PERAN NUTRISI DAN GAYA HIDUP DALAM PERKEMBANGAN NAFLD : REVIEW BERBASIS EVIDENCE (2023–2025)

Authors

  • Shellya Puti Sudesty S1 Pendidikan dokter, Fakultas Kedokteran, Universitas Lampung
  • Sri Octa Handayani S1 Pendidikan dokter, Fakultas Kedokteran, Universitas Lampung

DOI:

https://doi.org/10.31004/jkt.v6i4.52420

Keywords:

aktivitas fisik, gaya hidup, NAFLD, penyakit metabolik, pola nutrisi

Abstract

Non-alcoholic fatty liver disease (NAFLD; kini sering juga disebut MASLD) merupakan masalah kesehatan masyarakat yang tumbuh sejalan dengan peningkatan obesitas dan pola makan modern. Nutrisi dan gaya hidup adalah determinan kunci baik pada inisiasi maupun progresi penyakit. Tujuan literatur review ini adalah memetakan bukti ilmiah terbaru mengenai peran nutrisi dan modifikasi gaya hidup terhadap perkembangan NAFLD pada periode publikasi tahun 2023–2025. Proses penelusuran dilakukan mengikuti pedoman PRISMA 2020 menggunakan tiga basis data utama, yaitu PubMed, Scopus, dan ScienceDirect. Kriteria inklusi ditetapkan untuk memasukkan artikel primer dan tinjauan berbasis evidence yang memuat data empiris mengenai hubungan pola makan, komposisi nutrisi, aktivitas fisik, perilaku gaya hidup, atau intervensi nutrisi terhadap perkembangan maupun perbaikan NAFLD. Jenis studi yang diterima mencakup uji klinis, studi kohort, studi cross-sectional, meta-analisis, serta systematic reviews yang menyediakan data kuantitatif atau sintesis berbasis bukti. Literatur 2023-2025 menunjukkan bahwa kualitas diet dan modifikasi gaya hidup berperan penting dalam mitigasi NAFLD. Pola makan berkualitas dan intervensi diet–exercise terintegrasi menurunkan steatosis dan memperbaiki metabolisme, sementara konsumsi ultra-processed foods meningkatkan risiko melalui lipogenesis, inflamasi, dan disbiosis. Nutraceuticals dan probiotik memberi manfaat tambahan. Peran nutrisi dan gaya hidup menjadi peran utama dalam perkembangan NAFLD seperti pola makan berkulitas, intervansi diet-exercise terintegrasi, intermitten fasting, nutraceuticals dan probiotik.

References

Aziz, T., Niraj, M. K., Kumar, S., Kumar, R., & Parveen, H. (2024). Effectiveness of omega-3 polyunsaturated fatty acids in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Cureus, 16(8), e68002. https://doi.org/10.7759/cureus.68002

Bagnato, C. B., Bianco, A., Bonfiglio, C., Franco, I., Verrelli, N., Carella, N., Shahini, E., Zappimbulso, M., Giannuzzi, V., Pesole, P. L., Ancona, A., & Giannelli, G. (2024). Healthy lifestyle changes improve cortisol levels and liver steatosis in MASLD patients: Results from a randomized clinical trial. Nutrients, 16(23), 4225. https://doi.org/10.3390/nu16234225

Deng, Q., Lv, R., Zou, H., et al. (2024). Beneficial effects of intermittent fasting on NAFLD: Narrative review. Egyptian Liver Journal. https://doi.org/10.1186/s43066-024-00368-x

Deng, Y., et al. (2024). Early time-restricted eating randomized clinical trial in obesity. Obesity. https://doi.org/10.1002/oby.23926

Feng, R., et al. (2024). Time-restricted eating ameliorates NAFLD via nicotinamide metabolism and gut microbiota remodeling. Translational Gut Microbes. https://doi.org/10.1080/19490976.2024.2390164

Grinshpan, L. S., Eilat-Adar, S., Ivancovsky-Wajcman, D., Kariv, R., Gillon-Keren, M., & Zelber-Sagi, S. (2023). Ultra-processed food consumption and non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance: A systematic review. JHEP Reports, 6(1), 100964. https://doi.org/10.1016/j.jhepr.2023.100964

Henney, A. E., Gillespie, C. S., Alam, U., Hydes, T. J., & Cuthbertson, D. J. (2023). Ultra-processed food intake is associated with non-alcoholic fatty liver disease: Systematic review & meta-analysis. Nutrients, 15(10), 2266. https://doi.org/10.3390/nu15102266

Huang, T. D., Behary, J., & Zekry, A. (2020). Non-alcoholic fatty liver disease: A review of epidemiology, risk factors, diagnosis and management. Internal Medicine Journal, 50(9), 1038–1047. https://doi.org/10.1111/imj.14709

Huh, Y., Cho, Y. J., & Nam, G. E. (2022). Recent epidemiology and risk factors of nonalcoholic fatty liver disease. Journal of Obesity & Metabolic Syndrome, 31(1), 17–27. https://doi.org/10.7570/jomes22021

Kim, J. H., Lee, S., Park, E., et al. (2025). Omega-3 supplementation improves hepatic inflammation in diabetic NAFLD: Randomized trial. Clinical Nutrition. https://doi.org/10.1016/j.clnu.2025.02.014

Khodadadi, N., et al. (2024). 5:2 intermittent fasting randomized controlled trial. Nutrition & Diabetes. https://doi.org/10.1038/s41387-024-00277-4

Kord-Varkaneh, H., Salehi-Sahlabadi, A., Tinsley, G. M., et al. (2023). Effects of time-restricted feeding (16/8) plus low-sugar diet on NAFLD. Nutrition. https://doi.org/10.1016/j.nut.2022.111847

Lin, X., et al. (2024). Time-restricted eating: Systematic review. Frontiers in Nutrition. https://doi.org/10.3389/fnut.2024.1301122

Liu, Z., Huang, H., Zeng, Y., Chen, Y., & Xu, C. (2023). Association between ultra-processed food consumption and risk of NAFLD: NHANES 2011–2018. British Journal of Nutrition. https://doi.org/10.1017/S0007114522003956

Liu, Z., Jin, P., Liu, Y., Liu, C., Sun, P., Tian, C., Li, N., Zeng, Q., et al. (2024). A comprehensive lifestyle intervention based on a calorie-restricted diet ameliorates liver fat in patients with NAFLD. Nutrition Journal, 23, 64. https://doi.org/10.1186/s12937-024-00968-8

Mirrazavi, Z. S., et al. (2024). Various fasting diets and possible benefits for NAFLD: Mechanism update. Clinical Nutrition. https://doi.org/10.1016/j.clnu.2024.01.005

Monserrat-Mesquida, M., Bouzas, C., García, S., Mateos, D., Casares, M., Ugarriza, L., Gómez, C., Sureda, A., & Tur, J. A. (2025). Two-year Mediterranean diet intervention improves hepatic health in MASLD patients. Foods, 14(10), 1736. https://doi.org/10.3390/foods14101736

Moore, E., Patanwala, I., Jafari, A., Davies, I. G., Kirwan, R. P., Newson, L., Mazidi, M & Lane, K. E. (2024). A systematic review and meta-analysis of randomized controlled trials to evaluate plant-based omega-3 polyunsaturated fatty acids in nonalcoholic fatty liver disease patient biomarkers and parameters. Nutrition Reviews, 82(2), 143-165. https://doi.org/10.1093/nutrit/nuad054

Nilghaz, M., et al. (2025). DASH diet combined with time-restricted feeding improves hepatic markers: Randomized controlled trial. Scientific Reports. https://doi.org/10.1038/s41598-025-88393-7

Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S. H., Barb, D., Kleiner, D. E., & Loomba, R. (2023). AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology, 77(5), 1797–1835. https://doi.org/10.1097/HEP.0000000000000323

Shafiee, M., Sadeghi, A., Ghafouri-Taleghani, F., Nilghaz, M., et al. (2025). Effects of time-restricted feeding plus lacto-ovo vegetarian diet on MASLD. Scientific Reports. https://doi.org/10.1038/s41598-025-88773-z

Silva-Sperb, A. S., Moraes, H. A., de Moura, B. C., et al. (2024). PROBILIVER: Probiotic supplementation for 24 weeks in NASH. Frontiers in Nutrition, 11, 1362694. https://doi.org/10.3389/fnut.2024.1362694

Toh, J. Z. K., Pan, X.-H., Tay, P. W. L., Ng, C. H., Yong, J. N., Xiao, J., & Siddiqui, M. S. (2022). A meta-analysis on the global prevalence, risk factors and screening of coronary heart disease in nonalcoholic fatty liver disease. Clinical Gastroenterology and Hepatology, 20(11), 2462–2473.e10. https://doi.org/10.1016/j.cgh.2021.09.021

Tsitsou, S., et al. (2025). Mediterranean-type time-restricted feeding for NAFLD: CHRONO-NAFLD trial. Alimentary Pharmacology & Therapeutics. https://doi.org/10.1111/apt.18054

Us Altay, D., Kaya, Y., Mataracı Değirmenci, D., Kocyiğit, E., Üner, A., & Noyan, T. (2024). Non-alcoholic fatty liver disease: The importance of physical activity and nutrition education — A randomized controlled study. Journal of Gastroenterology & Hepatology, 39(12), 2723–2734. https://doi.org/10.1111/jgh.16756

Van den Burg, E. L., Schoonakker, M. P., et al. (2025). A fasting-mimicking diet reduces liver fat and fibrosis in NAFLD: Randomized controlled trial. Clinical Nutrition. https://doi.org/10.1016/j.clnu.2025.01.014

Wei, X., Lin, B., Huang, Y., et al. (2023). Effects of time-restricted eating on NAFLD: The TREATY-FLD randomized clinical trial. JAMA Network Open, 6(3), e233513. https://doi.org/10.1001/jamanetworkopen.2023.3513

Xue, Y., Peng, Y., Zhang, L., Ba, Y., Jin, G., & Liu, G. (2024). Effect of different exercise modalities on NAFLD: Network meta-analysis. Scientific Reports, 14, 6212. https://doi.org/10.1038/s41598-024-51470-4

Zanini, B., Benini, F., Marullo, M., Simonetto, A., Rossi, A., Cavagnoli, P., Bonalumi, A., Marconi, S., Pigozzi, M. G., Gilioli, G., Valerio, A., Donato, F., Castellano, M., & Ricci, C. (2024). Mediterranean-oriented dietary intervention reduces liver steatosis in NAFLD: Italian clinical trial. International Journal of Clinical Practice, Article 8861126. https://doi.org/10.1155/2024/8861126

Zelber-Sagi, S., & Moore, J. B. (2024). Practical lifestyle management of NAFLD for clinicians. Diabetes Spectrum, 37(1), 39–47. https://doi.org/10.2337/dsi23-0009

Zhang, J., Shu, L., & Chen, X. (2025). Ultra-processed foods and NAFLD: Updated systematic review and dose–response meta-analysis. Frontiers in Nutrition, 12, 1631975. https://doi.org/10.3389/fnut.2025.1631975

Zhang, Y. F., et al. (2024). Association of ultra-processed food intake with severe NAFLD: UK Biobank. Journal of Nutrition, Health & Aging. https://doi.org/10.1016/j.jnha.2024.100352

Zhao, L., Zhang, X., Clay-Gilmour, A., et al. (2023). Higher ultra-processed food intake associated with adverse liver outcomes. Hepatology Communications, 7(9), e0240. https://doi.org/10.1097/HC9.0000000000000240

Downloads

Published

2025-12-21