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Nutrition and Dietary Intake for 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 (20 September 2020) | Viewed by 36443

Special Issue 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,

In this Special Edition of Nutrients, we will discuss the impact of nutrition and selected dietary ingredients in the prevention and treatment of liver diseases.
We will focus on the role of nutrition in the therapy of liver diseases associated with the development of extreme protein malnutrition (e.g., hepatic cirrhosis, terminal hepatic failure with encephalopathy, malnutrition of people with alcoholic fatty liver disease) as well as nutrition of overweight and obese patients with concomitant fatty liver.
Particular attention will be given to the prevention of liver diseases, especially non-alcoholic fatty liver disease (NAFLD), as every 4th adult inhabitant of the earth suffers from this disease, and the basis of the therapy involves lifestyle modification—thus, a correct model of nutrition and physical activity.
In the area of NAFLD, we are particularly interested in the strategy of feeding people with fatty liver and normal BMI and the effect of intestinal microbiota on NAFLD progression.
Potential issues may include but are not limited to nutrition strategies for liver disease, especially NAFLD (including nutrition for people with NAFLD with normal body weight), fatty liver alcohol disease (ALD), nutrition for people with non-alcoholic liver fibrosis (NASH), and transplant liver nutrition, nutrition of people with hepatic encephalopathy, primary biliary cirrhosis (PBC), and primary biliary cholangitis (PBS).
We will be interested in the relationship among energy consumption, nutritional patterns (including the strategy of feeding a malnourished patient before a liver transplant), the use of caloric restrictions (in obese patients with steatosis and liver fibrosis), as well as the content of key macro and micro components, the presence of phytonutrients (e.g., polyphenols), and the content of diet components regulating the composition and function of the intestinal microbiota and the therapy of liver diseases. We welcome different types of manuscript submissions, including original research articles and up-to-date reviews (systematic reviews and meta-analyses).

Prof. Ewa Stachowska
Guest Editor

Manuscript Submission Information

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Keywords

  • Nutrition
  • Non-alcoholic fatty liver disease
  • Non-alcoholic liver fibrosis
  • Alcoholic fatty liver disease
  • Liver transplantation
  • Liver cirrhosis
  • Hepatic encephalopathy
  • Gut microbiota
  • Dietary pattern
  • Malnutrition
  • Undernutrition
  • Obesity

Published Papers (8 papers)

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Editorial

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2 pages, 166 KiB  
Editorial
Editorial “Nutrition and Dietary Intake for Liver-Related Diseases”
by Ewa Stachowska, Karolina Jakubczyk and Dominika Maciejewska-Markiewicz
Nutrients 2021, 13(2), 390; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020390 - 27 Jan 2021
Viewed by 1798
Abstract
In this special issue, we focus on the role of nutrition in the therapy of nonalcoholic liver disease (NAFLD) [...] Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)

Research

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15 pages, 3161 KiB  
Article
Inulin Supplementation Disturbs Hepatic Cholesterol and Bile Acid Metabolism Independent from Housing Temperature
by Mira J. Pauly, Julia K. Rohde, Clara John, Ioannis Evangelakos, Anja Christina Koop, Paul Pertzborn, Klaus Tödter, Ludger Scheja, Joerg Heeren and Anna Worthmann
Nutrients 2020, 12(10), 3200; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12103200 - 20 Oct 2020
Cited by 9 | Viewed by 4990
Abstract
Dietary fibers are fermented by gut bacteria into the major short chain fatty acids (SCFAs) acetate, propionate, and butyrate. Generally, fiber-rich diets are believed to improve metabolic health. However, recent studies suggest that long-term supplementation with fibers causes changes in hepatic bile acid [...] Read more.
Dietary fibers are fermented by gut bacteria into the major short chain fatty acids (SCFAs) acetate, propionate, and butyrate. Generally, fiber-rich diets are believed to improve metabolic health. However, recent studies suggest that long-term supplementation with fibers causes changes in hepatic bile acid metabolism, hepatocyte damage, and hepatocellular cancer in dysbiotic mice. Alterations in hepatic bile acid metabolism have also been reported after cold-induced activation of brown adipose tissue. Here, we aim to investigate the effects of short-term dietary inulin supplementation on liver cholesterol and bile acid metabolism in control and cold housed specific pathogen free wild type (WT) mice. We found that short-term inulin feeding lowered plasma cholesterol levels and provoked cholestasis and mild liver damage in WT mice. Of note, inulin feeding caused marked perturbations in bile acid metabolism, which were aggravated by cold treatment. Our studies indicate that even relatively short periods of inulin consumption in mice with an intact gut microbiome have detrimental effects on liver metabolism and function. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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15 pages, 875 KiB  
Article
Effects of Resveratrol Supplementation in Patients with Non-Alcoholic Fatty Liver Disease—A Meta-Analysis
by Karolina Jakubczyk, Karolina Skonieczna-Żydecka, Justyna Kałduńska, Ewa Stachowska, Izabela Gutowska and Katarzyna Janda
Nutrients 2020, 12(8), 2435; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12082435 - 13 Aug 2020
Cited by 35 | Viewed by 4584
Abstract
Non-alcoholic fatty liver disease (NAFLD) is regarded as one of the most common liver pathologies in many societies. Resveratrol, as a phenolic compound with powerful antioxidant and anti-inflammatory properties exerting positive effects on the lipid profile and lipid accumulation and also on insulin [...] Read more.
Non-alcoholic fatty liver disease (NAFLD) is regarded as one of the most common liver pathologies in many societies. Resveratrol, as a phenolic compound with powerful antioxidant and anti-inflammatory properties exerting positive effects on the lipid profile and lipid accumulation and also on insulin resistance, appears to be an effective, natural, and safe complementary treatment option in NAFLD therapy. This meta-analysis was undertaken to evaluate the effects of resveratrol supplementation in NAFLD patients. To this end, scientific databases PubMed/Medline/Embase were searched up to 19 March 2020. We included seven randomized clinical trials (RCTs) with a total of 302 patients with NAFLD. In all the trials included in the analysis, resveratrol was administered daily over periods between 56 and 180 days in doses ranging from 500 mg to 3000 mg a day. The results of this meta-analysis reveal that resveratrol supplementation, irrespective of the dose or duration, did not affect the analyzed parameters (p < 0.05). The sole exception was an increase in alanine aminotransferase following the administration of resveratrol (p = 0.041). Currently available evidence is insufficient to confirm the efficacy of resveratrol in the management of NAFLD. Due to the inconsistencies between the existing scientific reports, a number of which found a positive effect on NAFLD-related parameters; further research in this area is needed. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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13 pages, 444 KiB  
Article
Impact of Glutathione and Vitamin B-6 in Cirrhosis Patients: A Randomized Controlled Trial and Follow-Up Study
by Chia-Yu Lai, Shao-Bin Cheng, Teng-Yu Lee, Yung-Fang Hsiao, Hsiao-Tien Liu and Yi-Chia Huang
Nutrients 2020, 12(7), 1978; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12071978 - 03 Jul 2020
Cited by 6 | Viewed by 7736
Abstract
Vitamin B-6 and glutathione (GSH) are antioxidant nutrients, and inadequate vitamin B-6 may indirectly limit glutathione synthesis and further affect the antioxidant capacities. Since liver cirrhosis is often associated with increased oxidative stress and decreased antioxidant capacities, we conducted a double-blind randomized controlled [...] Read more.
Vitamin B-6 and glutathione (GSH) are antioxidant nutrients, and inadequate vitamin B-6 may indirectly limit glutathione synthesis and further affect the antioxidant capacities. Since liver cirrhosis is often associated with increased oxidative stress and decreased antioxidant capacities, we conducted a double-blind randomized controlled trial to assess the antioxidative effect of vitamin B-6, GSH, or vitamin B-6/GSH combined supplementation in cirrhotic patients. We followed patients after the end of supplementation to evaluate the association of vitamin B-6 and GSH with disease severity. In total, 61 liver cirrhosis patients were randomly assigned to placebo, vitamin B-6 (50 mg pyridoxine/d), GSH (500 mg/d), or B-6 + GSH groups for 12 weeks. After the end of supplementation, the condition of patient’s disease severity was followed until the end of the study. Neither vitamin B-6 nor GSH supplementation had significant effects on indicators of oxidative stress and antioxidant capacities. The median follow-up time was 984 d, and 21 patients were lost to follow-up. High levels of GSH, a high GSH/oxidized GSH ratio, and high GSH-St activity at baseline (Week 0) had a significant effect on low Child–Turcotte–Pugh scores at Week 0, the end of supplementation (Week 12), and the end of follow-up in all patients after adjusting for potential confounders. Although the decreased GSH and its related enzyme activity were associated with the severity of liver cirrhosis, vitamin B-6 and GSH supplementation had no significant effect on reducing oxidative stress and increasing antioxidant capacities. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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16 pages, 2772 KiB  
Article
Dietary Protein, Fiber and Coffee Are Associated with Small Intestine Microbiome Composition and Diversity in Patients with Liver Cirrhosis
by Shehnaz K. Hussain, Tien S. Dong, Vatche Agopian, Joseph R. Pisegna, Francisco A. Durazo, Pedram Enayati, Vinay Sundaram, Jihane N. Benhammou, Mazen Noureddin, Gina Choi, Walid S. Ayoub, Venu Lagishetty, David Elashoff, Marc T. Goodman and Jonathan P. Jacobs
Nutrients 2020, 12(5), 1395; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12051395 - 13 May 2020
Cited by 14 | Viewed by 3976
Abstract
The gut microbiome is a key factor in chronic liver disease progression. In prior research, we found that the duodenal microbiome was associated with sex, ethnicity, and cirrhosis complications. Here, we examined the association between diet and the duodenal microbiome in patients with [...] Read more.
The gut microbiome is a key factor in chronic liver disease progression. In prior research, we found that the duodenal microbiome was associated with sex, ethnicity, and cirrhosis complications. Here, we examined the association between diet and the duodenal microbiome in patients with liver cirrhosis. This study included 51 participants who completed a detailed food frequency questionnaire and donated duodenal biopsies for microbiome characterization by 16S ribosomal RNA gene sequencing. Data were analyzed for alpha diversity, beta diversity, and association of taxa abundance with diet quality and components using QIIME 2 pipelines. Diet quality was assessed through calculation of the Healthy Eating Index 2010. Participants with higher adherence to protein recommendations exhibited increased microbial richness and evenness (p = 0.03) and a different microbial profile compared to those with lower adherence (p = 0.03). Prevotella-9 and Agathobacter were increased in association with increased protein adherence. Fiber consumption was also associated with the duodenal microbial profile (p = 0.01), with several taxa exhibiting significantly decreased or increased abundance in association with fiber intake. Coffee drinking was associated with microbial richness and evenness (p = 0.001), and there was a dose–response association between coffee drinking and relative abundance of Veillonella (p = 0.01). We conclude that protein, fiber, and coffee are associated with diversity and composition of the duodenal microbiome in liver cirrhosis. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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19 pages, 2954 KiB  
Article
Increased Colonic Permeability and Lifestyles as Contributing Factors to Obesity and Liver Steatosis
by Domenica Maria Di Palo, Gabriella Garruti, Agostino Di Ciaula, Emilio Molina-Molina, Harshitha Shanmugam, Maria De Angelis and Piero Portincasa
Nutrients 2020, 12(2), 564; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12020564 - 21 Feb 2020
Cited by 33 | Viewed by 4764
Abstract
Intestinal permeability (IP) is essential in maintaining gut-metabolic functions in health. An unequivocal evaluation of IP, as marker of intestinal barrier integrity, however, is missing in health and in several diseases. We aimed to assess IP in the whole gastrointestinal tract according to [...] Read more.
Intestinal permeability (IP) is essential in maintaining gut-metabolic functions in health. An unequivocal evaluation of IP, as marker of intestinal barrier integrity, however, is missing in health and in several diseases. We aimed to assess IP in the whole gastrointestinal tract according to body mass index (BMI) and liver steatosis. In 120 patients (61F:59M; mean age 45 ± SEM 1.2 years, range: 18–75), IP was distinctively studied by urine recovery of orally administered sucrose (SO, stomach), lactulose/mannitol ratio (LA/MA, small intestine), and sucralose (SA, colon). By triple quadrupole mass-spectrometry and high-performance liquid chromatography, we measured urinary recovery of saccharide probes. Subjects were stratified according to BMI as normal weight, overweight, and obesity, and answered questionnaires regarding dietary habits and adherence to the Mediterranean Diet. Liver steatosis was assessed by ultrasonography. IP at every gastrointestinal tract was similar in both sexes and decreased with age. Stomach and small intestinal permeability did not differ according to BMI. Colonic permeability increased with BMI, waist, neck, and hip circumferences and was significantly higher in obese than in lean subjects. As determined by logistic regression, the odds ratio (OR) of BMI increment was significantly higher in subjects in the highest tertile of sucralose excretion, also after adjusting for age and consumption of junk food. The presence of liver steatosis was associated with increased colonic permeability. Patients with lower score of adherence to Mediterranean diet had a higher score of ‘junk food’. Intestinal permeability tended to increase in subjects with a lower adherence to Mediterranean diet. In conclusion, colonic (but not stomach and small intestinal) permeability seems to be linked to obesity and liver steatosis independently from dietary habits, age, and physical activity. The exact role of these last factors, however, requires specific studies focusing on intestinal permeability. Results should pave the way to both primary prevention measures and new therapeutic strategies in metabolic and liver diseases. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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Review

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30 pages, 3218 KiB  
Review
Bile Acids and GPBAR-1: Dynamic Interaction Involving Genes, Environment and Gut Microbiome
by Piero Portincasa, Agostino Di Ciaula, Gabriella Garruti, Mirco Vacca, Maria De Angelis and David Q.-H. Wang
Nutrients 2020, 12(12), 3709; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12123709 - 30 Nov 2020
Cited by 29 | Viewed by 4102
Abstract
Bile acids (BA) are amphiphilic molecules synthesized in the liver from cholesterol. BA undergo continuous enterohepatic recycling through intestinal biotransformation by gut microbiome and reabsorption into the portal tract for uptake by hepatocytes. BA are detergent molecules aiding the digestion and absorption of [...] Read more.
Bile acids (BA) are amphiphilic molecules synthesized in the liver from cholesterol. BA undergo continuous enterohepatic recycling through intestinal biotransformation by gut microbiome and reabsorption into the portal tract for uptake by hepatocytes. BA are detergent molecules aiding the digestion and absorption of dietary fat and fat-soluble vitamins, but also act as important signaling molecules via the nuclear receptor, farnesoid X receptor (FXR), and the membrane-associated G protein-coupled bile acid receptor 1 (GPBAR-1) in the distal intestine, liver and extra hepatic tissues. The hydrophilic-hydrophobic balance of the BA pool is finely regulated to prevent BA overload and liver injury. By contrast, hydrophilic BA can be hepatoprotective. The ultimate effects of BA-mediated activation of GPBAR-1 is poorly understood, but this receptor may play a role in protecting the remnant liver and in maintaining biliary homeostasis. In addition, GPBAR-1 acts on pathways involved in inflammation, biliary epithelial barrier permeability, BA pool hydrophobicity, and sinusoidal blood flow. Recent evidence suggests that environmental factors influence GPBAR-1 gene expression. Thus, targeting GPBAR-1 might improve liver protection, facilitating beneficial metabolic effects through primary prevention measures. Here, we discuss the complex pathways linked to BA effects, signaling properties of the GPBAR-1, mechanisms of liver damage, gene-environment interactions, and therapeutic aspects. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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17 pages, 4345 KiB  
Review
The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Ewa Stachowska, Piero Portincasa, Dominika Jamioł-Milc, Dominika Maciejewska-Markiewicz and Karolina Skonieczna-Żydecka
Nutrients 2020, 12(11), 3460; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12113460 - 11 Nov 2020
Cited by 29 | Viewed by 3881
Abstract
We aim to systematically review the efficacy of prebiotics in reducing anthropometric and biochemical parameters in individuals with non-alcoholic fatty liver disease (NAFLD). A systematic search using PubMed/MEDLINE, Embase, clinicaltrials.gov, Cinahl, and Web of Science of articles published up to 20 March 2020 [...] Read more.
We aim to systematically review the efficacy of prebiotics in reducing anthropometric and biochemical parameters in individuals with non-alcoholic fatty liver disease (NAFLD). A systematic search using PubMed/MEDLINE, Embase, clinicaltrials.gov, Cinahl, and Web of Science of articles published up to 20 March 2020 was performed for randomized controlled trials enrolling >20 adult patients. Random-effect meta-analysis for metabolic outcomes in NAFLD patients was performed for anthropometric data in addition to liver enzyme, carbohydrate, and lipid parameters. We found six trials (comprising a total of 242 patients) with NAFLD, with subjects aged 38–52 years. The mean time of fiber administration varied between 10 and 12 weeks. The main fiber types were psyllium (seeds or powder), Ocimum basilicum (seeds), and high-performance inulin and oligofructose powder at doses of either 10 or 16 g per day. The control group received either maltodextrin (powder or capsules) or crushed wheat (powder). Patients on the diet with added fiber had improvements in body mass index (BMI) (standardized mean difference (SMD) = −0.494, 95% confidence interval (CI): −0.864 to −0.125, p = 0.009); alanine aminotransferase (ALT) (SMD = −0.667, 95% CI: −1.046 to −0.288, p = 0.001); aspartate aminotransferase (AST) (SMD = −0.466, 95% CI: −0.840 to −0.091, p = 0.015); fasting insulin (SMD = −0.705, 95% CI: −1.115 to −0.295, p = 0.001); and homeostasis model assessment for insulin resistance (HOMA-IR) (SMD = −0.619, 95% CI: −1.026 to −0.211, p = 0.003). Hence, the results show that fiber supplements result in favorable changes as reflected in the measurement of anthropometric, metabolic, and liver-related biomarkers, i.e., body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA-IR), insulin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST). These effects suggest the potential benefits of fiber consumption for NAFLD populations. More prospective, controlled studies should be conducted to reveal specific details regarding the fiber type, dosage, and duration for optimal intervention. Full article
(This article belongs to the Special Issue Nutrition and Dietary Intake for Liver-Related Diseases)
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