EFFECTS OF NUTRITIONAL THERAPIES ON THE DEVELOPMENT AND TREATMENT OF NON-ALCOHOLIC FATTY LIVER DISEASE
DOI:
https://doi.org/10.56238/arev7n11-266Keywords:
Liver Disease, Nutritional Therapy, Hepatic MetabolismAbstract
Nonalcoholic fatty liver disease (NAFLD) is characterized by the accumulation of fat in the liver in individuals without a history of significant alcohol consumption, being associated with factors such as obesity, insulin resistance, and metabolic syndrome. In the absence of specific pharmacological treatments, nutritional therapy has emerged as an essential strategy for the treatment and prevention of disease progression. This study aims to relate the nutritional effects to the biochemical mechanisms of nonalcoholic fatty liver disease, as well as to identify the most commonly adopted nutritional practices in the management and treatment of the disease and to evaluate the effectiveness of different approaches in improving patients’ nutritional status and clinical outcomes. An integrative literature review was conducted using the LILACS and PubMed databases, selecting ten articles published between 2015 and 2025 that address nutritional interventions in nonalcoholic fatty liver disease (NAFLD). The data were tabulated and organized using the PRISMA 2020 diagram. The results demonstrate that lifestyle changes, especially the adoption of the Mediterranean diet, low intake of carbohydrates and proteins, regular physical exercise, and supplementation with vitamins, omega-3 fatty acids, and L-citrulline, are effective in improving hepatic steatosis, insulin resistance, and inflammatory markers. Personalized nutritional strategies, adapted to the genetic profile and clinical conditions of patients, proved essential for therapeutic success. It is concluded that the combination of nutritional therapy and physical activity constitutes the safest and most effective approach for controlling NAFLD, highlighting the importance of multidisciplinary support in improving clinical outcomes.
Downloads
References
ANANIA, Caterina et al. Mediterranean diet and nonalcoholic fatty liver disease. World journal of gastroenterology, v. 24, n. 19, p. 2083, 2018. DOI: https://doi.org/10.3748/wjg.v24.i19.2083
BENEDICT, Mark; ZHANG, Xuchen. Non-alcoholic fatty liver disease: An expanded review. World journal of hepatology, v. 9, n. 16, p. 715, 2017. DOI: https://doi.org/10.4254/wjh.v9.i16.715
BRASIL. Ministério da Saúde. Doação de órgãos: fígado. Disponível em: https://www.gov.br/saude/pt-br/composicao/saes/snt/doacao-de-orgaos/transplante-orgaos/figado. Acesso em: 15 set. 2024.
CALMET, Fernando; MARTIN, Paul; PEARLMAN, Michelle. Nutrition in patients with cirrhosis. Gastroenterology & hepatology, v. 15, n. 5, p. 248, 2019.
CARO-SABIDO, E. A.; LARROSA-HARO, A. Eficacia de la intervención nutricia y de la actividad física en niños y adolescentes con hígado graso no alcohólico asociado a obesidad: revisión sistemática exploratoria. Revista de Gastroenterología de México, v. 84, n. 2, p. 185-194, 2019. DOI: https://doi.org/10.1016/j.rgmx.2019.02.001
CHEN, Lian-hui et al. Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials. Clinical nutrition, v. 37, n. 2, p. 516-521, 2018. DOI: https://doi.org/10.1016/j.clnu.2016.12.009
CLEMENTE, Maria Grazia et al. Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions. World journal of gastroenterology, v. 22, n. 36, p. 8078, 2016. DOI: https://doi.org/10.3748/wjg.v22.i36.8078
FONSECA, Gustavo Soares Gomes Barros et al. Cirrose hepática e suas principais etiologias: Revisão da literatura. E-Acadêmica, v. 3, n. 2, p. e8332249-e8332249, 2022. DOI: https://doi.org/10.52076/eacad-v3i2.249
HAYASHI, Fumikazu et al. Physical inactivity and insufficient dietary intake are associated with the frequency of sarcopenia in patients with compensated viral liver cirrhosis. Hepatology Research, v. 43, n. 12, p. 1264-1275, 2013. DOI: https://doi.org/10.1111/hepr.12085
HERNANDEZ-RODAS, Maria Catalina; VALENZUELA, Rodrigo; VIDELA, Luis A. Relevant aspects of nutritional and dietary interventions in non-alcoholic fatty liver disease. International journal of molecular sciences, v. 16, n. 10, p. 25168-25198, 2015. DOI: https://doi.org/10.3390/ijms161025168
JANCZYK, Wojciech et al. Omega-3 Fatty acids therapy in children with nonalcoholic Fatty liver disease: a randomized controlled trial. The Journal of pediatrics, v. 166, n. 6, p. 1358-1363. e3, 2015. DOI: https://doi.org/10.1016/j.jpeds.2015.01.056
JAVAID, Nida et al. Evaluating the impact of early nutritional assessment and intervention in hospitalized liver cirrhosis patients. Arquivos de Gastroenterologia, v. 59, n. 01, p. 22-28, 2022. DOI: https://doi.org/10.1590/s0004-2803.202200001-05
JAVAID, Nida; IQBAL, Ayesha Zafar; HAMEEDA, Maryam. Nutritional management of liver cirrhosis and its complications in hospitalized patients. Arquivos de gastroenterologia, v. 58, p. 246-252, 2021. DOI: https://doi.org/10.1590/s0004-2803.202100000-43
KUDO, Maya et al. L‐citrulline inhibits body weight gain and hepatic fat accumulation by improving lipid metabolism in a rat nonalcoholic fatty liver disease model. Food Science & Nutrition, v. 9, n. 9, p. 4893-4904, 2021. DOI: https://doi.org/10.1002/fsn3.2439
LIMA, Manuela Machado. Perfíl Clínico e Epidemiológico das Doenças Hepáticas Crônicas da Cidade de Teresópolis. Revista da JOPIC, v. 4, n. 8, 2020.
MIQUELITO, Juliana; SIQUEIRA, Emílio Conceição. Evolução da doença hepática gordurosa não alcoólica: revisão de literatura. Revista de Saúde, v. 13, n. 1, p. 34-40, 2022. DOI: https://doi.org/10.21727/rs.v13i1.2915
MIRANDA, Letycia Paraiso Brandão et al. Estado nutricional e avaliação do global leadership initiative on malnutrition em pacientes com doença hepática crônica acompanhados em um hospital escola. Caderno Pedagógico, v. 21, n. 3, p. e3140-e3140, 2024. DOI: https://doi.org/10.54033/cadpedv21n3-063
MUSA-VELOSO, Kathy et al. Systematic review and meta-analysis of controlled intervention studies on the effectiveness of long-chain omega-3 fatty acids in patients with nonalcoholic fatty liver disease. Nutrition reviews, v. 76, n. 8, p. 581-602, 2018. DOI: https://doi.org/10.1093/nutrit/nuy022
OLIVEIRA, Claudia P. et al. Nutrition and physical activity in nonalcoholic fatty liver disease. Journal of diabetes research, v. 2016, n. 1, p. 4597246, 2016. DOI: https://doi.org/10.1155/2016/4597246
PAPPACHAN, Joseph M. et al. Non-alcoholic fatty liver disease: a clinical update. Journal of clinical and translational hepatology, v. 5, n. 4, p. 384, 2017. DOI: https://doi.org/10.14218/JCTH.2017.00013
PONTE, Isabelle Meneses et al. Esteato-hepatite não alcoólica: uma síndrome em evidência. Brazilian Journal of Health Review, v. 3, n. 1, p. 1077-1093, 2020. DOI: https://doi.org/10.34119/bjhrv3n1-084
RIBEIRO, Paula Mendes et al. Importância da terapia nutricional em pacientes com esteatose hepática não alcoólica: uma revisão narrativa. Revista Eletrônica Acervo Saúde, v. 15, n. 7, p. e10627-e10627, 2022. DOI: https://doi.org/10.25248/reas.e10627.2022
ROCHA, Beatriz Rodrigues et al. Influência dos alimentos funcionais na incidência das doenças crônicas não transmissíveis (DCNT). Intercontinental Journal on Physical Education ISSN 2675-0333, v. 3, n. 1, p. 1-20, 2021.
RODRÍGUEZ-CARRILLO, Alan Arturo et al. Impact of L-Citrulline Supplementation and HIIT on Lipid Profile, Arterial Stiffness, and Fat Mass in Obese Adolescents with Metabolic-Dysfunction-Associated Fatty Liver Disease: A Randomized Clinical Trial. Nutrients, v. 17, n. 3, p. 402, 2025. DOI: https://doi.org/10.3390/nu17030402
ROMAN, Sonia et al. Genome-based nutrition: an intervention strategy for the prevention and treatment of obesity and nonalcoholic steatohepatitis. World Journal of Gastroenterology: WJG, v. 21, n. 12, p. 3449, 2015. DOI: https://doi.org/10.3748/wjg.v21.i12.3449
SIMANCAS-RACINES, Daniel et al. Nutritional Strategies for Battling Obesity-Linked Liver Disease: the Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management. Current Obesity Reports, v. 14, n. 1, p. 1-16, 2025.
SIMANCAS-RACINES, Daniel et al. Nutritional Strategies for Battling Obesity-Linked Liver Disease: the Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management. Current Obesity Reports, v. 14, n. 1, p. 1-16, 2025. DOI: https://doi.org/10.1007/s13679-024-00597-6
TANTAI, Xinxing et al. Effect of sarcopenia on survival in patients with cirrhosis: a meta-analysis. Journal of hepatology, v. 76, n. 3, p. 588-599, 2022. DOI: https://doi.org/10.1016/j.jhep.2021.11.006
TRAUB, Julia et al. Malnutrition in patients with liver cirrhosis. Nutrients, v. 13, n. 2, p. 540, 2021. DOI: https://doi.org/10.3390/nu13020540
VIEIRA, Karina Amante et al. Aspectos nutricionais na DHGNA: mecanismos de desenvolvimento e tratamento da esteatose hepática não alcoólica. Demetra: Alimentação, Nutrição & Saúde, v. 15, p. e43955, 2020. DOI: https://doi.org/10.12957/demetra.2020.43955
VILAR-GOMEZ, Eduardo et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology, v. 149, n. 2, p. 367-378. e5, 2015. DOI: https://doi.org/10.1053/j.gastro.2015.04.005
VIRGOLINO, Ivna Paola Arruda Câmara et al. Doença hepática gordurosa não alcoólica: uma revisão da fisiopatologia ao tratamento. Brazilian Journal of Health Review, Curitiba, v. 7, n. 3, p. 01-12, maio/jun. 2024. DOI: https://doi.org/10.34119/bjhrv7n3-141
YANG, Fuwei et al. O valor da deficiência grave de vitamina D na predição do risco de mortalidade de pacientes com cirrose hepática: uma meta-análise. Clinics and Research in Hepatology and Gastroenterology. V. 43, p.722–729, 2019.
