Ernährungstherapie der nichtalkoholischen
                    Fettleber

Nicolai Worm

doi:10.1055/a-0636-1743

Ernährung & Medizin, Table of Contents

Ernährung & Medizin 2018; 33(03): 111-118
DOI: 10.1055/a-0636-1743

Praxis

Ernährungstherapie der nichtalkoholischen Fettleber

Von Leberfasten zur mediterranen Low-Carb-Ernährung

Nicolai Worm

Abstract

Zusammenfassung

Lange Zeit unterschätzt, hat sich die nichtalkoholische Fettlebererkrankung innerhalb von 3 Jahrzehnten zur am weitesten verbreiteten Lebererkrankung in den Industrienationen entwickelt [1]. Mittlerweile erlangt sie epidemische Ausmaße und ist damit zu einer bedrohlichen Volkskrankheit geworden.

Full Text

References

Literatur
1 Younossi Z, Anstee QM, Marietti M. et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol 2018; 15: 11-20
2 Arab JP, Arrese M, Trauner M. Recent insights into the pathogenesis of nonalcoholic fatty liver disease. Annu Rev Pathol 2018; 13: 321-350
3 Roeb E, Steffen HM, Bantel H. et al. S2k-Leitlinie nicht alkoholische Fettlebererkrankungen. Z Gastroenterol 2015; 53: 668-723
4 Lazo M, Hernaez R, Eberhardt MS. et al. Prevalence of nonalcoholic fatty liver disease in the United States: the Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol 2013; 178: 38-45
5 Wattacheril J, Sanyal AJ. Lean NAFLD: An underrecognized outlier. Curr Hepatol Rep 2016; 15: 134-139
6 Adams LA, Anstee QM, Tilg H. et al. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases. Gut 2017; 66: 1138-1153
7 Lonardo A, Sookoian S, Pirola CJ. et al. Non-alcoholic fatty liver disease and risk of cardiovascular disease. Metabolism 2016; 65: 1136-1150
8 Taylor R. Type 2 diabetes: etiology and reversibility. Diabetes Care 2013; 36: 1047-1055
9 Targher G, Lonardo A, Byrne CD. Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus. Nat Rev Endocrinol 2018; 14: 99-114
10 Mantovani A, Byrne CD, Bonora E. et al. Nonalcoholic fatty liver disease and risk of incident type 2 diabetes: A meta-analysis. Diabetes Care 2018; 41: 372-382
11 Zhou YY, Zhou XD, Wu SJ. et al. Synergistic increase in cardiovascular risk in diabetes mellitus with nonalcoholic fatty liver disease: a meta-analysis. Eur J Gastroenterol Hepatol 2018; 30: 631-636
12 Araujo AR, Rosso N, Bedogni G. et al. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future. Liver Int 2018; 38 (Suppl. 01) 47-51
13 Bril F, Cusi K. Management of nonalcoholic fatty liver disease in patients with type 2 diabetes: A call to action. Diabetes Care 2017; 40: 419-430
14 Kuhn JP, Meffert P, Heske C. et al. Prevalence of fatty liver disease and hepatic iron overload in a Northeastern German population by using quantitative MR imaging. Radiology 2017; 284: 706-716
15 Cusi K. Role of obesity and lipotoxicity in the development of nonalcoholic steatohepatitis: pathophysiology and clinical implications. Gastroenterology 2012; 142: 711-725.e716
16 Shulman GI. Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease. N Engl J Med 2014; 371: 1131-1141
17 Byrne CD, Targher G. NAFLD: a multisystem disease. J Hepatol 2015; 62 (Suppl. 01) S47-64
18 Donnelly KL, Smith CI, Schwarzenberg SJ. et al. Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease. J Clin Invest 2005; 115: 1343-1351
19 Ferre P, Foufelle F. Hepatic steatosis: a role for de novo lipogenesis and the transcription factor SREBP-1c. Diabetes Obes Metab 2010; 12 (Suppl. 02) 83-92
20 Ferramosca A, Zara V. Modulation of hepatic steatosis by dietary fatty acids. World J Gastroenterol 2014; 20: 1746-1755
21 Lambert JE, Ramos-Roman MA, Browning JD. et al. Increased de novo lipogenesis is a distinct characteristic of individuals with nonalcoholic fatty liver disease. Gastroenterology 2014; 146: 726-735
22 Ameer F, Scandiuzzi L, Hasnain S. et al. De novo lipogenesis in health and disease. Metabolism 2014; 63: 895-902
23 Ma W, Wu JH, Wang Q. et al. Prospective association of fatty acids in the de novo lipogenesis pathway with risk of type 2 diabetes: the Cardiovascular Health Study. Am J Clin Nutr 2015; 101: 153-163
24 Jacobs S, Jager S, Jansen E. et al. Associations of erythrocyte fatty acids in the de novo lipogenesis pathway with proxies of liver fat accumulation in the EPIC-Potsdam Study. PLoS One 2015; 10: e0127368
25 Kotronen A, Vehkavaara S, Seppala-Lindroos A. et al. Effect of liver fat on insulin clearance. Am J Physiol Endocrinol Metab 2007; 293: E1709-1715
26 Schwarz JM, Linfoot P, Dare D. et al. Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high-fat, low-carbohydrate and low-fat, high-carbohydrate isoenergetic diets. Am J Clin Nutr 2003; 77: 43-50
27 Martens EA, Gatta-Cherifi B, Gonnissen HK. et al. The potential of a high protein-low carbohydrate diet to preserve intrahepatic triglyceride content in healthy humans. PLoS One 2014; 9: e109617
28 Petersen KF, Dufour S, Savage DB. et al. The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome. Proc Natl Acad Sci USA 2007; 104: 12587-12594
29 Schwarz JM, Noworolski SM, Wen MJ. et al. Effect of a high-fructose weight-maintaining diet on lipogenesis and liver fat. J Clin Endocrinol Metab 2015; 100: 2434-2442
30 Tappy L. Fructose-containing caloric sweeteners as a cause of obesity and metabolic disorders. J Exp Biol. 2018 221. (Pt Suppl 1)
31 Green CJ, Hodson L. The influence of dietary fat on liver fat accumulation. Nutrients 2014; 6: 5018-5033
32 Juarez-Hernandez E, Chavez-Tapia NC, Uribe M. et al. Role of bioactive fatty acids in nonalcoholic fatty liver disease. Nutr J 2016; 15: 72
33 Parry SA, Hodson L. Influence of dietary macronutrients on liver fat accumulation and metabolism. J Investig Med 2017; 65: 1102-1115
34 Mardinoglu A, Wu H, Bjornson E. et al. An integrated understanding of the rapid metabolic benefits of a carbohydrate-restricted diet on hepatic steatosis in humans. Cell Metab. 2018; 27: 559-571.e555
35 Taylor R, Holman RR. Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Clin Sci (Lond) 2015; 128: 405-410
36 Haufe S, Haas V, Utz W. et al. Long-lasting improvements in liver fat and metabolism despite body weight regain after dietary weight loss. Diabetes Care 2013; 36: 3786-3792
37 Elias MC, Parise ER, de Carvalho L. et al. Effect of 6-month nutritional intervention on non-alcoholic fatty liver disease. Nutrition 2010; 26: 1094-1099
38 Browning JD, Davis J, Saboorian MH. et al. A low-carbohydrate diet rapidly and dramatically reduces intrahepatic triglyceride content. Hepatology 2006; 44: 487-488
39 Browning JD, Baker JA, Rogers T. et al. Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction. Am J Clin Nutr 2011; 93: 1048-1052
40 Bian H, Hakkarainen A, Lundbom N. Effects of dietary interventions on liver volume in humans. Obesity 2014; 22: 989-995
41 Kirk E, Reeds DN, Finck BN. et al. Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction. Gastroenterology 2009; 136: 1552-1560
42 Gepner Y, Shelef I, Schwarzfuchs D. et al. Effect of distinct lifestyle interventions on mobilization of fat storage pools: CENTRAL magnetic resonance imaging randomized controlled trial. Circulation 2018; 137: 1143-1157
43 Purcell K, Sumithran P, Prendergast LA. et al. The effect of rate of weight loss on long-term weight management: a randomised controlled trial. Lancet Diabetes Endocrinol 2014; 2: 954-962
44 Anderson JW, Konz EC, Frederich RC. et al. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001; 74: 579-584
45 Johansson K, Neovius M, Hemmingsson E. Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2014; 99: 14-23
46 Rehackova L, Arnott B, Araujo-Soares V. et al. Efficacy and acceptability of very low energy diets in overweight and obese people with Type 2 diabetes mellitus: a systematic review with meta-analyses. Diabet Med 2016; 33: 580-591
47 Leslie WS, Taylor R, Harris L. et al. Weight losses with low-energy formula diets in obese patients with and without type 2 diabetes: systematic review and meta-analysis. Int J Obes 2017; 41: 96-101
48 Rehackova L, Araujo-Soares V, Adamson AJ. et al. Acceptability of a very-low-energy diet in Type 2 diabetes: patient experiences and behaviour regulation. Diabet Med 2017; 34: 1554-1567
49 Hemmingsson E, Johansson K, Eriksson J. et al. Weight loss and dropout during a commercial weight-loss program including a very-low-calorie diet, a low-calorie diet, or restricted normal food: observational cohort study. Am J Clin Nutr 2012; 96: 953-961
50 Lim EL, Hollingsworth KG, Aribisala BS. et al. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011; 54: 2506-2514
51 Steven S, Taylor R. Restoring normoglycaemia by use of a very low calorie diet in long- and short-duration Type 2 diabetes. Diabet Med 2015; 32: 1149-1155
52 Sato K, Gosho M, Yamamoto T. et al. Vitamin E has a beneficial effect on nonalcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Nutrition 2015; 31: 923-930
53 Bozzetto L, Prinster A, Annuzzi G. et al. Liver fat is reduced by an isoenergetic MUFA diet in a controlled randomized study in type 2 diabetic patients. Diabetes Care 2012; 35: 1429-1435
54 Ryan MC, Itsiopoulos C, Thodis T. et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol 2013; 59: 138-143
55 Errazuriz I, Dube S, Slama M. et al. Randomized controlled trial of a MUFA or fiber-rich diet on hepatic fat in prediabetes. J Clin Endocrinol Metab 2017; 102: 1765-1774
56 Pirozzi C, Lama A, Simeoli R. et al. Hydroxytyrosol prevents metabolic impairment reducing hepatic inflammation and restoring duodenal integrity in a rat model of NAFLD. J Nutr Biochem 2016; 30: 108-115
57 Soto-Alarcon SA, Valenzuela R, Valenzuela A. et al. Liver protective effects of extra virgin olive oil: Interaction between its chemical composition and the cell-signaling pathways involved in protection. Endocr Metab Immune Disord Drug Targets 2018; 18: 75-84
58 Wang N, Liu Y, Ma Y. et al. Hydroxytyrosol ameliorates insulin resistance by modulating endoplasmic reticulum stress and prevents hepatic steatosis in diet-induced obesity mice. J Nutr Biochem 2018; 57: 180-188
59 Lu W, Li S, Li J. et al. Effects of omega-3 fatty acid in nonalcoholic fatty liver disease: A meta-analysis. Gastroenterol Res Pract 2016; 2016: 1459790
60 Scorletti E, Byrne CD. Omega-3 fatty acids and non-alcoholic fatty liver disease: Evidence of efficacy and mechanism of action. Mol Aspects Med; 2018 doi:10.1016/j.mam.2018.03.001
61 Bortolotti M, Maiolo E, Corazza M. et al. Effects of a whey protein supplementation on intrahepatocellular lipids in obese female patients. Clin Nutr 2011; 30: 494-498
62 Markova M, Pivovarova O, Hornemann S. et al. Isocaloric diets high in animal or plant protein reduce liver fat and inflammation in individuals with type 2 diabetes. Gastroenterology 2017; 152: 571-585.e578
63 O’Connor S, Chouinard-Castonguay S, Gagnon C. et al. Prebiotics in the management of components of the metabolic syndrome. Maturitas 2017; 104: 11-18
64 Ströhle A, Wolters M, Hahn A. Gesundheitliche Effekte von Ballaststoffen. Ein Update, Teil 2: Systemische Effekte und Präventionspotenzial. Dtsch Apotheker Ztg 2012; 152: 54-65
65 Abenavoli L. Non-alcoholic fatty liver disease and beneficial effects of dietary supplements. World J Hepatol 2015; 7: 1723-1724
66 Worm N, Teutsch M. Leberfasten nach Dr. Worm: Das innovative Low-Carb-Programm gegen die Fettleber. Stuttgart: TRIAS-Verlag; 2015
67 Worm N. Flexi-Carb! Mediterran genießen. Lebensstil beachten – Kohlenhydrate anpassen. Schlank und gesund bleiben. München: riva-Verlag; 2015
68 Lemberger H, Mangiameli F, Worm N. Flexi-Carb – Das Kochbuch. Mit 60 Rezepten in verschiedenen Kohlenhydratstufen. München: riva-Verlag; 2015
69 Worm N, Mangiameli F, Lemberger H. Die Flexi-Diät. Abnehmen mit mediterranem Low Carb – mit und ohne Mahlzeitenersatz. München: riva-Verlag; 2017
70 Teutsch M. Effekte einer auf Leberentfettung abgestimmten ergänzenden bilanzierten Diät auf Stoffwechsel und Anthropometrie. Adipositas 2014; 8: 177-234
71 Arslanow A, Teutsch M, Walle H. et al. Short-term hypocaloric high-fiber and high-protein diet improves hepatic steatosis assessed by controlled attenuation parameter. Clin Transl Gastroenterol 2016; 7: e176
72 Teufelhart M, Hofer H, Haslacher H. et al. Verbesserung der Lebersteifigkeit durch den Einsatz von HEPAFAST^®-Proteinshakes bei nicht- alkoholischen Fettlebererkrankungen (NAFLD). 8 Jahrestagung der Österreichischen Adipositas Gesellschaft. Wien: 2017
73 Schweinlin A, Ulbrich S, Stauß S. et al. Diätetische Therapie der nichtalkoholischen Fettlebererkrankung – eine randomisierte, kontrollierte Interventionsstudie. 55 Wissenschaftlicher Kongress der Deutschen Gesellschaft für Ernährung eV. Universität Hohenheim; 2018
74 Schweinlin A, Ulbrich S, Stauß S. et al. Vergleich einer Formula-basierten Ernährungstherapie mit Haferballaststoffen und einer isokalorischen diätetischen Therapie ohne Formula zur Therapie der nichtalkoholischen Fettlebererkrankung (NAFLD) – eine randomisierte, kontrollierte Interventionsstudie. Z Gastroenterol. 2018 [im Druck]
75 Worm N. Die LOGI-Methode in Theorie und Praxis – Glücklich und schlank. Lünen: Systemed-Verlag; 2003