Nutritional Assessments of Patients with Non-alcoholic Fatty Liver Disease

Center for Liver Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
Obesity Surgery (Impact Factor: 3.75). 07/2008; 20(2):154-60. DOI: 10.1007/s11695-008-9549-0
Source: PubMed


Obesity is not only associated with nonalcoholic fatty liver disease (NAFLD) but it also adversely affects the progression of other liver diseases. There are limited data regarding the dietary habits of patients with chronic liver disease.
Nutrition surveys containing 13 different food groups were mailed. Nutrition scores were calculated based on weekly servings. Foods were also divided into USDA food pyramid categories with conversion of each group into calories expended. Clinico-demographic data were available. NAFLD patients were compared to patients with chronic viral hepatitis.
A total of 233 subjects were included: age 52.5 +/- 10.0 years, Body mass index (BMI) 28.1 +/- 6.5, MS 24.2%, 31.8% NAFLD, 48.1% hepatitis C virus (HCV), and 20.2% hepatitis B virus (HBV). Six nutrition indices were different among the groups. NAFLD and HCV consumed more low-nutrient food (p = 0.0037 and 0.0011) and more high-sodium food than HBV (p = 0.0052 and 0.0161). Multivariate analysis showed that NAFLD and HCV consumed more high-fat sources of meat/protein than HBV (p = 0.0887 and 0.0626). NAFLD patients consumed less calories from fruits compared to HCV and HBV patients (p = 0.0273 and 0.0023). Nine nutrition indices differed according to BMI. Univariate analysis showed that obese/overweight patients consumed more high-fat sources of meat/protein (p = 0.0078 and 0.0149) and more high-sodium foods (p = 0.0089 and 0.0062) compared to the normal-weight patients. In multivariate analysis, normal-weight patients consumed more fruits than obese (p = 0.0307). Overweight patients also consumed more calories of meat and oil than normal-weight patients (p = 0.0185 and 0.0287).
NAFLD and HCV patients have similar dietary habits. Patients with HBV have the healthiest dietary habits. Specific dietary interventions should focus on decreasing intake of low-nutrient and high-sodium food, as well as high-fat sources of meat/protein.

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    • "We know that obesity management not only contributes to weight loss, but also enhances insulin sensitivity, modifies the serum lipid profiles and contributes to improved quality-of-life [9]. A recent study detailed the differences in diet between lean, overweight and obese subjects with NAFLD and hepatitis C [36]. This study showed that patients in the higher BMI groups (that is, BMI >25) consumed more high fat sources of protein, foods with a high sodium content and higher fat milk products. "
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    ABSTRACT: The prevalence of obesity worldwide has dramatically increased during the last three decades. With obesity comes a variety of adverse health outcomes which are grouped under the umbrella of metabolic syndrome. The liver in particular seems to be significantly impacted by fat deposition in the presence of obesity. In this article we discuss several liver conditions which are directly affected by overweight and obese status, including non-alcoholic fatty liver disease, chronic infection with hepatitis C virus and post-liver transplant status. The deleterious effects of obesity on liver disease and overall health can be significantly impacted by a culture that fosters sustained nutritional improvement and regular physical activity. Here we summarize the current evidence supporting non-pharmacological, lifestyle interventions that lead to weight reduction, improved physical activity and better nutrition as part of the management and treatment of these liver conditions.
    BMC Medicine 06/2011; 9(1):70. DOI:10.1186/1741-7015-9-70 · 7.25 Impact Factor
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    ABSTRACT: Background: Emerging prevalence of obesity and subsequently metabolic syndrome induced increment in non-alcoholic fatty liver disease (NAFLD). Incidence no definite treatment is still available for NAFLD and different groups of drugs were used to treat this condition and it's related hypertranaminasemia. This study aimed to compare efficacy of vitamin E with or without ursodexycholic acid (UDCA) as two routine treatment modalities in NAFLD. Methods: The study was done in a parallel-arms clinical trial; one using 400 IU vitamin E alone and another associated with 250 mg UDCA TDS. The patients enrolled in the study if they had ultrasound report of NAFD and abnormal ALT level, and were randomized in two groups, than followed for 6 months. ALT decrease to less than 1.5 times upper limit normal was assumed as the target therapeutic response. Findings: Age of two groups (58.5 ± 4.2) did not differ, neither the gender portion varied (54% were male). Body mass index was not different in two groups before the intervention and did not change significantly during the study (28.8 ± 1.2 kg/m2). In the combination treatment group, 13 cases and in the single therapy, 4 persons reached to therapeutic target (P = 0.46). Mean of ALT and AST variations following intervention did not differ in two groups, but transaminase levels significantly decreased at least for 30 IU/L after treatment (P = 0.02). Conclusion: Single therapy with vitamin E or combined therapy with UDCA caused recovery of NAFLD in 60% of patients; although adding UDCA had no significant effect on treatment outcome. Small sample size could cause a pitfall in this study that limits ability to establishing equivalence of two modalities.
    Journal of Isfahan Medical School 11/2010; 28(111):534-41.
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    ABSTRACT: Non-alcoholic fatty liver disease (NAFLD) is now the most common liver disease in both adults and children worldwide. As a disease spectrum, NAFLD may progress from simple steatosis to steatohepatitis, advanced fibrosis and cirrhosis. An estimated 20-35% of the general population has steatosis, 10% of whom will develop the more progressive non-alcoholic steatohepatitis associated with markedly increased risk of cardiovascular- and liver-related mortality. Development of NAFLD is strongly linked to components of the metabolic syndrome including obesity, insulin resistance, dyslipidaemia and type 2 diabetes. The recognition that NAFLD is an independent risk factor for CVD is a major public health concern. There is a great need for a sensitive non-invasive test for the early detection and assessment of the stage of NAFLD that could also be used to monitor response to treatment. The cellular and molecular aetiology of NAFLD is multi-factorial; genetic polymorphisms influencing NAFLD have been identified and nutrition is a modifiable environmental factor influencing NAFLD progression. Weight loss through diet and exercise is the primary recommendation in the clinical management of NAFLD. The application of systems biology to the identification of NAFLD biomarkers and factors involved in NAFLD progression is an area of promising research.
    Proceedings of The Nutrition Society 02/2010; 69(2):211-20. DOI:10.1017/S0029665110000030 · 5.27 Impact Factor
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