Effective roles of exercise and diet adherence in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is characterized by symptoms of excessive fat accumulation and steatosis in the liver without alcohol intake in patients.The associated pathogenic mechanism is not completely understood and there are no specific drugs for patients with NAFLD.Exercise and diet adherence are the best options for the management of NAFLD patients.Questionnaire associated analysis models of adherence to these interventions are used to assess their effectiveness in the management of NAFLD patients using specificity,sensitivity,and so on.Studies have indicated that the relative ratio of NAFLD can be reduced by physical activity with diet control.In the future,the pathogenesis of NAFLD should be clarified with stratified efforts to develop appropriate drugs,and both exercise and diet adherence should be optimized using better questionnaire design and evaluation models for patients with NAFLD.

Metabolic response to 6-week aerobic exercise training and dieting in previously sedentary overweight and obese pre-menopausal women:A randomized trial

Background： The aim of this study was to compare 6 weeks short-term moderate intensity aerobic exercise and dieting on serum metabolomics and cardio-metabolic risk factors in pre-menopausal women. Methods： Ninety previously inactive overweight and obese （BMI 25-35 kg/m2） women （age 41.5 ± 7.6 years） were randomized to either a 6-week Nordic walking exercise program （EX, n = 45） or dietary counseling group （DI, n = 45）. Body composition, serum glucose, insulin and lipids were measured. Serum low-molecular-weight metabolites and lipid constituents were analyzed by nuclear magnetic resonance spectroscopy. Measurements were done at baseline and 7 days after the last training session. Results： Six weeks aerobic exercise program yielded reductions in serum free fatty acids （-34.7%, 95% confidence interval （CI）, -50 to -18, p 〈 0.001）, glucose （-9.6%, 95%CI, -15 to -4, p 〈 0.001） and homeostasis model assessment of insulin resistance （HOMA-IR） （-28.7%, 95%CI, -48 to -10, p = 0.005） without changes in body weight or fat mass. Diet counseling resulted in loss of body weight （1.5%, 95%CI, -2.3 to -0.7, p = 0.001） but no changes in free fatty acids, fasting glucose, or HOMA-IR were found. Conclusion： Our results indicate that small weight loss does not produce measurable health benefits, whereas short-term regular aerobic exercise can improve glucose and lipid metabolism even in the absence of weight loss in previously sedentary overweight and obese women.

Regular moderate aerobic exercise improves high-fat diet-induced nonalcoholic fatty liver disease via monoacylglycerol O-acyltransferase 1 pathway suppression

Purpose:Monoacylglycerol O-acyltransferase 1(MGAT1)is reported to play a key role in the development of diet-induced nonalcoholic fatty liver disease(NAFLD).Thus,this study investigated the effect of exercise on suppression of the MGAT1 pathway in NAFLD tissue of high-fat diet(HFD)-induced obese rats.Methods:Male Sprague-Dawley rats were fed an HFD containing 45%fat for 6 weeks.Upon confirmation that NAFLD had been induced in the obese animals,they were divided into HFD-fed groups provided with exercise(HFD+EXE)or without exercise(HFD)and a group given dietary adjustment(DA)only,for a further 6 weeks of intervention treatment.The 6-week regular moderate aerobic exercise consisted of an accommodation phase with increasing exercise.Lipid accumulation in the liver tissue was determined by Oil Red O staining.The MGAT1 and liver lipogenic gene mRNA levels were measured by qPCR,and their protein levels by western blot assay.Results:Oil Red O staining showed that NAFLD was successfully induced by HFD-fed.The gene expression of MGAT1 was significantly lower in HFD+EXE than HFD.However,there was no significant difference between HFD+EXE and DA.The protein expression of MGAT1 was significantly lower in HFD+EXE than both HFD and DA.Messenger RNA and protein expression of other lipogenic genes were not different among groups.These data indicate that exercise suppresses MGAT1 pathway regardless of HFD feeding;in part,this effect could be greater than DA.Conclusion:Our data suggest that exercise can improve NAFLD,which is probably due to suppression of MGAT1 pathway.

Energy restriction and exercise modulate angiopoietins and vascular endothelial growth factor expression in the cavernous tissue of high-fat diet-fed rats

The purpose of the current study was to evaluate the effect of a high-fat （HF） diet, energy restriction and exercise on the expression of vascular endothelial growth factor （VEGF）, angiopoietin （Ang） I and 2, and their receptors in rat corpus cavernosum （CC）. Male Wistar rats were fed adlibitum with an H F diet for 8 or 16 weeks. After 8 weeks of the H F diet, a group of rats was subjected to energy restriction with or without exercise for 8 weeks. Control animals had free access to standard diet for the same period. After euthanasia, blood was collected and the penises removed for immunofluorescence assays （VEGF, VEGF receptor （VEGFR） I and 2, Angl, Ang2 and Tie2） and semiquantification of VEGF, VEGFR 1, VEGFR2, Angl, Ang2, Tie2, endothelial nitric oxide synthase （eNOS） and Aktlphospho-Akt by Western blotting. HF diet-fed rats exhibited lower high-density lipoprotein cholesterol （HDL-c） levels, higher systolic blood pressure and an increased atherogenic index. A significant increase in Ang2 expression in the CC was verified and coupled to a decrease in VEGF and VEGFRs. The Akt pathway was activated by the HF diet. Energy restriction and exercise increased eNOS expression and restored most HF diet-induced modifications except for VEGFR2 expression. These results emphasize the role of diet on vascular function regulation, demonstrating that cavernous imbalance of VEGF/VEGFRs and Angs/Tie2 systems occurs before serum lipid changes and obesity onset, antedating structural atherosclerotic features.

Exercise and Dietary Restriction for Promotion of Neurohealth Benefits

Physical exercise, whether aerobic, endurance or resistance types, plays a central role in establishing and maintaining the integrity of the brain and central nervous system (CNS). When exercise is adhered to in conjunction with selective food/drink intake and dietary restriction, it promotes neurohealth. In this article, we review the interactions of age and gender, as well as insulin and diabetes, with exercise, individuals’ cognitive-affective status and its interactions with exercise propensity, all of which modulate the eventual outcomes of the influence of exercise upon parameters of neurohealth. The combination of exercise with dietary restriction provides numerous factors pertaining to psychological, neurochemical and anti-pathological manifestations of neu-rophysiological resilience even through aging. The challenge evoked by the exercise-diet combination in the body mobilizes a multitude of adaptive cellular stress-response signaling pathways in neurons involving neurotrophic factors, anti-inflammatory cytokines, DNA-repair proteins, macroautophagy, and mitochondrial biogenesis.

Rearing Performance of Juvenile Brown Trout (<i>Salmo trutta</i>) Subjected to Exercise and Dietary Bioprocessed Soybean Meal

This 121-day experiment evaluated the rearing performance of brown trout Salmo trutta fed one of two isonitrogenous and isocaloric diets and reared at velocities of either 2.8 or 16.1 cm/s. Fishmeal was the primary protein source for the reference diet, and bioprocessed soybean meal replaced approximately 67% of the fishmeal in the experimental diet. At the end of the experiment, there were no significant differences in gain, percent gain, feed conversion rates, or specific growth rates between the dietary treatments. There were also no significant differences in intestinal morphology, splenosomatic, hepatosomatic, and viscerosomatic indices related to diet composition. However, gain, percent gain, feed fed, and specific growth rate were all significantly greater in brown trout reared at the higher velocity. No significant differences in any of the other variables measured were observed between the velocity treatments. There were no significant interactions between diet and velocity in any of the variables. Based on the results of this study, bioprocessed soybean meal can replace at least 67% of the fishmeal in brown trout diets, regardless of the rearing velocities used in this study. However, higher rearing velocities are recommended to maximize juvenile brown trout growth rates.

SESN2 ablation weakens exercise benefits on resilience of gut microbiota following high-fat diet consumption in mice

Gut dysbiosis is associated with several pathological processes.Previous study showed that regular exercise can protect against dysmetabolism in high-fat diet(HFD)fed mice through butyrate-SESN2 pathway,and SESN2 ablation weakened the protective effects of exercise.Here,we investigated whether SESN2-defi ciency suppresses the exercise response to microbiota composition and subsequently reduces the benefi ts of exercise on dysmetabolism induced by HFD.Wild type(WT)and SESN2^(-/-)mice were assigned to fi ve-groups,fed with either normal chow or HFD and with or without exercise training for 15-week.Fecal microbiota composition and function were assessed by 16S rRNA sequencing.The sequencing results showed that SESN2^(-/-)mice displayed differed microbiome profile from WT mice.Exercise enriched the microflora diversity and increased the benefi cial microbial species in WT mice,and SESN2 ablation weakened the benefi cial effects of exercise on microbial resilience following HFD consumption.Moreover,network analysis revealed that exercise increased correlation density and clustering of operational taxonomic units in WT mice only.KEGG demonstrated that some dominant metabolism-related enzymes and modules increased in SESN2^(-/-)mice.Our results indicated that the effects of exercise on metabolism are associated with the perturbations of gut microbiota composition and function,suggesting that SESN2 contributes to maintain metabolic homeostasis.

Do not forget diet and exercise during Ramadan

We conducted an analysis of internet search trends spanning from January 2022 to June 2023 in the ten most populous Muslim countries.Our study focused on key terms,including the prominent GLP1 analog"ozempic™",as well as"diet","exercise",and"diabetes".The findings revealed a substantial increase in searches for the GLP1 analog in eight countries.Concurrently,searches for"diet"and"exercise"predominantly exhibited a decline in nine and four countries,respectively.Notably,searches for"diabetes"displayed positive trends in only two countries.These patterns indicate a growing reliance on pharmaceutical interventions for managing diabetes and weight,often to the detriment of diet and exercise.Healthcare professionals and clinicians in Muslim countries should emphasize the importance of maintaining dietary and exercise regimens for patients with diabetes,even during the observance of Ramadan.

Integrated Review of Lifestyle Interventions Targeting Diet and Exercise in Early or First-Episode Psychosis

Aims: Life expectancy is reduced by 10 - 20 years in psychotic disorders compared with the general population, largely due to high incidence of physical health disorders: heart attack, stroke, obesity, cardiovascular disease (CVD), and type 2 diabetes. Early or first-episode psychosis patients can be especially vulnerable to physical health, psychological and social consequences of antipsychotic medication weight gain. The aim of this paper is to review diet and exercise lifestyle interventions employed to address these issues. Method: A review of research evidence on lifestyle interventions (diet and exercise) for individuals with early or first-episode psychosis (2000 to 2020) was undertaken. An internet-based literature search employed Medline, PsycINFO, Embase, PubMed and Web of Science. Results: Nine studies meeting the criteria were identified: comprising of three exercise intervention studies, one diet intervention study, and five combined diet and exercise intervention studies. Only one study used a RCT design with prior power analysis to determine participant numbers, two had a RCT design, two had a comparison group and four had no control group. Overall, these studies show that exercise and diet focused interventions may provide beneficial physical and mental health outcomes, but participant engagement and behaviour change may be difficult to achieve in early or first-episode psychosis due to individual factors associated with the experience of psychosis and medication prescribed, and health service related factors. Conclusion: There is a need for evidence-based lifestyle programmes in early or first-episode psychosis that includes individually targeted evidence based exercise and diet interventions. Further appropriately powered RCTs are required to strengthen the evidence base.

Both Diet and Exercise Are Necessary for Obese CKD Patients: A Pilot Prospective Randomized Controlled Study

Aim: This study aimed to examine the effects of exercise training on kidney function and nutrition status in obese Chronic Kidney Disease (CKD) patients. Methods: This is a prospective randomized controlled trial. Twelve adult obese CKD patients were randomly assigned to dietary instruction alone group (Group-D) or to both dietary instruction and exercise training group (Group-E). All patients received supervised dietary advice including calorie, protein, and salt intake for a period of 12 weeks. In addition, patients in Group-E underwent a fitness-training program. A change in glomerular filtration rate (GFR) was the main outcome. Secondary outcomes were changes in body mass index, serum creatinine-based estimated-GFR, serum albumin, and albuminuria. Results: Changes in GFR and all secondary outcomes were not statistically significant in either of the two groups. Although exercise training did not appear to significantly affect serum albumin levels in either group, it did present with a large sized effect. Conclusion: Exercise training might not have any effect on kidney function;however, the combination of exercise training along with dietary advice may prove to be more effective in maintaining the nutrition status when compared with dietary instructions alone in obese CKD patients. These results suggest that appropriate exercise training with dietary instructions is recommended for the treatment of obese CKD patients.

The Way Food, Diet, and Exercise Are Communicated in Women’s Health Magazine: From a Critical Perspective

Women’s Health Magazine creates a fantasy world for many women,in which they can attach themselves to the ideal beauty standards,and work towards reaching those ideals by engaging in diet and exercise.The advertisements in this magazine mostly give value to the Western ideal of white beauty,which is about the slenderness of the feminine physical body.However,the white beauty ideal makes women in different cultures such as the Turkish and Latin women to resemble this ideal by changing their darker hair colors to blonde,changing their darker eye colors to blue,and changing their curvy body types to slim;even though,their curviness represents sexual desire in their specific culture,and thus it leads these women to lose their cultural characteristics that make them more feminine(Mendible,2007,pp.3-8).In other words,the white ideal beauty causes many women in other cultures to have some kind of cultural assimilation in terms of their own beauty standards,and instead cause them to embrace an international standard of beauty that is Western,and many women such as the Turkish and Hispanic,as well as,the Korean,Chinese,and Japanese,undergo some kind of a process of cultural assimilation related to their cultural body characteristics,as a result(Yan&Bissell,2014,p.197).In other words,these women lose their indigenous body characteristics and they instead try to resemble the slender ideal body of the West with the spread of globalization,which has a major influence on that(Hoskins,2014,p.110).The aim of this paper is to show how the Women’s Health Magazine,a popular contemporary magazine,crates a discourse on food,diet,and exercise,which have a major influence in shaping and assimilating the body type of Turkish women from a critical perspective.

Pregnant Women with Diabetes under the Novel COVID-19 Pneumonia Epidemic Home Protection and Diet and Exercise Management

Under the epidemic situation of novel COVID-19 pneumonia, pregnant women belong to the susceptible population, and their physiological and psychological conditions are particularly worthy of attention. Diabetes patients during pregnancy may have a variety of complications, which can have a serious adverse impact on their own and fetal health. This article elaborates on home protection and diet and exercise guidance for pregnant women with diabetes in order to provide guidance for pregnant women with diabetes in a special period, and further prevent and control the pneumonia epidemic caused by novel COVID-19 infection in pregnant women.

Effectiveness of exercise in hepatic fat mobilization in nonalcoholic fatty liver disease: Systematic review

AIM: To investigate the efficacy of exercise interventions on hepatic fat mobilization in non-alcoholic fatty liver disease(NAFLD) patients.METHODS: Ovid-Medline, Pub Med, EMBASE and Cochrane database were searched for randomized trials and prospective cohort studies in adults aged ≥ 18 which investigated the effects of at least 8 wk of exercise only or combination with diet on NAFLD from 2010 to 2016. The search terms used to identify articles, in which exercise was clearly described by type, duration, intensity and frequency were: "NASH", "NAFLD", "nonalcoholic steatohepatitis", "non-alcoholic fatty liver disease", "fat", "steatosis", "diet", "exercise", "MR spectroscopy" and "liver biopsy". NAFLD diagnosis, as well as the outcome measures, was confirmed by either hydrogen-magnetic resonance spectroscopy(H-MRS) or biopsy. Trials that included dietary interventions along with exercise were accepted if they met all criteria. RESULTS: Eight studies met selection criteria(6 with exercise only, 2 with diet and exercise with a total of 433 adult participants). Training interventions ranged between 8 and 48 wk in duration with a prescribed exercise frequency of 3 to 7 d per week, at intensities between 45% and 75% of VO2 peak. The most commonly used imaging modality was H-MRS and one study utilized biopsy. The effect of intervention on fat mobilization was 30.2% in the exercise only group and 49.8% in diet and exercise group. There was no difference between aerobic and resistance exercise intervention, although only one study compared thetwo interventions. The beneficial effects of exercise on intrahepatic triglyceride(IHTG) were seen even in the absence of significant weight loss. Although combining an exercise program with dietary interventions augmented the reduction in IHTG, as well as improved measures of glucose control and/or insulin sensitivity, exercise only significantly decreased hepatic lipid contents.CONCLUSION: Prescribed exercise in subjects with NAFLD reduces IHTG independent of dietary intervention. Diet and exercise was more effective than exercise alone in reducing IHTG.

Non-pharmacological therapies for inflammatory bowel disease: Recommendations for self-care and physician guidance

We performed a scoping review on sought-after complementary therapies for patients with inflammatory bowel disease(IBD), specifically diet, physical activity and exercise(PA/E), and psychotherapy. We aim to update patients with IBD on therapies for self-care and provide physicians with guidance on how to direct their patients for the management of IBD. A search of MEDLINE, EMBASE, and PUBMED was completed in Sept 2016. Studies on diet, PA/E, or psychotherapy in patients with IBD were included. Medical Subject Heading terms and Boolean operators were used. The search was limited to full-text English articles describing an adult population. This review included 67 studies: Diet(n = 19); PA/E(n = 19); and psychotherapy(n = 29). We have made the following recommendations:(1) Diet: Consumption of diets rich in vegetables, fruit and soluble fiber may be beneficial in IBD. A trial of a low FODMAP diet can be considered in those patients with functional gastrointestinal symptoms. Restrictive diets are lacking in evidence and should be avoided;(2) PA/E: Regular lowmoderate intensity activity, including cardiovascular and resistance exercise, has been shown to improve quality of life(QOL) and may improve inflammation; and(3) psychotherapy: Therapies such as cognitive-behavioural interventions, mindfulness, hypnosis, and stress management have been shown to improve QOL, but evidence is limited on their impact on anxiety, depression, and disease activity. Overall, these complementary therapies are promising and should be used to treat patients with IBD from a more holistic perspective.

Effect of exercise training intensity on adipose tissue hormone sensitive lipase gene expression in obese women under weight loss

Background:Hormone sensitive lipase(HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exerciseinduced changes in adipose tissue metabolism.The purpose of this study was to determine whether aerobic exercise intensity influences abdominal adipose tissue HSL gene expression in obese women under weight loss. Methods:Thirty women(body mass index(BMI) = 33.0±0.7 kg/m^2,age = 58±1 years) completed one of three 20-week interventions: caloric restriction alone(CR only,n = 8),CR plus moderate-intensity exercise(CR + moderate-intensity,45%—50%heart rate reserve(HRR). 3 day/week,n = 9),or CR plus vigorous-intensity exercise(CR + vigorous-intensity,70%—75%HRR,3 day/week,n = 13).Each group had a similar prescribed energy deficit comprised of underfeeding alone(2800 kcal/week for CR only) or underfeeding(2400 kcal/week) plus exercise(400 kcal/week).Body composition and maximal aerobic capacity(VO_2max) were measured,and subcutaneous abdominal adipose tissue samples were collected before and after the interventions.Adipose tissue HSL gene expression was measured by real time reversetranscriptase polymerase chain reaction. Results:All three interventions reduced body weight,fat mass,percent fat.and waist to a similar degree(all p < 0.01).In addition,all interventions did not change absolute VO_2 max,but increased relative VO_2 max(p < 0.05 to P < 0.01).Compared to pre-intervention.neither CR only nor CR + moderate-intensity changed adipose tissue HSL gene expression,but CR + vigorous-intensity significantly increased adipose tissue HSL gene expression(p < 0.01).The changes of HSL gene expression levels in the CR + vigorous-intensity group were significantly different from those in the CR only(p < 0.05) and CR + moderate-intensity(p < 0.01) groups.In the whole cohort,changes in adipose tissue HSL gene expression correlated positively to changes in absolute(r = 0.55,p < 0.01) and relative(r = 0.32,p = 0.09) VO_2 max. Conclusion:These results support a potential effect of aerobic exercise training intensity on hormone sensitive lipase pathway in adipose tissue metabolism in obese women under weight loss.

Diet restriction and exercise alleviate cognitive reduction of high fat diet (HFD)-induced obese mice by rescuing inflammation-mediated compromised insulin signaling pathway through activating AMPK/SIRT1 signal pathway and suppressing TLR4 signal pathway

Obesity,caused by excessive energy,leads to body weight gain and various diseases,including cognitive impairment.Current studies suggest that diet restriction such as optimal fasting and regular exercise are crucial for improving cognitive capacity.However,further exploration is needed to understand the specific mechanisms of high fat diet(HFD)-induced cognitive decline in obesity.In the present study,4-month-old mice were subjected to HFD feeding for 18 weeks,followed by aerobic exercise and high-intensity intermittent exercise,regular diet feeding,and intermittent fasting for 8 weeks,and then used to evaluate cognitive capacity,inflammation,compromised insulin signaling pathway,and apoptosis in hippocampal tissue,as well as AMPK/SIRT1 and TLR4 signal pathways.Obese mice revealed impaired cognitive capacity as compared with mice fed with regular diets.In contrast,aerobic exercise,high-intensity intermittent exercise,regular diet,and intermittent fasting could inhibit apoptosis caused by inflammation-mediated compromised insulin signaling pathway in hippocampal tissues through activating the AMPK/SIRT1 signal pathway and suppressing the TLR4 signal pathway,thereby rescuing the cognitive impairment of obese mice.Therefore,diet restriction and exercise interventions may play a positive role in reverting obesity-induced cognitive impairment.

运动员的肠道菌群特征

背景:了解运动员肠道菌群的特征及影响因素有助于确定相关运动项目的最佳肠道微生物组成,寻求提高运动表现和恢复的有效途径,并为个性化营养方案提供独特视角。目的:总结运动员的肠道菌群特征,从运动训练和饮食摄入两方面阐述影响运动员肠道菌群特征的重要因素。方法:检索PubMed、ScienceDirect、中国知网、万方和维普数据库2004-2024年发表的文献,英文检索词为“microbiota,microbiome,athlete,exercise,training,diet,nutrition,dietary fiber,protein,ketogenic,fat”,中文检索词为“肠道菌群,肠道微生物,运动员,训练,比赛,饮食,营养”。排除研究质量较差及内容不相关的文献后,最终纳入65篇文献进行综述分析。结果与结论:①与普通人群相比,精英运动员的肠道菌群以α多样性增加、厚壁菌门/拟杆菌门比值升高、健康有益菌丰度增加、有助于运动表现的功能途径富集为主要特征;②项目类型和训练负荷与运动员肠道菌群物种结构及功能表达密切相关;③由代谢物介导的宿主与肠道微生物间的双向交流,是运动影响肠道菌群的重要机制;④阶段训练通常能够引发肠道微生物群产生适应性变化,并且菌群在结构或功能上的改变具有持续效应;⑤宏量营养素的种类、数量及组合形式能够显著影响肠道菌群结构和功能,并与运动训练发挥协同叠加或削弱抵消的作用;⑥未来应持续加强对运动员肠道菌群的相关探索,明确因果关系,建立运动训练干预新靶点。

绝经后女性维生素D水平与生殖特点和运动膳食情况的关系

背景:研究证明绝经后骨质疏松症与女性生殖特点和运动膳食有关,但是鲜有研究证明女性生殖特点及运动膳食是否对绝经后女性维生素D有影响。目的:探讨北京市绝经后女性维生素D水平与女性生殖特点和运动膳食情况的关系及其影响因素。方法:选取2017年9月至2018年5月北京市多个城区的17个社区现场问卷调查的727例46-75岁绝经后女性作为研究对象,问卷内容包括受试者的基本信息和月经史、绝经史、妊娠史、运动膳食情况等。采用电化学发光免疫分析仪及其配套试剂测定25-(OH)D水平;使用双能X射线骨密度检测仪测定腰椎(L1-L4、整体)和双髋关节(股骨颈、整体)的骨密度和T值;观察维生素D与生殖特点和运动膳食的相关性,并进行维生素D的影响因素分析。结果与结论:①维生素D正常组136例(18.7%),维生素D不足组389例(53.5%),维生素D缺乏组202例(27.8%);平均维生素D水平为(15.60±5.85)ng/mL。②随着维生素D水平的升高,不同部位的骨密度值及T值也随之升高。③维生素D水平与初潮年龄、月经持续天数、绝经阶段、运动情况、饮食类型、饮食偏好均呈正相关(P<0.05);与月经周期、绝经年龄、生育次数均呈负相关(P<0.05);与初孕年龄、怀孕次数无相关性(P>0.05)。④多因素有序Logistic回归分析结果显示,喝奶制品频率对绝经后女性维生素D值存在正向相关(P<0.05),且奶制品是维生素D水平的保护因素。⑤调查结果说明,北京市绝经后女性维生素D水平普遍不足、骨密度值普遍低下,维生素D水平与部分生殖特点、运动膳食情况存在关联,且其中喝奶制品是其保护因素。因此可以通过开展相关骨质疏松的健康教育,对绝经后女性膳食情况进行调整加以干预,增加体内维生素D含量,以期增加骨密度值,减少绝经后骨质疏松患病率。

Role of diet and lifestyle changes in nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD)has becomeone of the most common causes of liver disease worldwide and has been recognized as a major health burden.The prevalence of NAFLD has grown proportionallywith the rise in obesity,sedentary lifestyle,unhealthydietary pattern,and metabolic syndrome.Currently,there is no drug therapy that can be formulated fortreating NAFLD.A combination of dietary modificationsand increased physical activity remains the mainstayof NAFLD management.It is hard to maintain thismode of management;however,it seems to havesignificant long-term benefits.Furthermore,NAFLDpatients,whether obese or not,should be educatedthat a healthy diet and physical activity have benefitsbeyond weight reduction.Further large controlled randomized trials are needed in order to identify the bestdietary regimen and physical activity in the management of NAFLD patients.This review highlights the roleof diet and lifestyle modifications in the managementof NAFLD,and focuses on human studies regarding dietary modifications and physical activity.

Crosstalk between dietary patterns,obesity and nonalcoholic fatty liver disease

The prevalence of nonalcoholic fatty liver disease(NAFLD)is rising worldwide,paralleling the epidemic of obesity.The liver is a key organ for the metabolism of proteins,fats and carbohydrates.Various types of fats and carbohydrates in isocaloric diets differently influence fat accumulation in the liver parenchyma.Therefore,nutrition can manage hepatic and cardiometabolic complications of NAFLD.Even moderately reduced caloric intake,which leads to a weight loss of 5%-10%of initial body weight,is effective in improving liver steatosis and surrogate markers of liver disease status.Among dietary patterns,the Mediterranean diet mostly prevents the onset of NAFLD.Furthermore,this diet is also the most recommended for the treatment of NAFLD patients.However,clinical trials based on the dietary interventions in NAFLD patients are sparse.Since there are only a few studies examining dietary interventions in clinically advanced stages of NAFLD,such as active and fibrotic steatohepatitis,the optimal diet for patients in these stages of the disease must still be determined.In this narrative review,we aimed to critically summarize the associations between different dietary patterns,obesity and prevention/risk for NAFLD,to describe specific dietary interventions’impacts on liver steatosis in adults with NAFLD and to provide an updated overview of dietary recommendations that clinicians potentially need to apply in their daily practice.