NUTRITIONAL STRATEGIES IN THE MANAGEMENT OF NON-ALCOHOLIC FATTY LIVER DISEASE: A COMPREHENSIVE REVIEW

Abstract

Non-alcoholic fatty liver disease (NAFLD) is rapidly developing health issue in the globe and is considered to be the liver variant of the metabolic syndrome closely associated with obesity, insulin resistance and type 2 diabetes mellitus. The NAFLD etiology is multifactorial and involves the interaction of dietary, genetic, microbiological, and metabolic dysregulation. Currently, no known pharmacological interventions exist and, therefore, the disease management is based on nutritional and lifestyle interventions. The review combine the existing evidence on the role of macronutrients, micronutrients, antioxidants, and diets in the prevention and treatment of NAFLD. Overconsumption of refined carbohydrates, fructose, saturated fatty acids, and trans fatty acids are known to arouse the deposition of hepatic lipids through increased de novo lipogenesis, increased intake of free fatty acids, and oxidative stress. On the other hand, those diets rich in monounsaturated and polyunsaturated fats, dietary fiber, and bioactive substances are protective since they increase insulin sensitivity, reduce inflammation, and change the composition of the gut microbiota. Mediterranean diet is given special consideration because of its steadier positive outcomes in the prevention of hepatic steatosis and metabolic outcomes due to the presence of large amounts of olive oil, fruits, vegetables and omega-3 fatty acids. As well, micronutrients such as vitamin E and polyphenols play a role in the prevention of oxidative stress damage and hepatotoxicity. The lifestyle changes including energy limitation and physical activity also count and the loss of weight of 7-10 percent has been a major change in liver histology. Despite the encouraging outcomes, the limitations are the heterogeneity of the studies, absence of the long-term randomized controlled studies, and heterogeneity of the population of patients that presuppose the need to carry out further research. The individualized nutritional interventions and clinical outcomes over the long-run should be the next research study to maximize NAFLD management.