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Nutrients
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Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological...
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Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy

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

Deadline for manuscript submissions: closed (15 January 2023) | Viewed by 17982

Special Issue Editors

Prof. Dr. Shira Zelber-Sagi

E-Mail Website
Guest Editor
School of Public Health, University of Haifa, Haifa 32000, Israel
Interests: nutrition; metabolic disease; obesity; fatty liver; epidemiology
Prof. Dr. Jörn M Schattenberg

E-Mail Website
Guest Editor
Metabolic Liver Research Program, I. Department of Medicine, University Medical Center, 55131 Mainz, Germany
Interests: firbsoring liver disease; cirrhosis; NAFLD / NASH; biomarkler; therapeutic trials; liver health; quality of life
Prof. Dr. Jeffrey V Lazarus

E-Mail Website
Guest Editor
Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain
Interests: health systems; public health; fatty liver disease; viral hepatitis; social epidemiology

Special Issue Information

Dear Colleagues,

NAFLD is the most common liver disease worldwide, affecting as many as a quarter of the global adult population. Currently, there is no effective drug therapy for this condition. In addition, an effective concept to maintain liver health in the context of the increasing prevalence of metabolic risk factors is missing. Therefore, lifestyle modification is the first-line treatment. While weight reduction has been shown to be effective, diet consists of many other aspects such as macro- and micro-nutrients, types of fats or carbohydrates with distinct effects, food processing levels, cooking methods, timing of eating, and behavioral, social, and psychological aspects. Several types of diets have been tested including low-carb, ketogenic, very low calorie diets, and intermittent fasting, but the evidence is still scarce. In this Special Issue of Nutrients, we aim to elaborate on the association of diet with NAFLD pathogenesis, prevention, treatment, and care, and to recommend evidence-based supportive policy measures.

Prof. Dr. Shira Zelber-Sagi
Prof. Dr. Jörn M Schattenberg
Prof. Dr. Jeffrey V Lazarus
Guest Editors

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Keywords

  • diet
  • nutrition
  • fatty liver
  • NAFLD/NASH
  • saturated fat
  • carbohydrates
  • dietary modification
  • behavioral therapy

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Published Papers (6 papers)

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12 pages, 1305 KiB  
Article
Non-Alcoholic Fatty Liver Disease and Vitamin D in the UK Biobank: A Two-Sample Bidirectional Mendelian Randomisation Study
by Zixuan Zhang, Kimberley Burrows, Harriett Fuller, Elizabeth K. Speliotes, Kushala W. M. Abeysekera, James L. Thorne, Sarah J. Lewis, Michael A. Zulyniak and J. Bernadette Moore
Nutrients 2023, 15(6), 1442; https://doi.org/10.3390/nu15061442 - 16 Mar 2023
Cited by 5 | Viewed by 5136
Abstract
Evidence for a role for vitamin D in non-alcoholic fatty liver disease (NAFLD) pathogenesis is conflicting. As Mendelian randomisation (MR) avoids many limitations of conventional observational studies, this two-sample bidirectional MR analysis was conducted to determine the following: (i) whether genetically predicted 25-hydroxyvitamin [...] Read more.
Evidence for a role for vitamin D in non-alcoholic fatty liver disease (NAFLD) pathogenesis is conflicting. As Mendelian randomisation (MR) avoids many limitations of conventional observational studies, this two-sample bidirectional MR analysis was conducted to determine the following: (i) whether genetically predicted 25-hydroxyvitamin D [25(OH)D] levels are a risk factor for NAFLD, and (ii) whether genetic risk for NAFLD influences 25(OH)D levels. Single-nucleotide polymorphisms (SNPs) associated with serum 25(OH)D levels were obtained from the European ancestry-derived SUNLIGHT consortium. SNPs associated with NAFLD or NASH (p-value < 1 × 10−5) were extracted from previous studies and supplemented by genome-wide association studies (GWASs) performed in the UK Biobank. These GWASs were done both without (primary analysis) and with (sensitivity analysis) the population-level exclusion of other liver diseases (e.g., alcoholic liver diseases, toxic liver diseases, viral hepatitis, etc.). Subsequently, MR analyses were performed to obtain effect estimates using inverse variance weighted (IVW) random effect models. Cochran’s Q statistic, MR-Egger regression intercept, MR pleiotropy residual sum and outlier (MR-PRESSO) analyses were used to assess pleiotropy. No causal association of genetically predicted serum 25(OH)D (per standard deviation increase) with risk of NAFLD was identified in either the primary analysis: n = 2757 cases, n = 460,161 controls, odds ratio (95% confidence interval): 0.95 (0.76, −1.18), p = 0.614; or the sensitivity analysis. Reciprocally, no causal association was identified between the genetic risk of NAFLD and serum 25(OH)D levels, OR = 1.00 (0.99, 1.02, p = 0.665). In conclusion, this MR analysis found no evidence of an association between serum 25(OH)D levels and NAFLD in a large European cohort. Full article
(This article belongs to the Special Issue Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy)
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17 pages, 995 KiB  
Article
The Connection between Non-Alcoholic Fatty-Liver Disease, Dietary Behavior, and Food Literacy in German Working Adults
by Simon Blaschke, Nele Schad, Melina Schnitzius, Klaus Pelster and Filip Mess
Nutrients 2023, 15(3), 648; https://doi.org/10.3390/nu15030648 - 27 Jan 2023
Cited by 2 | Viewed by 2533
Abstract
(1) Background: German working adults are particularly at risk of non-alcoholic fatty-liver disease (NAFLD), which is connected to increased cardiovascular and overall morbidity and mortality. Dietary behavior (DB) and health knowledge are crucial factors in the conceptual NAFLD model, which can directly influence [...] Read more.
(1) Background: German working adults are particularly at risk of non-alcoholic fatty-liver disease (NAFLD), which is connected to increased cardiovascular and overall morbidity and mortality. Dietary behavior (DB) and health knowledge are crucial factors in the conceptual NAFLD model, which can directly influence this disease. These two factors largely align with the concept of food literacy (FL), which deals with proficiency in food-related skills and knowledge to promote healthy DB and prevent NAFLD. However, the potential of FL for NAFLD prevention remains unknown, because FL has not been tested in connection with DB and NAFLD. Therefore, the current study examined the direct and indirect connections between FL, DB, and NAFLD in a mediation model. (2) Methods: A total of 372 working adults (38% female) participated in a cross-sectional study by completing self-report questionnaires on FL and DB. In addition, an independent physician assessed the fatty-liver index (FLI) as an indicator of NAFLD in an occupational health checkup. (3) Results: The mediation model revealed that FL had a direct moderate connection with DB (β = 0.25, p < 0.01), but no direct connection with the FLI (β = −0.05, p = 0.36). However, DB showed a small to moderate connection with the FLI (β = −0.14, p = 0.01), which could indicate the indirect-only mediation of the relationship between FL and NAFLD via DB. (4) Conclusion: These results confirm the value of DB for the prevention of NAFLD. In addition, FL might be a vital component for improving DB and thereby function as a resource in the prevention of NAFLD. However, future longitudinal research is needed to substantiate the value of FL with respect to NAFLD. Full article
(This article belongs to the Special Issue Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy)
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13 pages, 761 KiB  
Article
Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity
by Alessandro Leone, Simona Bertoli, Giorgio Bedogni, Laila Vignati, Marta Pellizzari and Alberto Battezzati
Nutrients 2022, 14(18), 3771; https://doi.org/10.3390/nu14183771 - 13 Sep 2022
Cited by 11 | Viewed by 2748
Abstract
Obesity is a risk factor for NAFLD. However, not all people with obesity have an excessive intrahepatic fat content. Adherence to a high-quality dietary pattern may also promote liver health in obesity. A cross-sectional study of 2967 women with overweight and obesity was [...] Read more.
Obesity is a risk factor for NAFLD. However, not all people with obesity have an excessive intrahepatic fat content. Adherence to a high-quality dietary pattern may also promote liver health in obesity. A cross-sectional study of 2967 women with overweight and obesity was carried out to assess the association between a Mediterranean diet and fatty liver. All women underwent clinical examination, anthropometric measurements, blood sampling, ultrasound measurements of abdominal visceral and subcutaneous fat, and assessment of adherence to the Mediterranean diet using the 14-item MEDAS questionnaire. Fatty liver index (FLI), NAFLD fatty liver steatosis (NAFLD-FLS) and hepatic steatosis index (HSI) were calculated. In women with obesity, the MEDAS score was inversely associated with FLI (β = −0.60, 95% CI: −1.04, −0.16, p = 0.008), NAFLD-FLS (β = −0.092, 95% CI: −0.134, −0.049, p < 0.001) and HSI (β = −0.17, 95% CI: −0.30, −0.04, p = 0.011). Stronger associations were observed in premenopausal women with obesity. Mediterranean diet was inversely associated with NAFLD-FLS in women with overweight, independently of menopausal status. In conclusion, Mediterranean diet is associated with a better liver status in women with overweight and obesity. This may have a public health impact and be useful in drafting nutritional guidelines for NAFLD. Full article
(This article belongs to the Special Issue Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy)
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14 pages, 1530 KiB  
Article
High Meat Consumption Is Prospectively Associated with the Risk of Non-Alcoholic Fatty Liver Disease and Presumed Significant Fibrosis
by Dana Ivancovsky-Wajcman, Naomi Fliss-Isakov, Laura Sol Grinshpan, Federico Salomone, Jeffrey V. Lazarus, Muriel Webb, Oren Shibolet, Revital Kariv and Shira Zelber-Sagi
Nutrients 2022, 14(17), 3533; https://doi.org/10.3390/nu14173533 - 27 Aug 2022
Cited by 18 | Viewed by 4472
Abstract
Non-alcoholic fatty liver disease (NAFLD) has been associated with meat consumption in cross-sectional studies. However, only a few prospective studies have been conducted, and they did not test for liver fibrosis. We aimed to assess the association between meat consumption changes and the [...] Read more.
Non-alcoholic fatty liver disease (NAFLD) has been associated with meat consumption in cross-sectional studies. However, only a few prospective studies have been conducted, and they did not test for liver fibrosis. We aimed to assess the association between meat consumption changes and the incidence and remission of NAFLD and significant liver fibrosis. We used a prospective cohort study design, including 316 subjects aged 40–70 years, participating in baseline and follow-up evaluations at Tel-Aviv Medical Center. NAFLD was determined by liver ultrasound or controlled attenuation parameter (CAP), and liver fibrosis was determined by FibroScan. Meat consumption (g/day) was assessed by a food frequency questionnaire (FFQ). In multivariable-adjusted analyses, high consumption of red and/or processed meat (≥gender-specific median) was associated with a higher risk of NAFLD with elevated alanine aminotransferase (ALT) (OR = 3.75, 1.21–11.62, p = 0.022). Consistently high (in both baseline and follow-up evaluations) total meat consumption was associated with 2.55-fold (95% CI 1.27–5.12, p = 0.009) greater odds for new onset and/or persistence of NAFLD compared to consistently low meat consumption. A similar association was shown for consistently high consumption of red and/or processed meat (OR = 2.12, 95% CI 1.11–4.05, p = 0.022). Consistently high red and/or processed meat consumption was associated with 4.77-fold (95% CI 1.36–16.69, p = 0.014) greater odds for significant fibrosis compared to consistently low consumption. Minimizing the consumption of red and/or processed meat may help prevent NAFLD and significant fibrosis. Full article
(This article belongs to the Special Issue Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy)
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2 pages, 194 KiB  
Reply
Reply to Alvarez Stehle, E. Comment on “Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771”
by Alessandro Leone, Simona Bertoli, Giorgio Bedogni, Laila Vignati, Marta Pellizzari and Alberto Battezzati
Nutrients 2023, 15(5), 1140; https://doi.org/10.3390/nu15051140 - 24 Feb 2023
Cited by 2 | Viewed by 1192
Abstract
We thank Dr. Elvira Alvarez Stehle [...] Full article
(This article belongs to the Special Issue Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy)
2 pages, 188 KiB  
Comment
Comment on Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771
by Elvira Alvarez Stehle
Nutrients 2023, 15(5), 1139; https://doi.org/10.3390/nu15051139 - 24 Feb 2023
Cited by 1 | Viewed by 1060
Abstract
I read a recently published research study about the Mediterranean diet and its association with liver status with extraordinary interest [...] Full article
(This article belongs to the Special Issue Relationship between Diet and NAFLD: From Pathogenesis, Clinical and Epidemiological Studies to Prevention and Health Policy)
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