Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity

Abstract

Obesity is a risk factor for NAFLD. However, not all people with obesity have an excessive intrahepatic fat content. Adherence to a high-quality dietary pattern may also promote liver health in obesity. A cross-sectional study of 2967 women with overweight and obesity was carried out to assess the association between a Mediterranean diet and fatty liver. All women underwent clinical examination, anthropometric measurements, blood sampling, ultrasound measurements of abdominal visceral and subcutaneous fat, and assessment of adherence to the Mediterranean diet using the 14-item MEDAS questionnaire. Fatty liver index (FLI), NAFLD fatty liver steatosis (NAFLD-FLS) and hepatic steatosis index (HSI) were calculated. In women with obesity, the MEDAS score was inversely associated with FLI (β = −0.60, 95% CI: −1.04, −0.16, p = 0.008), NAFLD-FLS (β= −0.092, 95% CI: −0.134, −0.049, p < 0.001) and HSI (β = −0.17, 95% CI: −0.30, −0.04, p = 0.011). Stronger associations were observed in premenopausal women with obesity. Mediterranean diet was inversely associated with NAFLD-FLS in women with overweight, independently of menopausal status. In conclusion, Mediterranean diet is associated with a better liver status in women with overweight and obesity. This may have a public health impact and be useful in drafting nutritional guidelines for NAFLD.

The Effects of Greek Orthodox Christian Fasting during Holy Week on Body Composition and Cardiometabolic Parameters in Overweight Adults

“…Various factors contribute to fat accumulation in the liver, including increased fat availability from visceral fat tissue [ 24 ] and increased de novo lipogeneses due to peripheral insulin resistance [ 25 ]. On the other hand, the Mediterranean diet has been shown to regulate these processes [ 26 ] due to the antioxidant, anti-inflammatory and antifibrotic effects of polyphenols and monounsaturated fatty acids that are consumed in large amounts in this diet [ 27 ]. In the present study, dietary analysis showed that the synthesis of Greek Orthodox Christian fasting was similar to that of the Mediterranean diet in terms of macronutrient ratio (moderate carbohydrate, low protein and high fat intake, with particularly high monosaturated fat intake).…”

“…In the present study, dietary analysis showed that the synthesis of Greek Orthodox Christian fasting was similar to that of the Mediterranean diet in terms of macronutrient ratio (moderate carbohydrate, low protein and high fat intake, with particularly high monosaturated fat intake). Long-term adherence to such a dietary pattern may be affective in lowering liver fat accumulation, which is associated with an increased risk of various health problems, including non-alcoholic fatty liver disease [ 27 ].…”

Obesity Is Associated with Fatty Liver and Fat Changes in the Kidneys in Humans as Assessed by MRI

“…We also showed that obese individuals with a fatty liver are at a high risk of having fatty kidneys. The association between obesity and fatty liver disease is well known [28]. However, the association between obesity and fatty kidneys is less known.…”

The Role of the Fatty Liver Index (FLI) in the Management of Non-Alcoholic Fatty Liver Disease: A Systematic Review

“…In their study involving overweight and obese women, Alessandro Leone and colleagues [92] revealed a noteworthy link between adherence to the Mediterranean diet and improved liver health. Analysing parameters such as FLI, NAFLD-FLS and HSI, they found that greater adherence to the Mediterranean diet was associated with lower values of these indices.…”