Zeitschrift für Orthomolekulare Medizin 2015; 4(04): 24-27
DOI: 10.1055/s-0035-1547590
Praxistipps
© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG Stuttgart · New York

Therapie der nichtalkoholischen Fettleber

Nicolai Worm
,
Jürgen Stein
,
Alexander Ströhle
Further Information

Publication History

Publication Date:
27 January 2016 (online)

Zusammenfassung

Die Erhöhung der körperlichen Aktivität und Ernährungstherapie, v. a. die Kohlenhydratreduktion, sind die entscheidenden Bausteine in der Behandlung der nichtalkoholischen Fettleber. Eine Studie an Patienten mit hohem NAFLD-Risiko zeigt, dass durch Leberfasten mit Hepafast® Gewicht und Bauchumfang reduziert und Blutfettwerte sowie leber- und diabetesspezifische Parameter signifikant verbessert wurden.

 
  • Literatur

  • 1 Ströhle A, Stein J. Nichtalkoholische Fettlebererkrankung. Pathophysiologisch orientierte Diagnostik und Therapie Med Monatsschr Pharm 2015; 38(5): 166-78
  • 2 Shulman GI. Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease. N Engl J Med 2014; 371(12): 1131-1141
  • 3 Musso G, Cassader M, Rosina F, Gambino R. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials. Diabetologia 2012; 55(4): 885-904
  • 4 Keating SE, George J, Johnson NA. The benefits of exercise for patients with non-alcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol 2015; 1-4
  • 5 Ratziu V, Bellentani S, Cortez-Pinto H et al. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010; 53(2): 372-384
  • 6 Taylor R, Holman RR. Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Clin Sci (Lond) 2015; 128(7): 405-410
  • 7 Hession M, Rolland C, Kulkarni U et al. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities Obes Rev 2009; 10(1): 36-50
  • 8 Hu T, Mills KT, Yao L et al. Effects of low-­carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol 2012; 7: 44-54
  • 9 Ströhle A, Worm N. Metabolisches Syndrom: Pathophysiologische Grundlagen und rationale Empfehlungen zur Ernährungstherapie. Deutsch Apothek Z 2012; 152(1): 50-67
  • 10 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(1): 14-23
  • 11 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(12): 954-962
  • 12 Heymsfield SB, van Mierlo CA, van der Knaap HC et al. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes Relat Metab Disord 2003; 27(5): 537-549
  • 13 Franz MJ, VanWormer JJ, Crain AL et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007; 107(10): 1755-1767
  • 14 Asher RC, Burrows TL, Collins CE. Very low-energy diets for weight loss in adults: A review. Nutrition & Dietetics 2013; 70(2): 101-112
  • 15 Tsai AG, Wadden TA. The evolution of very-low-calorie diets: an update and meta-analysis. Obesity (Silver Spring) 2006; 14(8): 1283-1293
  • 16 Hamdy O, Zwiefelhofer D. Weight management using a meal replacement strategy in type 2 diabetes. Curr Diab Rep 2010; 10(2): 159-164
  • 17 Larson-Meyer DE, Heilbronn LK, Redman LM et al. Effect of calorie restriction with or without exercise on insulin sensitivity, beta-cell function, fat cell size, and ectopic lipid in overweight subjects. Diabetes Care 2006; 29(6): 1337-1344
  • 18 Harrison SA, Fecht W, Brunt EM, Neuschwander-Tetri BA. Orlistat for overweight subjects with nonalcoholic steatohepatitis: A randomized, prospective trial. Hepatology 2009; 49(1): 80-86
  • 19 Yu H, Jia W, Guo Z. Reducing Liver Fat by Low Carbohydrate Caloric Restriction Targets Hepatic Glucose Production in Non-Diabetic Obese Adults with Non-Alcoholic Fatty Liver Disease. J Clin Med 2014; 3(3): 1050-1063
  • 20 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(10): 2506-2514
  • 21 Larson-Meyer DE, Newcomer BR, Heilbronn LK et al. Effect of 6-month calorie restriction and exercise on serum and liver lipids and markers of liver function. Obesity (Silver Spring) 2008; 16(6): 1355-1362
  • 22 Viljanen AP, Iozzo P, Borra R et al. Effect of weight loss on liver free fatty acid uptake and hepatic insulin resistance. J Clin Endocrinol Metab 2009; 94(1): 50-55
  • 23 Lin WY, Wu CH, Chu NF, Chang CJ. Efficacy and safety of very-low-calorie diet in Taiwanese: a multicenter randomized, controlled trial. Nutrition 2009; 25(11–12): 1129-1136
  • 24 Lazo M, Solga SF, Horska A et al. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care 2010; 33(10): 2156-2163
  • 25 Elias MC, Parise ER, de Carvalho L et al. Effect of 6-month nutritional intervention on non-alcoholic fatty liver disease. Nutrition 2010; 26(11–12): 1094-1099
  • 26 Browning JD, Davis J, Saboorian MH, Burgess SC. A low-carbohydrate diet rapidly and dramatically reduces intrahepatic triglyceride content. Hepatology 2006; 44(2): 487-488
  • 27 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(5): 1048-1052
  • 28 Bian H, Hakkarainen A, Lundbom N, Yki-Jarvinen H. Effects of dietary interventions on liver volume in humans. Obesity (Silver Spring) 2014; 22(4): 989-995
  • 29 Kirk E, Reeds DN, Finck BN et al. Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction. Gastro­enterology 2009; 136(5): 1552-1560
  • 30 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(7): 1429-1435
  • 31 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(1): 138-143
  • 32 Hemmingsen B, Lund SS, Gluud C et al. Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. BMJ 2011; 343: d6898
  • 33 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(5): 579-584
  • 34 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(5): 953-961
  • 35 Ströhle A, Wolters M, Hahn A. Gesundheitliche Effekte von Ballaststoffen. Ein Update Teil 1: Von der Struktur zur Funktion. Deutsch Apothek Z 2012; 152: 40-48
  • 36 Ströhle A, Wolters M, Hahn A. Gesundheitliche Effekte von Ballaststoffen. Ein Update Teil 2: Systemische Effekte und Präventionspotenzial. Deutsch Apothek Z 2012; 152: 54-65
  • 37 Teutsch M. Effekte einer auf Leberentfettung abgestimmten ergänzenden bilanzierten Diät auf Stoffwechsel und Anthropometrie. Adipositas 2014; 8: 177-234
  • 38 Bedogni G, Bellentani S, Miglioli L et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol 2006; 6: 33
  • 39 Arslanow A. Two week protein-enriched low-calorie diet (HEPAFAST) shows rapid improvement of fatty liver as assessed by controlled attenuation parameter. Diabetologie und Stoffwechsel 2015; 10: P286