Abstract
Aim: To investigate the efficacy of lifestyle adjustment strategies as a preventive measure and/or treatment of obesity-related non-alcoholic fatty liver disease in adults. Method: A systematic review of literature through 1 July 2017 on the PubMed Database was performed. A comprehensive search was conducted using key terms, such as non-alcoholic fatty liver disease (NAFLD), combined with lifestyle intervention, diet, and exercise. All of the articles and studies obtained from the search were reviewed. Redundant literature was excluded. Results: Several types of dietary compositions and exercise techniques were identified. Most studies concluded and recommended reduction in the intake of saturated and trans fatty acids, carbohydrates, and animal-based protein, and increased intake of polyunsaturated fatty acids (PUFAs), monounsaturated fatty acids (MUFAs), plant-based proteins, antioxidants, and other nutrients was recommended. The Mediterranean and Paleo diet both seem to be promising schemes for NAFLD patients to follow. Exercise was also encouraged, but the type of exercise did not affect its efficacy as a NAFLD treatment when the duration is consistent. Conclusions: Although these different dietary strategies and exercise regimens can be adopted to treat NAFLD, current literature on the topic is limited in scope. Further research should be conducted to truly elucidate which lifestyle adjustments individually, and in combination, may facilitate patients with obesity-related NAFLD.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is a significant global health concern that has been increasing at an alarming rate
Endogenous choline sources do produce enough to meet the body requirements, leaving an individual in a state of choline deficiency [40]. This increases de novo hepatic lipogenesis, decreases bile acid synthesis, and promotes cholesterol accumulation, which leads to hepatic steatosis that eventually progresses to NAFLD [40]
There are many types of diet compositions and exercise techniques that can be adopted to modify the lifestyles of patients with NAFLD in an effort prevent, treat, and or retard the progression of disease
Summary
Non-alcoholic fatty liver disease (NAFLD) is a significant global health concern that has been increasing at an alarming rate. The global epidemic of obesity has increased the risk of metabolic syndrome [2,3]. Weight loss is the primary treatment for obesity, a primary cause of NAFLD with common risk factors, such as cardiovascular disease, diabetes, hypertension, dyslipidemia, and metabolic syndrome [4]. While weight loss alone in overweight and obese to ideal body weight may help to prevent and treat NAFLD, exercise, and other treatment interventions must be instituted on an individualized basis in lean NALFD patients who have underlying insulin resistance and metabolic irregularities [2,5]. The overall and basic goals of lifestyle-based treatment include caloric restriction, changes in diet composition, increased exercise, stress reduction, and improved sleep, and are indicated in Figure 1 [8]. An individualized assessment should be employed to determine the proper lifestyle adaptation for each patient
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