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Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary...
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Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition)

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (25 April 2024) | Viewed by 17553

Special Issue Editors

Dr. Pere Torán-Monserrat

E-Mail Website
Guest Editor
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08303 Mataró, Spain
Interests: primary care medicine; clinical epidemiology; cohort studies; evidence-based medicine; clinical medicine; portfolio theory; diabetes; health; hypertension; preventive medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Ingrid Arteaga

E-Mail Website
Co-Guest Editor
Unitat de Suport a la Recerca (USR) Metropolitana Nord, Fundació Institut Universitari d’Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), 08303 Mataró, Barcelona, Spain
Interests: primary care; non-alcoholic fatty liver disease

Special Issue Information

Dear Colleagues,

In recent years, non-alcoholic fatty liver disease (NAFLD) has become an emerging disease worldwide closely related to an increase in obesity and type 2 diabetes mellitus (T2DM). In fact, in Western countries, NAFLD has become the most common liver disease in both adult and paediatric populations. This pathology is closely related to metabolic syndrome (MS). Therefore, it is an important risk factor for the development of other comorbidities such as pre-diabetes, diabetes, insulin resistance, dyslipidaemia and cardiovascular diseases. Moreover, the presence of NAFLD, together with any of these comorbidities, is associated with increased cardiovascular and liver morbidity and mortality, including its progression to cirrhosis and hepatocarcinoma. However, we do not have sufficient data on the impact of NAFLD on the general population or the consequences it may have in the future.

Since obesity and NAFLD are very prevalent in our environment, they tend to be underestimated; however, they are potentially serious pathologies due to their association with multiple cardiovascular risk factors. Obesity at an early age is mostly related to cultural level, family socioeconomic status, and, especially, the lifestyle changes that have occurred over the last few years (e.g., the consumption of unhealthy food and sedentary habits). As a result, NAFLD leads to an increase in the overall burden of disease, causing a considerable expenditure of health resources and an increase in long-term mortality.

Primary care is the most appropriate setting for implementing early detection strategies as well as any intervention aimed at weight loss through nutrition and physical exercise. Framing this as a challenge for preventive practices provides an opportunity to avoid the development of advanced stages of this disease as well as its multiple associated comorbidities and complications.

Considering all this, in this Special Issue of Nutrients entitled "Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition)", we encourage researchers to submit articles that examine strategies for the early detection of NAFLD, its risk factors and interventions aimed at weight loss through physical exercise and especially nutrition.

Dr. Pere Torán-Monserrat
Guest Editors

Dr. Ingrid Arteaga
Co-Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • NAFLD
  • metabolic syndrome
  • chronic liver disease
  • fibrosis
  • steatosis
  • primary care
  • nutrition
  • nutritional intervention
  • weight loss
  • prevention

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Published Papers (5 papers)

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Research

12 pages, 1389 KiB  
Article
The Effect of Mobile Lifestyle Intervention Combined with High-Protein Meal Replacement on Liver Function in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Pilot Randomized Controlled Trial
by Eunbyul Cho, Sunwoo Kim, Soonkyu Kim, Ju Young Kim, Hwa Jung Kim, Yumi Go, Yu Jung Lee, Haesol Lee, Siye Gil, Sung Kwon Yoon and Keonho Chu
Nutrients 2024, 16(14), 2254; https://doi.org/10.3390/nu16142254 - 13 Jul 2024
Viewed by 2354
Abstract
While many studies have explored dietary substitutes and mobile apps separately, a combined approach to metabolic dysfunction-associated steatotic liver disease (MASLD) has not been investigated. This study evaluated short-term mobile interventions coupled with partial meal replacement in patients with MASLD. Sixty adults with [...] Read more.
While many studies have explored dietary substitutes and mobile apps separately, a combined approach to metabolic dysfunction-associated steatotic liver disease (MASLD) has not been investigated. This study evaluated short-term mobile interventions coupled with partial meal replacement in patients with MASLD. Sixty adults with MASLD and a body mass index ≥25 kg/m2 from a health examination center were randomized into an intervention group using a mobile app with partial meal replacements or a control group receiving standard educational materials. Liver enzyme levels, lipid profiles, and anthropometric measurements were assessed at baseline and after 4 weeks. Twenty-five participants in the intervention group and 24 in the control group completed the trial. Significant reductions were observed in the intervention group for alanine aminotransferase (−28.32 versus [vs.] −10.67, p = 0.006) and gamma-glutamyl transferase (−27.76 vs. 2.79, p = 0.014). No significant changes in aspartate aminotransferase, body weight, or waist circumference were noted in the intervention group. Four weeks of mobile lifestyle intervention incorporating partial meal replacements improved liver enzyme profiles in patients with MASLD. This strategy demonstrated the potential for mitigating elevated liver enzyme levels without altering body weight or waist circumference. Comprehensive and longer-term research is needed to substantiate and elaborate these preliminary outcomes. Full article
(This article belongs to the Special Issue Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition))
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17 pages, 2415 KiB  
Article
The Link between Abdominal Obesity Indices and the Progression of Liver Fibrosis: Insights from a Population-Based Study
by María Teresa Julián, Ingrid Arteaga, Pere Torán-Monserrat, Guillem Pera, Alejandra Pérez-Montes de Oca, Irene Ruiz-Rojano, Elena Casademunt-Gras, Carla Chacón and Nuria Alonso
Nutrients 2024, 16(11), 1586; https://doi.org/10.3390/nu16111586 - 23 May 2024
Cited by 4 | Viewed by 1540
Abstract
There is currently no available information on the correlation between abdominal obesity indices and the risk of liver fibrosis progression. We aimed to investigate the relationship between the body mass index (BMI), waist circumference (WC), and the visceral adiposity index (VAI) with the [...] Read more.
There is currently no available information on the correlation between abdominal obesity indices and the risk of liver fibrosis progression. We aimed to investigate the relationship between the body mass index (BMI), waist circumference (WC), and the visceral adiposity index (VAI) with the progression of liver fibrosis. The study also evaluated the association between these indices and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. A total of 1403 subjects participated in the cross-sectional and longitudinal population-based study. Liver stiffness was assessed via transient elastography, at baseline and follow-up (median: 4.2 years). The subgroup with dysglycemia was also analyzed. In the cross-sectional study, the highest quartile of VAI, BMI ≥ 30 kg/m2, and abdominal obesity showed significant associations with the prevalence of MASLD and liver fibrosis, as well as with fibrosis progression. However, VAI showed no association with MASLD incidence. Among the dysglycemic subjects, there was no observed association between VAI and the incidence of MASLD or the progression of fibrosis. In conclusion, the BMI, WC, and the VAI are associated with an increased risk of progression to moderate-to-advanced liver fibrosis in the general population. However, the VAI does not perform better than the BMI and WC measurement. Full article
(This article belongs to the Special Issue Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition))
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19 pages, 381 KiB  
Article
Multipanel Approach including miRNAs, Inflammatory Markers, and Depressive Symptoms for Metabolic Dysfunction-Associated Steatotic Liver Disease Diagnosis during 2-Year Nutritional Intervention
by Ana Luz Tobaruela-Resola, José I. Riezu-Boj, Fermin I. Milagro, Paola Mogna-Pelaez, José I. Herrero, Mariana Elorz, Alberto Benito-Boillos, Josep A. Tur, J. Alfredo Martínez, Itziar Abete and M. Angeles Zulet
Nutrients 2024, 16(11), 1547; https://doi.org/10.3390/nu16111547 - 21 May 2024
Cited by 3 | Viewed by 1788
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), with a prevalence of 30% of adults globally, is considered a multifactorial disease. There is a lack of effective non-invasive methods for accurate diagnosis and monitoring. Therefore, this study aimed to explore associations between changes in circulating [...] Read more.
Metabolic dysfunction-associated steatotic liver disease (MASLD), with a prevalence of 30% of adults globally, is considered a multifactorial disease. There is a lack of effective non-invasive methods for accurate diagnosis and monitoring. Therefore, this study aimed to explore associations between changes in circulating miRNA levels, inflammatory markers, and depressive symptoms with hepatic variables in MASLD subjects and their combined potential to predict the disease after following a dietary intervention. Biochemical markers, body composition, circulating miRNAs and hepatic and psychological status of 55 subjects with MASLD with obesity and overweight from the FLiO study were evaluated by undergoing a 6-, 12- and 24-month nutritional intervention. The highest accuracy values of combined panels to predict the disease were identified after 24 months. A combination panel that included changes in liver stiffness, high-density lipoprotein cholesterol (HDL-c), body mass index (BMI), depressive symptoms, and triglycerides (TG) yielded an AUC of 0.90. Another panel that included changes in hepatic fat content, total cholesterol (TC), miR15b-3p, TG, and depressive symptoms revealed an AUC of 0.89. These findings identify non-invasive biomarker panels including circulating miRNAs, inflammatory markers, depressive symptoms and other metabolic variables for predicting MASLD presence and emphasize the importance of precision nutrition in MASLD management and the sustained adherence to healthy lifestyle patterns. Full article
(This article belongs to the Special Issue Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition))
13 pages, 761 KiB  
Article
Time-Restricted Fasting Improves Liver Steatosis in Non-Alcoholic Fatty Liver Disease—A Single Blinded Crossover Trial
by Jack Feehan, Alexandra Mack, Caroline Tuck, Jorge Tchongue, Darcy Q. Holt, William Sievert, Gregory T. Moore, Barbora de Courten and Alexander Hodge
Nutrients 2023, 15(23), 4870; https://doi.org/10.3390/nu15234870 - 22 Nov 2023
Cited by 10 | Viewed by 7055
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is associated with visceral adiposity. We assessed the effectiveness of time-restricted fasting (TRF) for 16 h daily without calorie restrictions compared to standard care (SC; diet and lifestyle advice) in improving visceral adiposity and steatosis via controlled [...] Read more.
Background: Non-alcoholic fatty liver disease (NAFLD) is associated with visceral adiposity. We assessed the effectiveness of time-restricted fasting (TRF) for 16 h daily without calorie restrictions compared to standard care (SC; diet and lifestyle advice) in improving visceral adiposity and steatosis via controlled attenuation parameter (CAP). Methods: In a prospective single-blind randomized controlled trial, 32 participants with NAFLD were randomly assigned to TRF or SC for 12 weeks. The secondary endpoints were changes in liver stiffness, anthropometry, blood pressure, and other metabolic factors. Results: Twenty-eight participants completed the first arm of the study (TRF = 14, SC = 14), with 23 completing the crossover arm (TRF = 10, SC = 13). The baseline demographics were similar between the groups. Intermittent fasting caused a significant decrease in hepatic steatosis (p = 0.038), weight (p = 0.005), waist circumference (p = 0.001), and BMI (p = 0.005) compared to standard care. Intermittent fasting also resulted in additional within-group changes that were not seen in the standard care intervention. Conclusion: TRF offers superior improvements in patients with NAFLD, improving steatosis, weight, and waist circumference despite a lack of change in overall caloric intake. Time-restricted fasting should be considered as a primary weight loss intervention in the context of NAFLD. Trial registration: ACTRN12613000935730. Full article
(This article belongs to the Special Issue Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition))
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11 pages, 648 KiB  
Article
High Extra Virgin Olive Oil Consumption Is Linked to a Lower Prevalence of NAFLD with a Prominent Effect in Obese Subjects: Results from the MICOL Study
by Calogero Claudio. Tedesco, Caterina Bonfiglio, Maria Notarnicola, Maria Rendina, Antonino Castellaneta, Alfredo Di Leo, Gianluigi Giannelli and Luigi Fontana
Nutrients 2023, 15(21), 4673; https://doi.org/10.3390/nu15214673 - 4 Nov 2023
Cited by 6 | Viewed by 4137
Abstract
Extra virgin olive oil (EVOO) has healthy benefits for noncommunicable diseases (NCDs). However, limited evidence is available about the effects of liver disease and non-alcoholic fatty liver disease (NAFLD). We evaluate whether dose-increased consumption of EVOO is associated with a lower prevalence of [...] Read more.
Extra virgin olive oil (EVOO) has healthy benefits for noncommunicable diseases (NCDs). However, limited evidence is available about the effects of liver disease and non-alcoholic fatty liver disease (NAFLD). We evaluate whether dose-increased consumption of EVOO is associated with a lower prevalence of NAFLD and if these effects vary based on body weight. The study included 2436 subjects with a 33% NAFLD prevalence. Daily EVOO was categorized into tertiles: low (0–24 g/day), moderate (25–37 g/day), and high consumption (>37 g/day). Subjects were also classified by body mass index (BMI) as normo-weight (18.5–24.9), overweight (25–29.9), and obese (≥30). Logistic regression analysis was applied to calculate odds ratios (ORs) for NAFLD, considering a 20-gram increment in EVOO intake and accounting for EVOO categories combined with BMI classes. The ORs were 0.83 (0.74;0.93) C.I. p = 0.0018 for continuous EVOO, 0.89 (0.69;1.15) C.I. p = 0.37, and 0.73 (0.55;0.97) C.I. p = 0.03 for moderate and high consumption, respectively, when compared to low consumption. Overall, the percent relative risk reductions (RRR) for NAFLD from low to high EVOO consumption were 18% (16.4%;19.2%) C.I. and 26% (25%;27.4%) C.I. in overweight and obese subjects. High EVOO consumption is associated with a reduced risk of NAFLD. This effect is amplified in overweight subjects and even more in obese subjects. Full article
(This article belongs to the Special Issue Management of Non-alcoholic Fatty Liver Disease from Primary Care: Dietary and Nutritional Considerations (2nd Edition))
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