Nutrition in pathophysiology and treatment of nonalcoholic fatty liver disease.
OBJECTIVE
Overnutrition resulting in obesity plays a key role in nonalcoholic fatty liver disease, the major reason for abnormal liver function in many parts of the world. Currently, it is not clear which type of diet preferentially results in this common disease.


RESULTS
Excess nutrition leads to accumulation of various lipids in the liver, where fatty acids are considered the main driving force in the disease process. A liver loaded with fat is commonly associated with insulin resistance, the key pathophysiological phenomenon observed in nonalcoholic fatty liver disease. Not surprisingly, attempts to reduce body weight and thereby total liver fat are considered the key therapeutical steps in this disorder. Although voluntary weight loss is often not successful to reverse the disease process, various surgical procedures have proven effective in reducing overweight situations and liver steatosis. Weight loss not only reduces the amount of liver fat but also might improve inflammation and fibrosis in nonalcoholic steatohepatitis.


CONCLUSIONS
Although pharmacological approaches are eagerly awaited to achieve similar benefits; current available therapies have so far not fulfilled this expectation. Despite this frustration, such approaches are expected to be available in the near future.
Moschen
Alexander R
AR
Department of Medicine, Christian Doppler Research Laboratory for Gut Inflammation, Innsbruck Medical University, Innsbruck, Austria.
Tilg
Herbert
H
D000818:Animals; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D016207:Cytokines / Q000502:physiology; D004032:Diet / Q000009:adverse effects; D005081:Exercise Therapy; D005234:Fatty Liver / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D008055:Lipids / Q000502:physiology; D009765:Obesity / Q000150:complications / Q000628:therapy; D000077403:Orlistat; D018384:Oxidative Stress / Q000502:physiology; D015431:Weight Loss
D019440:Anti-Obesity Agents; D016207:Cytokines; D007783:Lactones; D008055:Lipids; D000077403:Orlistat