Journal of Clinical Nutrition & Dietetics

The prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) is growing at an alarming rate as the prevalence of obesity and cardiovascular risk factors are increasing rapidly [1]. Although there is a relatively long time for management of obesity and reversing its effects on the health, we have a short time for management of NAFLD and prevention of the disease progression to the Nonalcoholic Steatohepatitis (NASH), and hepatic cirrhosis. Thus, it is important to treat the disease before that it would be too late for treatment. On the other hand, since the patients with NAFLD do not experience any signs and symptoms, the disease might not be diagnosed at its early stages, and when the disease is diagnosed, patients are not eager to get the treatment and follow the management strategies. All of these problems lead to unsuccessful treatment of the disease, and progression of it to the later stages such as NASH and cirrhosis.

The only proven treatment strategy for NAFLD is lifestyle modifications; it has been shown that 10% weight loss within 6 months is associated with improvement of the disease [2]. Also, the superiority of adding dietary supplements to the lifestyle modifications have been shown previously [3,4]. Supplementation with probiotics has shown promising effects on the management of NAFLD in relatively long time [5-7]. Furthermore, adding Cinnamon and turmeric, as insulin sensitizes, to the dietary intakes increased the efficacy of diet therapy in patients with NAFLD [8,9]. Resveratrol, as an anti-oxidant agent, also reduces both inflammation [10,11], and metabolic disturbances [12] in patients with NAFLD. Moreover, flaxseed supplementation, as an excellent source of lignans, n-3 fatty acids, and fibre, has shown significant beneficial effects on the all characteristics of NAFLD [13]. Thus, it seems that addition of supplements with anti-inflammatory, anti-oxidative, and insulin sensitizer effects can help patients with NAFLD to manage their disease more conveniently.

In conclusion, adherence to a healthy life style and a preferred dietary supplementation should be advised in patients with NAFLD. Considering the high prevalence of the disease in overweight people, and people with metabolic syndrome, these guidelines should be provided for all people at risk of development of the disease.

References

1. Rinella ME (2015) Nonalcoholic fatty liver disease: a systematic review. JAMA 313:2263-2273.
2. Ghaemi A, Taleban FA, Hekmatdoost A, Rafiei A, Hosseini V, et al. (2013) How Much Weight Loss is Effective on Nonalcoholic Fatty Liver Disease? Hepat Mon 13:e15227.
3. Eslamparast T, Eghtesad S, Poustchi H, Hekmatdoost A (2015) Recent advances in dietary supplementation, in treating non-alcoholic fatty liver disease. World J Hepatol 7:204-212.
4. Rahimlou M, Ahmadnia H, Hekmatdoost A (2015) Dietary supplements and pediatric non-alcoholic fatty liver disease: Present and the future. World J Hepatol 7:2597-2602.
5. Eslamparast T, Poustchi H, Zamani F, Sharafkhah M, Malekzadeh R, et al. (2014) Synbiotic supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. Am J ClinNutr99:535-542.
6. Eslamparast T, Zamani F, Hekmatdoost A, Sharafkhah M, Eghtesad S, et al. (2014) Effects of synbiotic supplementation on insulin resistance in subjects with the metabolic syndrome: a randomised, double-blind, placebo-controlled pilot study. Br J Nutr 112:438-445.
7. Eslamparast T, Eghtesad S, Hekmatdoost A, Poustchi H (2013) Probiotics and Nonalcoholic Fatty liver Disease. Middle East J Dig Dis 5:129-136.
8. Askari F, Rashidkhani B, Hekmatdoost A (2014) Cinnamon may have therapeutic benefits on lipid profile, liver enzymes, insulin resistance, and high-sensitivity C-reactive protein in nonalcoholic fatty liver disease patients. Nutr Res 34:143-148.
9. Ghorbani Z, Hekmatdoost A, Mirmiran P (2014) Anti-hyperglycemic and insulin sensitizer effects of turmeric and its principle constituent curcumin. Int J Endocrinol Metab 12:e18081.
10. Faghihzadeh F, Adibi P, Rafiei R, Hekmatdoost A (2014) Resveratrol supplementation improves inflammatory biomarkers in patients with nonalcoholic fatty liver disease. Nutr Res 34:837-843.
11. Faghihzadeh F, Hekmatdoost A, Adibi P (2015) Resveratrol and liver: A systematic review: the official journal of Isfahan University of Medical Sciences. J Res Med Sci 20:797-810.
12. Faghihzadeh F, Adibi P, Hekmatdoost A (2015) The effects of resveratrol supplementation on cardiovascular risk factors in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled study. Br J Nutr 114:796-803.
13. Yari Z, Rahimlou M, Eslamparast T, Ebrahimi DN, Poustchi H, et al. (2016) Flaxseed supplementation in non-alcoholic fatty liver disease: a pilot randomized, open labeled, controlled study. Int J Food Sci Nutr 1:1-9.