Fatty Liver Diet Recommendations – Association and Dietary Quality in Spanish Households during the First Outbreak of the COVID-19 Pandemic
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Fatty Liver Diet Recommendations
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Can The Mediterranean Diet Help Combat Fatty Liver?
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Definition of Non-Alcoholic Liver Disease (NAFLD) and the Role of Consumption of Sugary Foods and Other Dietary Supplements in Its Development
Fatty Liver Diet: A Beginner’s Step By Step Guide To Managing Fatty Liver Disease By Brandon Gilta
Received: March 11, 2021 / Updated: April 14, 2021 / Accepted: April 21, 2021 / Published: April 24, 2021
NAFLD is the most common liver disease in the world, and its increase has paralleled the global increase in diabetes and obesity. It is associated with the accumulation of fat in the liver developing into nonalcoholic steatohepatitis (NASH), a type of inflammation that can lead to liver fibrosis and cirrhosis. Currently, there is no effective pharmacological treatment for NAFLD. Treatment is therefore based on lifestyle modifications including dietary changes and exercise, although it is not known what the most effective intervention is. The purpose of this review, therefore, is to discuss the role of specific nutrients and the effects of different dietary components on NAFLD. It has been proven that a poor diet that contains calories, sugars and high fat and low in fatty acids, fibers and micronutrients play an important role in the development and progression of this disease. However, few clinical trials have evaluated the effect of nutritional interventions on NAFLD. We therefore summarize what is currently known about the effects of macronutrients, foods and dietary patterns on the prevention and treatment of NAFLD. Most current guidelines recommend a low-calorie, nutritious diet, such as the Mediterranean diet, as the most effective dietary regimen for treating NAFLD. More clinical trials are needed, however, to identify the best food-based treatments.
Non-alcoholic fatty liver disease (NAFLD) is a general term used to cover progressive liver diseases characterized by evidence of excess fat in the liver (hepatic steatosis) on imaging or histology (macrovesicular steatosis) a > 5% of hepatocytes), and the absence of secondary causes. (drinking, drugs, hereditary diseases) [1, 2]. NAFLD is the most common cause of chronic liver disease in the world and represents an important, growing and often neglected public health problem [ 3 , 4 ]. Fatty liver disease is associated with the global economy and the development of lifestyles similar to traditional cultures [ 4 , 5 ]. It is also associated with other metabolic diseases such as type 2 diabetes mellitus (T2DM), obesity, metabolic syndrome (MetS), and dyslipidemia. In addition, a form of NAFLD called nonalcoholic steatohepatitis (NASH) has a potentially progressive course, leading to liver fibrosis, cirrhosis and/or hepatocellular carcinoma (HCC) – a condition that may require treatment with liver transplantation .
Nutrition is a major contributor to the development of NAFLD. Therefore, different types of food can change its behavior [5, 6, 7, 8, 9, 10, 11, 12, 13], which means that it is important to discuss in general the role of nutrition and its main components in nature. history. The cost of NAFLD. Therefore, the purpose of this text is to provide an overview of the general phenomenon of NAFLD and to examine the effect of specific foods and dietary patterns in the development of the disease.
What Is Fatty Liver Disease?
The purpose of this informative review is to provide a comprehensive overview of NAFLD and to assess the effects of specific nutrients and dietary patterns on disease progression. We searched for scientific studies published in the last 10 years and written in English in the PubMed MEDLINE Database, NCBI and Google Scholar websites using specific search terms (“NAFLD” or “MAFLD”, “nutritional body”, “diabetes”, “insulin”. resistance, “metabolic diseases”, “cardiovascular diseases”, “fructose”, “carbohydrates”, “fats”, “fiber”, “protein”, “lipogenesis”, “food ketogenic”, “Mediterranean diet”, “vegan” / “vegetarian diet”, “DASH”, “intermittent fasting” and “microbiota”). In addition, recent reviews, meta-analyses, consensus documents and guidelines on NAFLD, diet and physiology methods are also included. In order to make sense of the search and choose the most appropriate articles, we used the mentioned words and used different Boolean operators. Finally, a total of 170 articles were selected, of which 93 were systematic reviews, meta-analyses, consensus documents or guidelines, and 67 were human observational or interventional studies; A small number of animal studies were also included. Human intervention studies with nutritional supplements were excluded because the purpose of the study was to evaluate the effect of natural nutrition on the development of NAFLD. Publication, implementation and integration, as well as the characteristics of the patients included in the trial must be taken into account in the interpretation of the results.
NAFLD is an acquired disease that is caused by life stress and is characterized by fatty tissue in the liver. It progresses at different stages of development among individuals but usually follows a four-stage course. The first stage involves the storage of liver fat, also known as non-alcoholic fatty liver (NAFL). The second stage, characterized by fatty liver, occurs in approximately 7-30% of NAFLD patients and leads to inflammation of the liver known as NASH. Chronic liver disease results in the formation of liver fibers; This stage is called fibrosis and is associated with the activation of stellate cells of the liver and the replacement of hepatocytes with fibrillar collagen and other extracellular matrix proteins that endanger liver function and liver structure. The final stage is cirrhosis, a severe stage of NAFLD when hepatocytes are completely replaced by fibrosis, which leads to liver failure [12, 13].
Early histological features of NASH require the presence of steatosis, ballooning, and lobular swelling in the liver tissue; other histological changes include portal inflammation, polymorphonuclear infiltrates, Mallory-Denk bodies, apoptotic bodies, clear cells, microvacuolar steatosis, and megamitochondria  (Table 1). NASH can be classified from mild (F0-F1) to progressive fibrosis (≥F3, bridge) and finally cirrhosis (F4). Higher levels of fibrosis affect survival  and are associated with more advanced diseases that can lead to liver cirrhosis, HCC, and, finally, the need for a liver transplant . In contrast, only a small number of cases of HCC have been reported in patients with isolated NAFL.
Both NAFL and NASH are asymptomatic until the end of the disease; therefore, most patients are diagnosed only in advanced stages. This is especially important for NASH patients because they have an increased risk of HCC, cardiovascular disease (CVD), and mortality; therefore, the diagnosis of steatohepatitis through an accurate diagnosis is important in this population.
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A review of the lifestyle and subtypes of NAFLD shows that the specific criteria that describe it are inherently problematic. Experts have come to the conclusion that NAFLD does not reflect current knowledge, therefore, MAFLD has been suggested as the next term to describe this type of disease. However, MAFLD is not yet accepted in the literature; therefore, in this review, we follow the principle of talking about this type of disease with the acronym ‘NAFLD’ .
NAFLD is the most common liver disease in the world [4, 5]. Many studies have tried to estimate the global incidence of NAFLD/NASH, but due to the extreme differences in study parameters and appropriate tests available, something clear and reliable is currently not available [ 7]. Global prevalence estimates for the general population are 25% for NAFLD and 3-5% for NASH [13, 16]. It is important to highlight that the prevalence of NAFLD varies worldwide. In addition, after taking into account the lifestyle and nutritional deficiencies of Western European standards, individuals of Asian, Hispanic, Indian and American origin are more prone to NAFLD than those of European and African descent  . Adult prevalence is estimated at 27-34% in North America, 25% in Europe, and 15-20% in Asia. The incidence of NAFLD in China, which is estimated to have a higher relative rate of 22.2% in the past decade, shows the rapid impact.
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