir J, Heller KJ. Ethanol Production by Selected Intestinal Microorganisms and Lactic Acid Bacteria Growing under Different Nutritional Conditions. Front Microbiol 2016; 7:47. [PMID: 26858714 PMCID: PMC4732544 DOI: 10.3389/fmicb.2016.00047] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/11/2016] [Indexed: 01/20/2023] Open
Abstract
To gain some specific insight into the roles microorganisms might play in non-alcoholic fatty liver disease (NAFLD), some intestinal and lactic acid bacteria and one yeast (Anaerostipes caccae, Bacteroides thetaiotaomicron, Bifidobacterium longum, Enterococcus fecalis, Escherichia coli, Lactobacillus acidophilus, Lactobacillus fermentum, Lactobacillus plantarum, Weissella confusa, Saccharomyces cerevisiae) were characterized by high performance liquid chromatography for production of ethanol when grown on different carbohydrates: hexoses (glucose and fructose), pentoses (arabinose and ribose), disaccharides (lactose and lactulose), and inulin. Highest amounts of ethanol were produced by S. cerevisiae, L. fermentum, and W. confusa on glucose and by S. cerevisiae and W. confusa on fructose. Due to mannitol-dehydrogenase expressed in L. fermentum, ethanol production on fructose was significantly (P < 0.05) reduced. Pyruvate and citrate, two potential electron acceptors for regeneration of NAD(+)/NADP(+), drastically reduced ethanol production with acetate produced instead in L. fermentum grown on glucose and W. confusa grown on glucose and fructose, respectively. In fecal slurries prepared from feces of four overweight volunteers, ethanol was found to be produced upon addition of fructose. Addition of A. caccae, L. acidophilus, L. fermentum, as well as citrate and pyruvate, respectively, abolished ethanol production. However, addition of W. confusa resulted in significantly (P < 0.05) increased production of ethanol. These results indicate that microorganisms like W. confusa, a hetero-fermentative, mannitol-dehydrogenase negative lactic acid bacterium, may promote NAFLD through ethanol produced from sugar fermentation, while other intestinal bacteria and homo- and hetero-fermentative but mannitol-dehydrogenase positive lactic acid bacteria may not promote NAFLD. Also, our studies indicate that dietary factors interfering with gastrointestinal microbiota and microbial metabolism may be important in preventing or promoting NAFLD.
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Affiliation(s)
- Fouad M F Elshaghabee
- Department of Microbiology and Biotechnology, Max Rubner-Institut (Federal Research Institute of Nutrition and Food)Kiel, Germany; Department of Dairy Science, Faculty of Agriculture, Cairo UniversityGiza, Egypt
| | - Wilhelm Bockelmann
- Department of Microbiology and Biotechnology, Max Rubner-Institut (Federal Research Institute of Nutrition and Food) Kiel, Germany
| | - Diana Meske
- Department of Microbiology and Biotechnology, Max Rubner-Institut (Federal Research Institute of Nutrition and Food) Kiel, Germany
| | - Michael de Vrese
- Department of Microbiology and Biotechnology, Max Rubner-Institut (Federal Research Institute of Nutrition and Food) Kiel, Germany
| | - Hans-Georg Walte
- Department of Safety and Quality of Milk and Fish, Max Rubner-Institut (Federal Research Institute of Nutrition and Food) Kiel, Germany
| | | | - Knut J Heller
- Department of Microbiology and Biotechnology, Max Rubner-Institut (Federal Research Institute of Nutrition and Food) Kiel, Germany
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Sasdelli AS, Barbanti FA, Marchesini G. How Much Fat Does One Need to Eat to Get a Fatty Liver? A Dietary View of NAFLD. HUMAN NUTRITION FROM THE GASTROENTEROLOGIST’S PERSPECTIVE 2016:109-122. [DOI: 10.1007/978-3-319-30361-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Isocaloric Pair-Fed High-Carbohydrate Diet Induced More Hepatic Steatosis and Inflammation than High-Fat Diet Mediated by miR-34a/SIRT1 Axis in Mice. Sci Rep 2015; 5:16774. [PMID: 26608583 PMCID: PMC4660435 DOI: 10.1038/srep16774] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/07/2015] [Indexed: 02/08/2023] Open
Abstract
To investigate the different effects of isocaloric high-fat diet (HFD) and high-carbohydrate diet (HCD) on hepatic steatosis and the underlying mechanisms, especially the role of microRNA-34a/silent information regulator T1 (SIRT1) axis, C57BL/6J mice (n = 12/group) were isocaloric pair-fed with Lieber-DeCarli liquid diet containing either high fat (HFLD) or high carbohydrate (HCLD) for 16 weeks. As compared to the HFLD fed mice, despite the similar final body weights, HCLD feeding: (1) induced more severe hepatic steatosis; (2) up-regulated hepatic expression of miR-34a accompanied with significant decrease of SIRT1 and nicotinamide phosphoribosyltransferase (NAMPT), SIRT1 activity and phosphorylation of AMPK; (3) up-regulated de novo lipogenesis (DNL) related proteins expression (ACC, SCD1), and down-regulated expressions of miR-122, miR-370 and miR-33; (4) decreased mRNA expressions of genes Cpt1, Pparα and Pgc1α related to fatty acid oxidation; (5) increased hepatic total cholesterol concentration and decreased expression of cholesterol metabolism related genes Abcg5, Abcg8, Abcg11, Cyp7a1 and Cyp8b1; and (6) induced higher hepatic inflammatory response accompanied with significant increased mRNA expressions of Il1β, Tnfα and Mcp1. Thus, isocaloric HCLD feeding induced greater severity in hepatic steatosis and inflammatory response than HFLD feeding, potentially through miR-34a/SIRT1 axis mediated promotion of DNL, inhibition of fatty acid oxidation and cholesterol metabolism.
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An YM, Jun DW, Lee SM. Development and Application of Low-Carbohydrates and Low-Simple Sugar Nutrition Education Materials for Non-Alcoholic Fatty Liver Disease Patients. Clin Nutr Res 2015; 4:250-8. [PMID: 26566520 PMCID: PMC4641987 DOI: 10.7762/cnr.2015.4.4.250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 01/01/2023] Open
Abstract
We developed nutrition education materials for non-alcoholic fatty liver disease (NAFLD) patients focusing on low-carbohydrate and low-simple sugar diet and assessed subjective difficulty and compliance for the developed materials. The materials were developed in 2 types, a booklet for face-to-face education and a handout for phone education. The booklet covered 4 topic areas of fatty liver, low-carbohydrate and low-simple sugar diet, weight control, and meal plan. The handout material included several eating behavior tips. To assess practical usability of nutrition education using the developed materials, subjective compliance and difficulty levels were examined in a sample for NAFLD patients. A total of 106 patients recruited from 5 general hospitals were randomly assigned to a low-carbohydrate and low-simple sugar weight control diet group or a general weight control diet group. Each participant received a 6-week nutrition education program consisting of a face-to-face education session and two sessions of phone education. The developed materials were used for the low-carbohydrate and low-simple sugar weight control diet group and general weight control information materials were used for the control group. Subjective difficulty and compliance levels were evaluated three times during the education period. Subjective difficulty level was significantly higher in the low-carbohydrate and low-simple sugar diet group compared to the control group at the end of the second week, but such a discrepancy disappeared afterward. No significant difference was found for subjective compliance between the groups at each time. In conclusion, the developed nutrition education materials for low-carbohydrate and low-simple sugar diet are reasonably applicable to general Korean NAFLD patients.
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Affiliation(s)
- Yoo-Min An
- Department of Food and Nutrition, Sungshin Women's University, Seoul 01133, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
| | - Seung Min Lee
- Department of Food and Nutrition, Sungshin Women's University, Seoul 01133, Korea
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Chan R, Wong VWS, Chu WCW, Wong GLH, Li LS, Leung J, Chim AML, Yeung DKW, Sea MMM, Woo J, Chan FKL, Chan HLY. Diet-Quality Scores and Prevalence of Nonalcoholic Fatty Liver Disease: A Population Study Using Proton-Magnetic Resonance Spectroscopy. PLoS One 2015; 10:e0139310. [PMID: 26418083 PMCID: PMC4587971 DOI: 10.1371/journal.pone.0139310] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/12/2015] [Indexed: 12/13/2022] Open
Abstract
Dietary pattern analysis is an alternative approach to examine the association between diet and nonalcoholic fatty liver disease (NAFLD). This study examined the association of two diet-quality scores, namely Diet Quality Index-International (DQI-I) and Mediterranean Diet Score (MDS) with NAFLD prevalence. Apparently healthy Chinese adults (332 male, 465 female) aged 18 years or above were recruited through a population screening between 2008 and 2010 in a cross-sectional population-based study in Hong Kong. DQI-I and MDS, as well as major food group and nutrient intakes were calculated based on dietary data from a food frequency questionnaire. NAFLD was defined as intrahepatic triglyceride content at ≥5% by proton-magnetic resonance spectroscopy. Multivariate logistic regression models were used to examine the association between each diet-quality score or dietary component and prevalent NAFLD with adjustment for potential lifestyle, metabolic and genetic factors. A total of 220 subjects (27.6%) were diagnosed with NAFLD. DQI-I but not MDS was associated with the prevalence of NAFLD. A 10-unit decrease in DQI-I was associated with 24% increase in the likelihood of having NAFLD in the age and sex adjusted model (95% CI: 1.06-1.45, p = 0.009), and the association remained significant when the model was further adjusted for other lifestyle factors, metabolic and genetic factors [OR: 1.26 (95% CI: 1.03-1.54), p = 0.027]. Multivariate regression analyses showed an inverse association of the intake of vegetables and legumes, fruits and dried fruits, as well as vitamin C with the NAFLD prevalence (p<0.05). In conclusion, a better diet quality as characterized by a higher DQI-I and a higher consumption of vegetables, legumes and fruits was associated with a reduced likelihood of having NAFLD in Hong Kong Chinese.
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Affiliation(s)
- Ruth Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Winnie Chiu-Wing Chu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Liz Sin Li
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong
| | - Angel Mei-Ling Chim
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - David Ka-Wai Yeung
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong
| | - Mandy Man-Mei Sea
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong
| | - Francis Ka-Leung Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Henry Lik-Yuen Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
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Mosallaei Z, Mazidi M, Safariyan M, Norouzy A, Mohajeri SAR, Esmaily H, Bahari A, Ghayour-Mobarhan M, Nematy M. Dietary intake and its relationship with non-alcoholic fatty liver disease (NAFLD). MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2015. [DOI: 10.3233/mnm-150032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Zahra Mosallaei
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mazidi
- Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safariyan
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolreza Norouzy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Amir Reza Mohajeri
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Bahari
- Department of Gastroenterology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Sullivan JS, Le MT, Pan Z, Rivard C, Love-Osborne K, Robbins K, Johnson RJ, Sokol RJ, Sundaram SS. Oral fructose absorption in obese children with non-alcoholic fatty liver disease. Pediatr Obes 2015; 10:188-95. [PMID: 24961681 PMCID: PMC4948988 DOI: 10.1111/ijpo.238] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 01/31/2014] [Accepted: 02/17/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Fructose intake is associated with non-alcoholic fatty liver disease (NAFLD) development. OBJECTIVE The objective of this study was to measure fructose absorption/metabolism in paediatric NAFLD compared with obese and lean controls. METHODS Children with histologically proven NAFLD, and obese and lean controls received oral fructose (1 g kg(-1) ideal body weight). Serum glucose, insulin, uric acid, and fructose, urine uric acid, urine fructose, and breath hydrogen levels were measured at baseline and multiple points until 360 min after fructose ingestion. RESULTS Nine NAFLD (89% Hispanic, mean age 14.3 years, mean body mass index [BMI] 35.3 kg m(-2)), six obese controls (67% Hispanic, mean age 12.7 years, mean BMI 31.0 kg m(-2)) and nine lean controls (44% Hispanic, mean age 14.3 years, mean BMI 19.4 kg m(-2)) were enrolled. Following fructose ingestion, NAFLD vs. lean controls had elevated serum glucose, insulin and uric acid (P < 0.05), higher urine uric acid (P = 0.001), but lower fructose excretion (P = 0.002) and lower breath hydrogen 180-min AUC (P = 0.04). NAFLD vs. obese controls had similar post-fructose serum glucose, insulin, urine uric acid and breath hydrogen, but elevated serum uric acid (P < 0.05) and lower urine fructose excretion (P = 0.02). CONCLUSIONS Children with NAFLD absorb and metabolize fructose more effectively than lean subjects, associated with an exacerbated metabolic profile following fructose ingestion.
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Affiliation(s)
- Jillian S Sullivan
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics and the Digestive Health Institute, Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
| | - MyPhuong T Le
- Section of Nephrology, Department of Medicine, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO
| | - Zhaoxing Pan
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO,Colorado Clinical and Translational Sciences Institute, University of Colorado Denver, Aurora, CO
| | - Christopher Rivard
- Section of Nephrology, Department of Medicine, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO
| | - Kathryn Love-Osborne
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Kristen Robbins
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics and the Digestive Health Institute, Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
| | - Richard J Johnson
- Section of Nephrology, Department of Medicine, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO
| | - Ronald J Sokol
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics and the Digestive Health Institute, Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO,Colorado Clinical and Translational Sciences Institute, University of Colorado Denver, Aurora, CO
| | - Shikha S Sundaram
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics and the Digestive Health Institute, Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
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Abreu ICMED, Guerra JFDC, Pereira RR, Silva M, Lima WGD, Silva ME, Pedrosa ML. Hypercholesterolemic diet induces hepatic steatosis and alterations in mRNA expression of NADPH oxidase in rat livers. ACTA ACUST UNITED AC 2015; 58:251-9. [PMID: 24863087 DOI: 10.1590/0004-2730000002831] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 01/24/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aimed to determine whether a hypercholesterolemic diet induces hepatic steatosis, alterations in mRNA expression of NADPH oxidase subunits, and antioxidant defenses. MATERIALS AND METHODS Fischer rats were divided into two groups of eight animals according to the treatment, control (C) and hypercholesterolemic diet (H). Those in group C were fed a standard diet (AIN-93M), and those of the group H were fed a hypercholesterolemic diet (25% soybean oil and 1% cholesterol). RESULTS The hypercholesterolemic diet did not affect body weight, but resulted in the accumulation of lipids in the liver, increased serum activities of aminotransferases and cholesterol levels. Biomarker of lipid peroxidation (TBARS) and mRNA expression of NADPH oxidase subunits p22(phox) and p47(phox) were increased in the liver of animals in group H. Besides, the activity and expression of antioxidant enzymes were altered. CONCLUSION The results show increased mRNA expression of NADPH oxidase subunits and changes in antioxidant enzyme activities in diet-induced hepatic steatosis.
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Affiliation(s)
| | | | | | - Maísa Silva
- Research Center in Biological Sciences, UFOP, Ouro Preto, MG, Brazil
| | | | | | - Maria Lúcia Pedrosa
- School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
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Kallwitz ER, Daviglus ML, Allison MA, Emory KT, Zhao L, Kuniholm MH, Chen J, Gouskova N, Pirzada A, Talavera GA, Youngblood ME, Cotler SJ. Prevalence of suspected nonalcoholic fatty liver disease in Hispanic/Latino individuals differs by heritage. Clin Gastroenterol Hepatol 2015; 13:569-76. [PMID: 25218670 PMCID: PMC4333050 DOI: 10.1016/j.cgh.2014.08.037] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/20/2014] [Accepted: 08/28/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Nonalcoholic fatty liver disease (NAFLD) was shown to disproportionally affect Hispanic persons. We examined the prevalence of suspected NAFLD in Hispanic/Latino persons with diverse backgrounds. METHODS We studied the prevalence of suspected NAFLD among 12,133 persons included in the Hispanic Community Health Study/Study of Latinos. We collected data on levels of aminotransferase, metabolic syndrome (defined by National Cholesterol Education Program-Adult Treatment Panel III guidelines), demographics, and health behaviors. Suspected NAFLD was defined on the basis of increased level of aminotransferase in the absence of serologic evidence for common causes of liver disease or excessive alcohol consumption. In multivariate analyses, data were adjusted for metabolic syndrome, age, acculturation, diet, physical activity, sleep, and levels of education and income. RESULTS In multivariate analysis, compared with persons of Mexican heritage, persons of Cuban (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.57-0.85), Puerto Rican (OR, 0.67; 95% CI, 0.52-0.87), and Dominican backgrounds (OR, 0.71; 95% CI, 0.54-0.93) had lower rates of suspected NAFLD. Persons of Central American and South American heritage had a similar prevalence of suspected NAFLD compared with persons of Mexican heritage. NAFLD was less common in women than in men (OR, 0.49; 95% CI, 0.40-0.60). Suspected NAFLD associated with metabolic syndrome and all 5 of its components. CONCLUSIONS On the basis of an analysis of a large database of health in Latino populations, we found the prevalence of suspected NAFLD among Hispanic/Latino individuals to vary by region of heritage.
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Affiliation(s)
- Eric R Kallwitz
- Department of Medicine, Loyola University Medical Center, Maywood, Illinois.
| | - Martha L Daviglus
- Department of Preventive Medicine, University of Illinois, Chicago, Illinois
| | - Matthew A Allison
- Department of Family and Preventive Medicine, University of California, San Diego, California
| | - Kristen T Emory
- Department of Family and Preventive Medicine, University of California, San Diego, California
| | - Lihui Zhao
- Department of Preventive Medicine, University of Illinois, Chicago, Illinois
| | - Mark H Kuniholm
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Jinsong Chen
- Department of Preventive Medicine, University of Illinois, Chicago, Illinois
| | - Natalia Gouskova
- Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, North Carolina
| | - Amber Pirzada
- Department of Preventive Medicine, University of Illinois, Chicago, Illinois
| | - Gregory A Talavera
- School of Public Health, San Diego State University, San Diego, California
| | - Marston E Youngblood
- Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, North Carolina
| | - Scott J Cotler
- Department of Medicine, Loyola University Medical Center, Maywood, Illinois
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Barreyro FJ, Holod S, Finocchietto PV, Camino AM, Aquino JB, Avagnina A, Carreras MC, Poderoso JJ, Gores GJ. The pan-caspase inhibitor Emricasan (IDN-6556) decreases liver injury and fibrosis in a murine model of non-alcoholic steatohepatitis. Liver Int 2015; 35:953-66. [PMID: 24750664 DOI: 10.1111/liv.12570] [Citation(s) in RCA: 230] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/17/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Hepatocyte apoptosis, the hallmark of non-alcoholic steatohepatitis (NASH) contributes to liver injury and fibrosis. Although, both the intrinsic and extrinsic apoptotic pathways are involved in the pathogenesis of NASH, the final common step of apoptosis is executed by a family of cysteine-proteases termed caspases. Thus, our aim was to ascertain if administration of Emricasan, a pan-caspase inhibitor, ameliorates liver injury and fibrosis in a murine model of NASH. METHODS C57/BL6J-mice were fed regular chow or high fat diet (HFD) for 20 weeks. All mice were treated with vehicle or Emricasan. RESULTS Mice fed a HFD diet demonstrate a five-fold increase in hepatocyte apoptosis by the TUNEL assay and a 1.5-fold and 1.3-fold increase in caspase-3 and-8 activities respectively; this increase in apoptosis was substantially attenuated in mice fed a HFD treated with Emricasan (HFD-Em). Likewise, liver injury and inflammation were reduced in mice fed HFD-Em as compare to HFD by measuring serum aspartate aminotransferase and alanine aminotransferase levels, NAS histological score and IL 1-β, TNF-α, monocyte chemoattractant protein (MCP-1) and C-X-C chemokine ligand-2 (CXCL2) quantitative reverse-transcription polymerase chain reaction (qPCR). These differences could not be attributed to differences in hepatic steatosis as liver triglycerides content were similar in both HFD groups. Hepatic fibrosis was reduced by Emricasan in HFD animals by decreasing αSMA (a marker for hepatic stellate cell activation), fibrosis score, Sirius red staining, hydroxyproline liver content and profibrogenic cytokines by qPCR. CONCLUSION In conclusion, these data demonstrate that in a murine model of NASH, liver injury and fibrosis are suppressed by inhibiting hepatocytes apoptosis and suggests that Emricasan may be an attractive antifibrotic therapy in NASH.
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Affiliation(s)
- Fernando J Barreyro
- Laboratory of Microbiology, Faculty of Chemical and Natural Sciences, National University of Misiones, CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas), Posadas, Argentina; Laboratory of Oxygen Metabolism, University Hospital, University of Buenos Aires, Buenos Aires, Argentina
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Nishioji K, Sumida Y, Kamaguchi M, Mochizuki N, Kobayashi M, Nishimura T, Yamaguchi K, Itoh Y. Prevalence of and risk factors for non-alcoholic fatty liver disease in a non-obese Japanese population, 2011-2012. J Gastroenterol 2015; 50:95-108. [PMID: 24619537 DOI: 10.1007/s00535-014-0948-9] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/14/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) in non-obese subjects is not rare in Japan, but it has not been clearly described. To clarify its prevalence and risk factors, we investigated the clinical characteristics of NAFLD in non-obese subjects in comparison with NAFLD in obese subjects in the Japanese general population. METHODS A cross-sectional study was performed with 5433 subjects who received health checkups from 2011 to 2012. Subjects consuming more than 20 g of alcohol per day and those with autoimmune liver disease, viral hepatitis, uncontrolled biliary disease and insufficient data were excluded. Subjects with a body mass index (BMI) ≥25 kg/m(2) were considered obese, and subjects with a BMI <25 kg/m(2) were considered non-obese. RESULTS A total of 3271 subjects were enrolled. The overall prevalence of NAFLD was 24.6%: 68.5% in obese subjects and 15.2% in non-obese subjects. The multivariate logistic regression analysis revealed that ≥10 kg of weight gain since the age of 20 was significantly associated with NAFLD in non-obese subjects of both genders, and eating an evening meal within 2 h before going to bed 3 days or more per week and drinking <20 g of alcohol per day were negatively associated in non-obese females. Metabolic factors such as waist circumference and triglycerides were predictors of NAFLD in non-obese subjects, and body fat percentage was a predictor in non-obese males. CONCLUSIONS Lifestyle as well as metabolic factors may play crucial roles in the pathogenesis of NAFLD, even in the non-obese Japanese population.
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Affiliation(s)
- Kenichi Nishioji
- Health Care Division, Kyoto Second Red Cross Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan,
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Abstract
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are an increasingly common chronic liver disease closely associated with diabetes and obesity that have reached epidemic proportions. Reports on the prevalence of NAFLD have suggested that 27-34% of the general population in the USA and 40-90% of the obese population worldwide have this disease. Increasing urbanisation rate and associated inappropriate lifestyle changes are not only the risk factors of diabetes, but also unmask genetic predisposition in various populations for the metabolic syndrome and its manifestations including NAFLD and NASH. Lifestyle modifications and balanced nutrition are among the foremost management strategies along with ursodeoxycholic acid, metformin, vitamin E and pentoxifylline. Although weight reduction associated with current therapeutic strategies has shown some promise, maintaining it in the long run is largely unsuccessful. With the safety of pharmacotherapy still being uncertain and can be started only after confirmation, other reasonable interventions such as nutrition hold promise in preventing disease progression. The role of dietary components including branched-chain amino acids, methionine, choline and folic acid is currently being evaluated in various clinical trials. Nutritional approaches sought to overcome the limitations of pharmacotherapy also include evaluating the effects of natural ingredients, such as silymarin and spirulina, on liver disease. Understanding the specific interaction between nutrients and dietary needs in NAFLD and maintaining this balance through either a diet or a nutritional product thus becomes extremely important in providing a more realistic and feasible alternative to treat NAFLD. A planned complete nutritional combination addressing specific needs and helping to prevent the progression of NAFLD is the need of the hour to avert people from ending up with complications.
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Pallayova M, Taheri S. Non-alcoholic fatty liver disease in obese adults: clinical aspects and current management strategies. Clin Obes 2014; 4:243-53. [PMID: 25825857 DOI: 10.1111/cob.12068] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 05/15/2014] [Accepted: 05/28/2014] [Indexed: 12/18/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder whose prevalence is strongly linked to the current epidemic of obesity in many western countries. The prevalence of NAFLD is two to four times higher in populations with pre-existing metabolic comorbidities than in the general population. The diagnosis of primary NAFLD involves establishing the presence of hepatic steatosis or steatohepatitis by imaging or histology, along with establishing the non-alcoholic nature of the disease process and excluding competing aetiologies for hepatic steatosis. Among the indirect serum biomarkers, the NAFLD fibrosis score can help to identify patients with NAFLD and with higher likelihood of having fibrosis or cirrhosis. A liver biopsy should be considered in NAFLD patients at increased risk for steatohepatitis/advanced fibrosis and in cases where a liver biopsy is necessary to exclude co-existing chronic liver diseases and other aetiologies for hepatic steatosis. The treatment and management recommendations for obesity-associated NAFLD are aimed towards weight reduction. The currently available interventions employed to promote weight loss and improve the metabolic responses in NAFLD include lifestyle modification, pharmacotherapy and bariatric surgery.
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Affiliation(s)
- M Pallayova
- Faculty of Medicine, PJ Safarik University, Kosice, Slovak Republic
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50
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Da Silva HE, Arendt BM, Noureldin SA, Therapondos G, Guindi M, Allard JP. A Cross-Sectional Study Assessing Dietary Intake and Physical Activity in Canadian Patients with Nonalcoholic Fatty Liver Disease vs Healthy Controls. J Acad Nutr Diet 2014; 114:1181-94. [DOI: 10.1016/j.jand.2014.01.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 01/06/2014] [Indexed: 02/06/2023]
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