Abstract
There are very few reports about the intake of nutrients for the development or progression of non-alcoholic steatohepatitis (NASH). The aim of this study was to identify the dietary habits and the nutrient intake in patients with NASH, in comparison to chronic hepatitis C (HCV)-related patients. We prospectively evaluated the intake of macronutrients and micronutrients in 124 NAFLD and 162 HCV patients, compared to 2326 subjects as a control group. We noticed major differences in macro- and micronutrients intakes in NASH and HCV patients compared to controls. Proteins, carbohydrate (glucose, fructose, sucrose, maltose and amide), saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), folic acid, vitamin A and C (p < 0.0001), and thiamine (p < 0.0003) ingestion was found to be higher in patients with NASH, while total lipids, polyunsaturated fatty acid (PUFA), riboflavin and vitamin B6 daily intake were lower compared to controls (p < 0.0001). Similarly, NASH patients had significantly reduced carbohydrate intake (p < 0.0001) and an increased intake of calcium (p < 0.0001) compared to HCV positive patients. Finally, we showed in NASH males an increase in the intake of SFA, PUFA, soluble carbohydrates (p < 0.0001) and a decrease in the amount of fiber (p < 0.0001) compared to control males. In NASH female population, we showed an increase of daily total calories, SFA, MUFA, soluble carbohydrates, starch and vitamin D ingested (p < 0.0001) with a reduction of fibers and calcium (p < 0.0001) compared to control females. This study showed how NASH patients’ diets, in both male and females, is affected by a profound alteration in macro- and micronutrients intake.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is defined as a progressive disease caused by an increased fat storage in the liver of patients who do not consume excessive alcohol and do not have any type of virus related liver disease [1]
Its close association with obesity and with insulin resistance and dyslipidemia led to the hypothesis that NAFLD is the hepatic manifestation of metabolic syndrome [8]
We studied 2326 apparently healthy blood donors who were negative for HCV antibody and hepatitis B surface antigen (HBsAg), and had normal liver tests
Summary
Non-alcoholic fatty liver disease (NAFLD) is defined as a progressive disease caused by an increased fat storage in the liver of patients who do not consume excessive alcohol and do not have any type of virus related liver disease [1] It is considered the hepatic manifestation of metabolic syndrome [2], and represents a growing challenge in terms of prevention and treatment. The prevalence of NAFLD is rapidly increasing, ranging 20–30% in the general population [3]; it is strongly associated with obesity and is found in up to 91% of severely obese patients undergoing bariatric surgery, and up to 5% of these patients may have unsuspected cirrhosis [4]. Its close association with obesity and with insulin resistance and dyslipidemia led to the hypothesis that NAFLD is the hepatic manifestation of metabolic syndrome [8]
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