Nutritional aspects in patients with non-alcoholic steatohepatitis (NASH).

BACKGROUND AND OBJECTIVES: Metabolic alterations are a common feature in patients affected by non-alcoholic steato-hepatitis (NASH). A strong correlation exists between overweight, in particular visceral fat accumulation, and prevalence of NASH, especially in men. Thus, diet-induced weight loss represents a fundamental tool in disease management of these patients. The aim of the present study was to evaluate body composition and nutrient utilisation in patients with NASH, comparing them with patients affected by chronic hepatitis related to hepatitis C virus (HCV) infection and with healthy subjects. MATERIALS AND METHODS: Twenty male outpatients with NASH (age: 41 +/- 11 yr; BMI: 26.2 +/- 2.1 kg/m2) and 14 HCV male patients (age 44.6 +/- 13 yr; BMI: 24.8 +/- 2.8 kg/m2) were enrolled in the study. A group of 20 healthy male subjects (age: 39 +/- 10 yr; BMI: 23.3 +/- 1.1 kg/m2) were studied as controls. Body composition was assessed by anthropometry and dual-energy X-ray absorptiometry; resting metabolic rate and nutrient oxidation by indirect calorimetry. A 7-day food diary was collected. The main biochemical parameters were measured using standardised laboratory techniques. RESULTS: Body weight was higher in NASH patients with respect to HCV patients and control subjects (respectively 75.2 +/- 8.9 vs 68.5 +/- 9.4 and vs 67.0 +/- 8.0 kg; P < 0.01) and this was essentially due to fat mass increase. Fat-free mass reduction was found in HCV patients with respect to both NASH and control subjects. Patients with NASH had a significantly higher waist circumference (P < 0.01) and a lower resting metabolic rate (RMR) with respect to HCV and control subjects. Energy intake was significantly higher in NASH patients (P < 0.01) compared to the other two groups. CONCLUSIONS: NASH patients showed an increase in body weight, fat mass and visceral fat accumulation with respect to HCV and control subjects. The reduction in RMR, coupled with increase energy intake may explain the body composition alterations found in these patients.

Decrease in extra-cellular water compartment in overweight women after administration of oligomineral water associated to a hypocaloric diet regimen.

AIM: Alteration in body fluid distribution may have relevant implications in several human diseases. The use of oligomineral water is associated with increased diuresis and this could be extremely useful in subjects with water retention. The aim of the present study was to evaluate the effect of daily administration of 1.5 liters of oligomineral water over 4 weeks on body water compartment (extracellular and intracellular water [ECW and ICW]) in healthy overweight women who underwent a hypocaloric dietary regimen. METHODS: Twenty-four healthy premenopausal women (aged 32+/-6 years; body mass index [BMI]: 27.4+/-2 kg/m(2)) were randomly divided into 2 groups and assigned to consume 1.5 liters daily of either tap (Group A) or oligomineral water over a 4-week period. Body composition was assessed by anthropometry and multifrequence bio-impedance analysis. RESULTS: Body weight and fat mass significantly decreased after dietary treatment in the 2 groups examined; although not statistically significant, a higher difference in body weight before and after treatment was found in Group B when compared to Group A (2.2+/-1 kg vs 1.7+/-0.8 kg; p=0.057). Body weight reduction was related to fat mass decrease, while no significant difference was found in fat-free mass among groups. TBW and ECW were reduced in both groups after treatment, while a greater reduction in both variables was found in Group B (p<0.01). The post-treatment ECW/TBW ratio was lower in Group B with respect to Group A (p<0.01). CONCLUSIONS: A supplementation with oligomineral water in overweight women, when associated to a hypocaloric dietary treatment, is able to reduce total and extracellular water content; this findings could have relevant implication in planning a successful dietary regimen for achieving and maintaining a normal body weight.