Intermittent Fasting as a Treatment for Nonalcoholic Fatty Liver Disease: What Is the Evidence?

Memel, Zoe; Wang, Jeffrey; Corey, Kathleen E.

doi:10.1002/cld.1172

Cited by 21 publications

(12 citation statements)

References 10 publications

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“…Intermittent fasting (IF) has recently gained a lot of attention due to its possible effectiveness in the process of weight reduction [ 144 ]. IF is characterized by alternating periods of fasting and feeding.…”

Section: Nutrition—what Is Beyond the Obvious?mentioning

confidence: 99%

Small Intestinal Bacterial Overgrowth and Non-Alcoholic Fatty Liver Disease: What Do We Know in 2023?

Gudan

Kozłowska-Petriczko

Bodnarczuk³

et al. 2023

Nutrients

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Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease associated with the pathological accumulation of lipids inside hepatocytes. Untreated NAFL can progress to non-alcoholic hepatitis (NASH), followed by fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). The common denominator of the above-mentioned metabolic disorders seems to be insulin resistance, which occurs in NAFLD patients. Obesity is the greatest risk factor for lipid accumulation inside hepatocytes, but a part of the NAFLD patient population has a normal body weight according to the BMI index. Obese people with or without NAFLD have a higher incidence of small intestinal bacterial overgrowth (SIBO), and those suffering from NAFLD show increased intestinal permeability, including a more frequent presence of bacterial overgrowth in the small intestine (SIBO). The health consequences of SIBO are primarily malabsorption disorders (vitamin B12, iron, choline, fats, carbohydrates and proteins) and bile salt deconjugation. Undetected and untreated SIBO may lead to nutrient and/or energy malnutrition, thus directly impairing liver function (e.g., folic acid and choline deficiency). However, whether SIBO contributes to liver dysfunction, decreased intestinal barrier integrity, increased inflammation, endotoxemia and bacterial translocation is not yet clear. In this review, we focus on gut–liver axis and discuss critical points, novel insights and the role of nutrition, lifestyle, pre- and probiotics, medication and supplements in the therapy and prevention of both SIBO and NAFLD.

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Section: Nutrition—what Is Beyond the Obvious?mentioning

confidence: 99%

Small Intestinal Bacterial Overgrowth and Non-Alcoholic Fatty Liver Disease: What Do We Know in 2023?

Gudan

Kozłowska-Petriczko

Bodnarczuk³

et al. 2023

Nutrients

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“…Restricting food consumption for 14 hours or more depletes the body’s glycogen stores. This shifts the metabolic circuitry to increasing hepatic lipid oxidation, decreasing lipogenesis, and using ketones as the primary energy source [ 46 ]. In addition to the potential metabolic benefits of fasting, limiting food consumption during Ramadan fasting can help reduce cholesterol levels, improve blood lipid profiles, and even lead to weight loss.…”

Section: Reviewmentioning

confidence: 99%

Implications of Ramadan Fasting in the Setting of Gastrointestinal Disorders

Tibi¹,

Ahmed²,

Nizam³

et al. 2023

Cureus

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Intermittent fasting is an increasingly popular dieting technique with many well-studied benefits, such as permitting weight loss in obese patients, lowering low-density lipoprotein cholesterol (LDL-C) levels and triglyceride levels, and optimizing circadian rhythms. A special type of intermittent fasting occurs during Ramadan, when Muslims worldwide fast daily from dawn to sunset for a month. Ramadan fasting has demonstrated several health benefits, including improving the gut microbiome, modifying gut hormone levels, and lowering proinflammatory markers such as cytokines and blood lipids. Although fasting has many health benefits, fasting during Ramadan may aggravate chronic medical conditions. We aim to review the literature devoted to Ramadan fasting and its effects on Muslim patients with gastrointestinal (GI) disorders, such as Inflammatory bowel disease (IBD), peptic ulcer disease (PUD), upper GI bleeding (UGIB), gastroesophageal reflux disease (GERD), and liver conditions. We will discuss recommendations for diet and medication compliance during Ramadan in the recommended pre-Ramadan counseling sessions. In this study, we used PubMed to research journals using the key terms "Ramadan," "intermittent fasting," and "gastrointestinal diseases." The current literature studying the impact of Ramadan on gastrointestinal disorders shows that patients with IBD have a minimal risk of disease exacerbation, although older men with ulcerative colitis (UC) were more prone to exacerbation during fasting. Patients with duodenal ulcers were at a higher risk of hemorrhage after Ramadan fasting. Although with mixed results, studies show patients with liver disease demonstrated improvements in liver enzymes, cholesterol, and bilirubin after Ramadan. Physicians should offer pre-Ramadan counseling to educate patients on the risks of fasting and encourage shared decision-making. To facilitate more definitive discussions between the physician and a Muslim patient, clinicians should seek a deeper understanding of how Ramadan fasting affects certain health conditions and offer accommodations, such as diet and medication adjustments.

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“…Finally, timerestricted fasting is eating only during certain hours of the day. 30 The hypothesized mechanism behind IF and its effect on the liver is a shift to ketones as the primary energy source during extended fasts, leading to increased catabolism of hepatic triglycerides. Recently, there have been data looking at the impact of IF on patients with NAFLD.…”

Section: Role Of Specific Diets In Nafldmentioning

confidence: 99%