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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)
Abstract:
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