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HIGHLY SPECILIAZED DIET FOR NAFLD AND NASH TO ACHIEVE POSSIBLE REVERSAL OF PATHOLOGY

These results support the benefit of energy-restricted diets, high adherence to the MedDiet, and high antioxidant capacity
of the diet for the management of NAFLD in individuals with overweight or obesity.
SO THIS NAFLD DIET
1. Energey restricted
2. Med Diets properties
3. High Antioxidant capacity

The RHS consists of adults selected randomly from an urban general population. The cohort
has a high prevalence of the components of metabolic syndrome and obesity [7], and a
NAFLD prevalence of 32.6% and annual incidence rate of 6.2% [7, 8]. Prevalent and incident NAFLD were strongly
associated with components of the metabolic syndrome and obesity, and PNPLA3 gene polymorphisms [7–9].

We did not find resolution of NAFLD in this general population cohort. The observed improvements in anthropometric,
clinical and biochemical measurements were inadequate for resolution of NAFLD.

7. Dassanayake AS, Kasthuriratne A, Rajindrajith S, Kalubowila U, Chakrawarthi S, De Silva AP, et al. Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J GastroenterolHepatol 2009; 24: 1284–8. [PubMed] [Google Scholar]
8. Niriella MA, Pathmeswaran A, De Silva ST, Kasturiratna A, Perera KR, Subasinghe SKCE, et al. Incidence and risk factors for non-alcoholic fatty liver disease among adults: a 7-year follow-up study in an urban Sri Lankan community. Liver International 2017; 37(11):1715–22. 10.1111/liv.13478 [PubMed] [CrossRef] [Google Scholar]

Marin-Alejandre BA, Abete I, Cantero I, Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Quiroga J, Martinez-Echeverria A, Uriz-Otano JI, Huarte-Muniesa MP, Tur JA, Martinez JA, Zulet MA. The Metabolic and Hepatic Impact of Two Personalized Dietary Strategies in Subjects with Obesity and Nonalcoholic Fatty Liver Disease: The Fatty Liver in Obesity (FLiO) Randomized Controlled Trial. Nutrients. 2019; 11(10):2543. https://doi.org/10.3390/nu11102543

These are daytime sleepiness, sleep attacks, insomnia, hypnagogic visual hallucinations (visual hallucinations while falling asleep), sleep paralysis

1)      Colds

2)      Flu

3)      Allergic rhinitis

4)      Sinusitis

5)      Bacterial infections 

1)      Following head injury

2) Foul-smelling, unilateral discharge

3)      Bloody unilateral discharge

4)      Symptoms continue for more than 3 weeks

5)      Fever

1)      Cyclical nasal obstruction – unilateral, alternating nasal obstruction lasting 1-4 hrs., Tx nasal steroid sprays

2)      Positional nasal obstruction – unilateral, dependent nostril block, Tx nasal steroid sprays

3)      Allergic rhinitis – recurrent attacks of nasal block, watery nasal discharge, itchy nose, itchy eyes, nose and throat, pale boggy nasal mucosa early stages, hyperemic and granular in chronic conditions, Tx with steroid nasal sprays, antihistamines, cromolyn sodium nasal solution, antileukotrienes

4)      Infectious rhinitis

5)      Atrophic rhinitis

6)      Vasomotor rhinitis

7)      Metabolic/Endocrine causes – pregnancy, menses, OC, hypothyroidism, DM, Tx with saline nasal sprays

8)      Polyps – allergy, chronic sinusitis, recurrent sinus infections,

9)      Drug-induced nasal obstruction

10)    Deviated septum

11)    Perforated septum – nasal trauma, frequent nose picking, nasal surgery, excessive nasal crusting, foul smell crusting, nasal obstruction, epistaxis, inspiratory nasal whistle, septal perforation, otolaryngology referral

12)    Septal hematoma/abscess – nasal septal surgery, nasal trauma, nasal obstruction, septal swelling, nasal pain, fever, otolaryngology referral

13)    Nasal valve collapse – commonest cause is septal deviation, aging, nasal valve scarring, nostril collapse in respiration,

14)    Turbinate Hypertrophy – longstanding allergic rhinitis, vasoconstrictor nasal drops abuse, persistent nasal obstruction, nasal obstruction unrelieved by nasal vasoconstrictors, antihistamines, if no response for steroid nasal drops otolaryngology referral

15)    Adenoid hypertrophy

16)    Nasal polyps

17)    Neoplasm

1)      Adenoid hypertrophy – nasal obstruction, nasal drainage, snoring, sleeping with open mouth, sleep apnea, if no response for antibiotics ENT referral for ? adenoidectomy

Notes :

1)      Asthma, nasal polyps and aspirin intolerance may be a marker of oral aspirin ingestion anaphylaxis

1)      Persistent unilateral nasal obstruction

2)      Persistent unilateral nasal discharge

3)      Offensive nasal discharge

4)      Bloody nasal discharge

5)      P/H nasal injury (septal deviation, septal perforation)

6)      Suspected child abuse

7)      Treatment-resistant nasal obstruction (septal deviation, mechanical obstruction)

8)      P/H nasal surgery (septal deviation, septal perforation)

9)      Cocaine use

10)    Unilateral epistaxis (neoplasms)

1)      Nasal polyps (may be a marker of cystic fibrosis in < 16 yrs)

2)      Persistent unilateral nasal discharge – unilateral choanal atresia

3)      Persistent unexplained unilateral nasal obstruction with/without discharge and/or bleeding

1)      Alvi A and Ching LM. Nasal obstruction: Common causes and manifestations. Postgraduate Medicine Online 2004;116;5;

Noncommunicable diseases kill 41 million people each year, equivalent to 71% of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85% of these "premature" deaths occur in low- and middle-income countries.
Ref -
WHO 2020. https://www.who.int/news/item/01-06-2020-covid-19-significantly-impacts-health-services-for-noncommunicable-diseases Accessed 11:03 AM 3/16/2022