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Nutrients
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Effects of Macronutrient Intake on Liver-Related Diseases
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Effects of Macronutrient Intake on Liver-Related Diseases

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 October 2022) | Viewed by 16648

Special Issue Editor

Prof. Dr. Ewa Stachowska

E-Mail Website
Guest Editor
Human Nutrition and Mebolomics, Pomeranian Medical University, ul Broniewskiegi 24, Szczecin, Poland
Interests: nutrition in liver diseases; non-alcoholic fatty liver disease; nutrigenetics; gut microbiota and its impact on liver function
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We invite you to submit your manuscript for a Special Issue of Nutrients: "Effects of Macronutrient Intake on Liver-Related Diseases”. We would like to focus on the role of nutrients in the progression and prevention of liver-related diseases.

We particularly invite researchers who plan to publish results of meta-analyses, systematic reviews, and randomized control trials as well as those who plan to write interesting review papers in the area of nutrition, macronutrients, and liver-related diseases.

The liver-related diseases on which we wish to focus in this Special Issue are:

(a) Diseases caused by infections (especially hepatitis A, B, or C);

(b) Autoimmune hepatitis;

(c) Liver cancer or bile duct cancer; 

(d) Inherited liver disorders such as hemochromatosis or Wilson's disease;

(e) Nonalcoholic fatty liver disease (NAFLD);

(f) Cirrhosis, especially malnutrition/sarcopenia patients with cirrhosis.

A Special Issue will focus on the introduction of supplementation or specific exclusions in the treatment of patients with NAFLD. Previous publications on the nutrition of these patients have highlighted benefits of feeding strategies using the restriction of specific food components (fats or simple carbohydrates) or time restrictions (time-restricted diets or intermittent fasting).

We are interested in the results of studies going a step further and exploring mixed therapies, e.g., the use of food-ingredient manipulation along with the introduction of time restrictions, or work on the role of selected micronutrients in diets with food-group restrictions (e.g., gluten-free diets, the Paleo diet, the DASH diet or the Spanish Mediterranean Ketogenic Diet).

We would like to invite investigators who study the role of the anti-inflammatory ingredients of a Mediterranean diet (MD) in the mitigation of liver-related diseases’ progression. We hope that the list of components of the MD diet described as playing positive roles in the inhibition of the progression of liver diseases (such as fiber, polyphenols, n-3 fatty acids or caffeine) will be extended with other interesting components that will inspire more researchers.

Finally, we invite researchers who have interesting results in the area of the nutrition of patients with cirrhosis and malnutrition/sarcopenia. We especially invite investigators who have results from RCTs on strategies to reverse sarcopenia among malnourished patients with cirrhosis, as well as results from interesting studies using animal models.

In addition to well-known dietary ingredients that are used (with mixed results) such as branched-chained amino acids, we invite researchers with results for other, long-term ammonia-lowering agents.

Prof. Dr. Ewa Stachowska
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutrition
  • macronutrients
  • enteral nutrition
  • supplementation
  • probiotic
  • prebiotic
  • hepatitis A, B, or C
  • autoimmune hepatitis
  • liver cancer
  • bile duct cancer
  • inherited liver disorders such as hemochromatosis or Wilson's disease
  • nonalcoholic fatty liver disease (NAFLD)
  • cirrhosis, especially malnutrition/sarcopenia patients with cirrhosis

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Published Papers (4 papers)

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Research

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15 pages, 1154 KiB  
Article
Precision Nutrition in NAFLD: Effects of a High-Fiber Intervention on the Serum Metabolome of NAFD Patients—A Pilot Study
by Ewa Stachowska, Dominika Maciejewska-Markiewicz, Joanna Palma, Karolina Anna Mielko, Badr Qasem, Katarzyna Kozłowska-Petriczko, Marcin Ufnal, Katarzyna Ewa Sokolowska, Victoria Hawryłkowicz, Patrycja Załęska, Karolina Jakubczyk, Ewa Wunsch, Karina Ryterska, Karolina Skonieczna-Żydecka and Piotr Młynarz
Nutrients 2022, 14(24), 5355; https://doi.org/10.3390/nu14245355 - 16 Dec 2022
Cited by 9 | Viewed by 3679
Abstract
Non-alcoholic fatty liver disease (NAFLD) is associated with dysfunction of the intestinal microbiota and its metabolites. We aimed to assess whether replacing bread with high-fiber buns beneficially changes the metabolome in NAFLD patients. This study involved 27 adult patients with NAFLD validated by [...] Read more.
Non-alcoholic fatty liver disease (NAFLD) is associated with dysfunction of the intestinal microbiota and its metabolites. We aimed to assess whether replacing bread with high-fiber buns beneficially changes the metabolome in NAFLD patients. This study involved 27 adult patients with NAFLD validated by FibroScan® (CAP ≥ 234 dB/m). Patients were asked to replace their existing bread for two meals with high-fiber buns. In this way, the patients ate two rolls every day for 2 months. The following parameters were analysed (at the beginning and after 2 months): the anthropometric data (BIA), eating habits (24 h food recalls), gut barrier markers (lipopolysaccharide S and liposaccharide binding protein (LPS, LBP)), serum short-chain fatty acids (SCFAs) and branched chain fatty acids (BCFAs) by GC/MS chromatography, as well as serum metabolites (by 1H NMR spectroscopy). After 2 months of high-fiber roll consumption, the reduction of liver steatosis was observed (change Fibroscan CAP values from 309–277 dB/m). In serum propionate, acetate, isovaleric, and 2-methylbutyric decrease was observed. Proline, choline and one unknown molecule had higher relative concentration in serum at endpoint. A fiber-targeted dietary approach may be helpful in the treatment of patients with NAFLD, by changing the serum microbiota metabolome. Full article
(This article belongs to the Special Issue Effects of Macronutrient Intake on Liver-Related Diseases)
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9 pages, 483 KiB  
Article
Fatty Acids and Eicosanoids Change during High-Fiber Diet in NAFLD Patients—Randomized Control Trials (RCT)
by Dominika Maciejewska-Markiewicz, Arleta Drozd, Joanna Palma, Karina Ryterska, Viktoria Hawryłkowicz, Patrycja Załęska, Ewa Wunsh, Katarzyna Kozłowska-Petriczko and Ewa Stachowska
Nutrients 2022, 14(20), 4310; https://doi.org/10.3390/nu14204310 - 15 Oct 2022
Cited by 9 | Viewed by 2818
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is a wide spectrum condition characterized by excessive liver fat accumulation in people who do not abuse alcohol. There is no effective medical treatment for NAFLD; therefore, most important recommendations to reduce liver steatosis are diet and [...] Read more.
Background: Non-alcoholic fatty liver disease (NAFLD) is a wide spectrum condition characterized by excessive liver fat accumulation in people who do not abuse alcohol. There is no effective medical treatment for NAFLD; therefore, most important recommendations to reduce liver steatosis are diet and lifestyle, including proper physical activity. The aim of our study was to analyze the fatty acids and eicosanoids changes in the serum of patients who consumed high-fiber rolls for 8 weeks. Materials and Methods: The group of 28 Caucasian participants was randomly divided into two groups, those who received 24 g of fiber/day—from 2 buns of 12 g each (n = 14), and those who received 12 g of fiber/day—from 2 buns of 6 g (n = 14). At the beginning and on the last visit of the 8-week intervention, all patients underwent NAFLD evaluation, biochemical parameter measurements, and fatty acids and eicosanoids evaluation. Results: Patients who received 12 g of fiber had significantly reduced liver steatosis and body mass index. In the group who received 24 g of fiber/day, we observed a trend to liver steatosis reduction (p = 0.07) and significant decrease in aspartate aminotransferase (p = 0.03) and total cholesterol (p = 0.03). All changes in fatty acid and eicosanoids profile were similar. Fatty acids analysis revealed that extra fiber intake was associated with a significant increase in monounsaturated fatty acids and decrease in saturated fatty acids. Moreover, both groups showed increased concentration of gamma linoleic acid and docosahexaenoic acid. We also observed reduction in prostaglandin E2. Conclusions: Our study revealed that a high amount of fiber in the diet is associated with a reduction in fatty liver, although this effect was more pronounced in patients in the lower fiber group. However, regardless of the amount of fiber consumed, we observed significant changes in the profile of FAs, which may reflect the positive changes in the lipids liver metabolism. Regardless of the amount of fiber consumed, patients decreased the amount of PGE2, which may indicate the lack of disease progression associated with the development of inflammation. Full article
(This article belongs to the Special Issue Effects of Macronutrient Intake on Liver-Related Diseases)
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13 pages, 926 KiB  
Article
Dietary Composition and Its Association with Newly Diagnosed Nonalcoholic Fatty Liver Disease and Insulin Resistance
by Phunchai Charatcharoenwitthaya, Eakchakarj Tansakul, Kusuma Chaiyasoot, Wimolrak Bandidniyamanon and Natthinee Charatcharoenwitthaya
Nutrients 2021, 13(12), 4438; https://doi.org/10.3390/nu13124438 - 11 Dec 2021
Cited by 16 | Viewed by 3573
Abstract
Dietary modification is essential for treating nonalcoholic fatty liver disease (NAFLD); however, the dietary components are less well defined. We enrolled 252 adults with no history of liver disease and excessive alcohol use to evaluate the relationship between macronutrients and NAFLD and insulin [...] Read more.
Dietary modification is essential for treating nonalcoholic fatty liver disease (NAFLD); however, the dietary components are less well defined. We enrolled 252 adults with no history of liver disease and excessive alcohol use to evaluate the relationship between macronutrients and NAFLD and insulin resistance. Participants took photographs of their meals and documented their food intake in a food diary for seven consecutive days. A dietitian estimated the type and portion size of food items and analyzed nutrients with INMUCAL-Nutrients software. Later, participants underwent transient elastography to diagnose NAFLD and blood tests to measure insulin resistance using the homeostasis model. Total energy intake and the proportion of carbohydrate, fat, and protein consumption did not differ between participants with NAFLD (n = 41) and those without NAFLD (n = 211). Using multiple logistic regression analysis, daily intake of protein < 1.0 g/kg (OR: 3.66, 95% CI: 1.41–9.52) and full-fat dairy product ≥ 50 g (OR: 0.42, 95% CI: 0.18–0.99) were associated with NAFLD. Insulin resistance was associated with a daily intake of protein < 1.0 g/kg (OR: 3.09, 95% CI: 1.59–6.05), full-fat dairy product ≥ 50 g (OR: 0.46, 95% CI: 0.25–0.82), and dietary fiber ≥ 8 g (OR: 0.41, 95% CI: 0.22–0.74). Our data show that a low protein intake increases the odds for NAFLD and insulin resistance. Contrarily, a high intake of full-fat dairy products and dietary fiber has been associated with a potential protective effect against NAFLD and insulin resistance. Full article
(This article belongs to the Special Issue Effects of Macronutrient Intake on Liver-Related Diseases)
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Review

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17 pages, 2064 KiB  
Review
The Prevalence of Small Intestinal Bacterial Overgrowth in Patients with Non-Alcoholic Liver Diseases: NAFLD, NASH, Fibrosis, Cirrhosis—A Systematic Review, Meta-Analysis and Meta-Regression
by Anna Gudan, Dominika Jamioł-Milc, Victoria Hawryłkowicz, Karolina Skonieczna-Żydecka and Ewa Stachowska
Nutrients 2022, 14(24), 5261; https://doi.org/10.3390/nu14245261 - 9 Dec 2022
Cited by 24 | Viewed by 5849
Abstract
Bacterial overgrowth in the small intestine (SIBO) is a pathological growth of the intestinal microbiota in the small intestine that causes clinical symptoms and can lead to digestive and absorption disorders. There is increasing evidence that people with NAFLD have a distinct gut [...] Read more.
Bacterial overgrowth in the small intestine (SIBO) is a pathological growth of the intestinal microbiota in the small intestine that causes clinical symptoms and can lead to digestive and absorption disorders. There is increasing evidence that people with NAFLD have a distinct gut microflora profile as well metabolome changes compared to people without NAFLD. Thorough analysis of observational and RCT studies in the current databases (EMBASE, Web of Science, PubMed, Cinahl, Clinical Trials) was conducted from 3 November 2021 to 21 June 2022. The following inclusion criteria were applied: confirmed NAFLD, NASH, LIVER FIBROSIS, CIRRHOSIS due to steatosis; diagnostic methods of liver diseases—biopsy, elastography, transabdominal ultrasound; nonalcoholic fatty liver disease activity score; confirmed SIBO; diagnostic methods of SIBO–breath tests (hydrogen test; methane test and mix test; duodenal and jejunal aspiration before any type of intervention; adults above 18yo; number of participants ≥20; full articles. We excluded review articles, populations with HBV/HCV infection and alcohol etiology and interventions that may affect NAFLD or SIBO treatment. The quality of each study methodology was classified by means of the Cochrane Collaboration’s tool (RCT) and Newcastle—Ottawa Quality Assessment Scale adapted for cross-sectional, cohort and case-control studies. The random effects meta-analysis of outcomes for which ≥2 studies contributed data was conducted. The I2 index to measure heterogeneity and the χ2 test of homogeneity (statistically significant heterogeneity p < 0.05) were applied. For categorical outcome, the pooled event rate (effect size) was calculated. This systematic review was reported according to PRISMA reporting guidelines. We initially identified 6643 studies, from which 18 studies were included in final meta-analysis. The total number of patients was 1263. Accepted SIBO diagnostic methods were both available breath tests (n-total = 15) and aspirate culture (n-total = 3). We found that among patients with non-alcoholic liver diseases, the random overall event rate of SIBO was 0.350 (95% CI, 0.244–0.472), p = 0.017. The subgroup analysis regarding a type of diagnosis revealed that the lowest ER was among patients who developed simultaneously NAFLD, NASH and fibrosis: 0.197 (95% CI, 0.054–0.510) as compared to other annotated subgroups. The highest prevalence of SIBO was observed in the NASH subgroup: 0.411 (95% CI, 0.219–0.634). There were no statistically significant differences in the prevalence of SIBO in different subgroups (p = 0.854). Statistically significant heterogeneity between studies was estimated (I2 = 86.17%, p = 0.00). Egger’s test did not indicate a publication bias (df = 16, p = 0.885). A meta-regression using a random-effects model revealed that higher percentage of males in the population with liver diseases is a predisposing factor toward SIBO (Q = 4.11, df = 1, p = 0.0426 with coefficient = 0.0195, SE = 0.0096, Z = 2.03). We showed that the prevalence of SIBO in patients with chronic non-alcoholic liver diseases can be as high as 35%, and it increases with the percentage of men in the population. The prevalence of SIBO does not differ significantly depending on the type of chronic liver disease. Despite the high heterogeneity and moderate and low quality of included studies, our meta-analysis suggests the existence of a problem of SIBO in the population of patients with non-alcoholic liver diseases, and the presence of SIBO, in turn, determines the therapeutic treatment of such type of patients, which indicates the need for further research in this area. The study protocol was registered with the international Prospective Register of Systematic Reviews (PROSPERO ID: CRD42022341473). Full article
(This article belongs to the Special Issue Effects of Macronutrient Intake on Liver-Related Diseases)
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