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Diet, Weight Loss and Nonalcoholic Fatty Liver Disease (NAFLD) pp. 301-312 $100.00
Authors:  (Maria Cristina Elias, Edison R. Parise, Luciana Carvalho, Fany Govetri Sena Crispim, Bruna Elias Rebello, Division of Gastroenterology and Hepatology, Federal University of São Paulo, Brazil)
It is estimated that 20 to 30% of the adult population in developed countries are
suffering from nonalcoholic fatty liver disease (NAFLD), and 3.5 a 5% from
nonalcoholic steatohepatites (NASH). In obese subjects there is an estimated prevalence
of 50 to 90% of NAFLD, and 19% of NASH (Preiss and Sattar 2008). Dyslipidemia,
viceral obesity, insulin resistance, and type 2 diabetes mellitus are risk factors usually
present in NAFLD, linking the disease to metabolic syndrome, a common finding in
many of NAFLD patients (Collantes, Ong et al. 2004; Perez-Aguilar, Benlloch et al.
2004; Adams, Angulo et al. 2005; Angelico, Del Ben et al. 2005; Suzuki, Lindor et al.
2005; Utzschneider and Kahn 2006; Merat, Aduli et al. 2008).
.At present, there is no standard recommended treatment for NAFLD/NASH
(Mendez-Sanchez, Arrese et al. 2007). The treatment includes lifestyle modifications, and
the use of pharmacological agents, as antioxidants, lipid lowering and insulin sensitizers
(Siebler and Galle 2006; Cave, Deaciuc et al. 2007; Mendez-Sanchez, Arrese et al. 2007).
The nutritional treatment is related to diseases associated with NAFLD, as obesity,
dyslipidemia, diabetes mellitus and hypertension (Nehra, Angulo et al. 2001;
Grattagliano, Portincasa et al. 2007).
The American Gastroenterological Association (AGA) recommends a target of 10%
of the baseline weight as an initial goal of weight loss if overweight is present (i.e. BMI
higher than 25 kg/m²). Weight loss should be gradual (over 6 months). According to the
researchers, it can be reached by associating dietary restriction to physical activity. Both
of them seem to act favorably in IR (Iniative 2000; Suzuki, Lindor et al. 2005; Adams
and Angulo 2006; Siebler and Galle 2006; Grattagliano, Portincasa et al. 2007; Mendez-
Sanchez, Arrese et al. 2007; Yamamoto, Iwasa et al. 2007).
Researches have also shown the effectiveness of weight loss in the normalization of
liver enzymes, in the reversal of insulin resistance and hepatic steatosis, with a balanced
diet, rich in fiber, antioxidants, and n – 3 fatty acids (Ueno, Sugawara et al. 1997; Okita,
Hayashi et al. 2001; Delzenne, Daubioul et al. 2002; Harrison, Kadakia et al. 2002;
Dixon, Bhathal et al. 2004; Yamamoto, Iwasa et al. 2007; Elias, Parise et al. 2009). 

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Diet, Weight Loss and Nonalcoholic Fatty Liver Disease (NAFLD) pp. 301-312