General measures
- Aim for normal weight! – Necessary therapeutic measure of the first order! Notice:
- In particular, obesity and insulin resistance (decreased or abolished action of the hormone insulin) play a prominent role in the progression (progression) of non-alcoholic fatty liver (NAFLD) to non-alcoholic steatohepatitis (NASH).
- Insulin resistance, inflammation, and alterations in adipokines and angiogenesis factors associated with NAFLD are closely linked to HCC (hepatocellular carcinoma; liver cell carcinoma) risk.
Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis and participation in a medically supervised weight loss program. Goal: sustained weight reduction of 0.5-1.0 kg per weekAccording to a study of patients who had NASH and reduced their body weight by more than 10 percent, they showed significant improvement in liver biopsy (tissue removal from the liver): decrease in fatty degeneration (steatosis), ballooning and inflammation. In some patients, even fibrosis regressed.
- Alcohol abstinence (complete abstinence from alcohol) in alcoholic fatty liver (ALD) and NSAD cirrhosis; alcohol restriction (female < 10 g/d; male < 20 g/d) in non-alcoholic fatty liver (NAFLD).
- Nicotine restriction (abstaining from tobacco use); due toSmoking is associated with advanced liver fibrosis in NAFLD. (strong consensus)
- Regular physical activity
- Good adjustment of concomitant diseases such as diabetes mellitus type 2, hypercholesterolemia, etc.
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of environmental stress:
- Antimony
- Barium salts
- Borates
- Chromates
- Copper
- Phosphorus
- Petrochemical products – mineral oils, etc.
Operative therapy
- If weight-reducing diets and lifestyle modification fail in severe obesity (obesity grade II (BMI >35), bariatric surgery (bariatric surgery) should be considered. (strong consensus)
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Hepatitis A vaccination
- Hepatitis B vaccination
- Pneumococcal vaccination
Regular checkups
- Regular medical checkups
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Observance of the following special dietary recommendations:
- Reduced calorie intake, especially reduction of carbohydrates (mono- and disaccharides/simple and double sugars; contained in sweets, sweet drinks (soft drinks), processed foods and convenience foods, among others).
- Low-fat diet
- Low animal protein – research shows that, especially in older people who are overweight, a diet high in animal protein is associated with an increased risk of non-alcoholic fatty liver.
- Foods high in:
- L-Carnitine
- Omega-3 fatty acids (DHA, EPA) for elevated triglycerides.
- Probiotics
- Diet: A high-protein, low-calorie diet is more effective at reducing liver fat than a low-protein diet. The study authors hypothesize that a high-protein diet suppresses fat absorption, storage and synthesis.
- Selection of appropriate foods based on the nutritional analysis.
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training).
- Regular walking in patients with nonalcoholic fatty liver disease can lower intrahepatic triglycerides as effectively as joggingJogging: 5 times per week for 30 minutes at 65-80% of maximum heart rateWalking: 5 times per week for 30 minutes at 45-55% of maximum heart rate
- Regular physical training, regardless of any weight loss taking place, resulted in the reduction of fat content in the liver. The highest benefit was seen in the collectives that performed endurance training with higher training intensity or more frequent training.
- Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine is available exclusively to our partners.
