Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients (original) (raw)
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Hepatobiliary Surgery and Nutrition
Background: With the rising global prevalence of fatty liver disease related to metabolic dysfunction, the association of this common liver condition with chronic kidney disease (CKD) has become increasingly evident. In 2020, the more inclusive term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to replace the term non-alcoholic fatty liver disease (NAFLD). The observed association between MAFLD and CKD and our understanding that CKD can be a consequence of underlying metabolic dysfunction support the notion that individuals with MAFLD are at higher risk of having and developing CKD compared with those without MAFLD. However, to date, there is no appropriate guidance on CKD in individuals with MAFLD. Furthermore, there has been little attention paid to the link between MAFLD and CKD in the Nephrology community. Methods and Results: Using a Delphi-based approach, a multidisciplinary panel of 50 international experts from 26 countries reached a consensus on some of the open research questions regarding the link between MAFLD and CKD. Conclusions: This Delphi-based consensus statement provided guidance on the epidemiology, mechanisms, management and treatment of MAFLD and CKD, as well as the relationship between the severity of MAFLD and risk of CKD, which establish a framework for the early prevention and management of these two common and interconnected diseases.
British Journal of Nutrition
Lifestyle interventions remain the cornerstone therapy for non-alcoholic fatty liver disease (NAFLD). This randomised controlled single-blind clinical trial investigated the effect of Mediterranean diet (MD) or Mediterranean lifestyle, along with weight loss, in NAFLD patients. In all, sixty-three overweight/obese patients (50 (sd 11) years, BMI=31·8 (sd 4·5) kg/m2, 68 % men) with ultrasonography-proven NAFLD (and elevated alanine aminotransferase (ALT) and/or γ-glutamyl transpeptidase (GGT) levels) were randomised to the following groups: (A) control group (CG), (B) Mediterranean diet group (MDG) or (C) Mediterranean lifestyle group (MLG). Participants of MDG and MLG attended seven 60-min group sessions for 6 months, aiming at weight loss and increasing adherence to MD. In the MLG, additional guidance for increasing physical activity and improving sleep habits were given. Patients in CG received only written information for a healthy lifestyle. At the end of 6 months, 88·8 % of par...
American Journal of Nephrology
Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled “PREvención con DIeta MEDiterránea-Plus” (PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55–75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (eGFR). Secondary outcomes were changes in uri...
Nutrients
Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease worldwide, and lifestyle modification is the current standard treatment. The aim of the study was to estimate the effect of two different physical activity (PA) programs, a Low Glycemic Index Mediterranean Diet (LGIMD), and their combined effect on the NAFLD score as measured by FibroScan®. Methods: Moderate or severe NAFLD subjects (n = 144) were randomly assigned to six intervention arms during three months. Interventions arms were a control diet, LGIMD, aerobic activity program (PA1), combined activity program (PA2), and LGIMD plus PA1 or LGIMD plus PA2. The data were compared at baseline, at 45 days, and at 90 days. Analysis of variance was performed under the intention-to-treat principle. Results: There was a statistically significant reduction in the NAFLD score after 45 days of treatment in every working arm except for Arm 1 (control diet). After 90 days, the best results were shown...
Nutrients
Lifestyle modifications are the main support of nonalcoholic fatty liver disease (NAFLD) therapy. Weight loss is one of the primary goals in NAFLD, but the effects of different calorie-restricted diets remain unclear. Thus, we evaluated the effects of two calorie-restricted diets—the Mediterranean diet (Med diet) and low-fat diet—on liver status, cardiometabolic markers, and fatty acid profiles in patients with NAFLD. Twenty-four overweight/moderately obese men were randomly assigned to consume one of these diets. Lipid levels, glucose, insulin, liver enzymes, steatosis, and fatty acid profiles of serum and erythrocytes phospholipids were assessed. After 3 months, all participants had a significant weight loss (>9%), with improvements in waist circumference, body fat %, index of visceral adiposity (VAI), lipid accumulation product, fatty liver (FLI), and hepatic steatosis (HSI) index (p < 0.001). Both diets significantly lowered triglycerides, total and LDL-cholesterol, liver ...
Hepatology, 2016
Fatty liver accumulation results from an imbalance between lipid deposition and removal, driven by the hepatic synthesis of triglycerides and de novo lipogenesis. The habitual diet plays a relevant role in the pathogenesis of NAFLD, and both risky (e.g., fructose) and protective foods (Mediterranean diet) have been described, but the contribution of excess calories remains pivotal. Accordingly, weight loss is the most effective way to promote liver fat removal. Several controlled studies have confirmed that an intense approach to lifestyle changes, carried on along the lines of cognitive-behavior treatment, is able to attain the desired 7-10% weight loss, associated with reduced liver fat, NASH remission, and also reduction of fibrosis. Even larger effects are reported following bariatric surgery-induced weight loss in NAFLD, where 80% of subjects achieve NASH resolution at 1-year follow-up. These results provide solid data to evaluate the safety and effectiveness of the pharmacologic treatment of NASH. The battle against metabolic diseases, largely fuelled by increased liver fat, needs a comprehensive approach to be successful in an obesiogenic environment. In this review, we will discuss the role of hepatic lipid metabolism, genetic background, diet and physical activity on fatty liver. They are the basis for a lifestyle approach to NAFLD treatment.
2018
Background: Non-alcoholic fatty liver sickness (NAFLD) is a variety of liver pathological conditions that intensely related to other chronic diseases including obesity and diabetes. Objectives: Systematically evaluating the role of lifestyle interventions on reducing the activity of NAFLD. Methods: Collecting all the studies regarding the effects of changing the diet, exercise or combination of both on the activity or markers of NAFLD during the period from 2006 to 2017. Results: Database searches returned 122 citations with 92 included in more than one search then the final studied which include in this study was 19 articles. Five articles studied the effects of a combination of dietary and exercise interventions, four of these articles showed positive results regarding the Dietetic Association (ADA) Quality Criteria Checklist, while only one article showed a neutral results, i.e. 80.0% of the articles showed a positive effect of the combination of diet and exercise on the effect o...
Crescent journal of medical and biological sciences, 2023
Introduction Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, mainly caused by a sedentary and unhealthy lifestyle (1). This disease is characterized by fat accumulation, especially triglycerides, in the cytoplasm of liver cells at a rate of 5%-10% of liver weight in the absence of alcohol consumption (1). NAFLD is closely related to an unhealthy lifestyle, including increased calorie intake and reduced physical activity and exercise. The last three decades have witnessed a significant increase in the average body mass index (BMI) and obesity, which are the pathophysiological drivers of NAFLD (2). Currently, there are different therapeutic strategies for the management of NAFLD. However, proven treatments for this disease have yet to be found (3). The first step in treating the disease is to modify the patient's lifestyle and control the risk factors for the disease (4). Randomized controlled trials have shown that lifestyle interventions reduce body weight in NAFLD patients, improve hepatic triglyceride content determined by magnetic resonance techniques, and mitigate the complications of NAFLD (combination of steatosis, inflammation, and hepatocyte ballooning), as determined by liver biopsy (5-11). A recent systematic review and meta-analysis showed that the overall prevalence of NAFLD worldwide was 32.4%, and its frequency was significantly higher in men (12). A clinical trial on 261 patients with NASH (proven by biopsy) who underwent frequent liver biopsy after 12 months of low-calorie and low-fat diet intervention (750 kcal less than the daily requirement) and walking (200 min/wk) reported the effect of weight loss induced by a healthy lifestyle on liver histology (13). In another 18-month study involving 278 subjects with dyslipidemia or central obesity (half of whom had NAFLD), exercise and diet interventions did not affect liver fat content or cardiovascular risk parameters (5).
Journal of hepatology, 2018
Around 10-20% of patients with non-alcoholic fatty liver disease (NAFLD) are non-obese. The benefit of weight reduction in such patients is unclear. We aim to study the efficacy of lifestyle intervention in non-obese patients with NAFLD and to identify factors that predict treatment response. A total of 154 community NAFLD patients were randomised to a 12-month lifestyle intervention programme involving regular exercise, or to standard care. The primary outcome was remission of NAFLD at Month 12 by proton-magnetic resonance spectroscopy. After the programme, the patients were prospectively followed until Year 6. The Asian body mass index (BMI) cut-off of 25 kg/m was used to define non-obese NAFLD. Patients were assigned to the intervention (n = 77) and control (n = 77) groups (39 and 38 in each group had baseline BMI <25 and ≥25 kg/m, respectively). More patients in the intervention group achieved the primary outcome than the control group regardless of baseline BMI (non-obese: 6...