Mediterranean dietary pattern and non-alcoholic fatty liver diseases: a case-control study

Abstract

The Mediterranean (MED) diet was associated with a reduced risk of chronic disease, but the epidemiological studies reported inconsistent findings related to the MED diet and non-alcoholic fatty liver disease (NAFLD) risk. This age and the gender-matched case-control study were conducted among 247 adult patients. The MED diet score was obtained based on the Trichopoulou model. Multivariate logistic regression was used to examine the association between the MED diet and NAFLD risk. NAFLD prevalence in people with low, moderate and high adherence to the MED diet was 33, 13⋅1 and 4⋅6 %, respectively. The increasing intake of the MED diet was significantly related to the increment intake of nuts and fruits, vegetables, monounsaturated fatty acid/polyunsaturated fatty acid ratio, legumes, cereals and fish. However, total energy consumption, low-fat dairy and meats intake were reduced (P for all < 0⋅05). Following control for age, the person in the highest of the MED diet tertile compared with the lowest, the odds of NAFLD decreased (OR: 0⋅40, 95 % CI: 0⋅17–0⋅95). This relation became a little stronger after further adjusting for sex, diabetes, physical activity and supplement intake (OR: 0⋅36, 95 % CI: 0⋅15–0⋅89). However, this association disappeared after adjusting for body mass index, waist and hip circumference (OR: 0⋅70, 95 % CI: 0⋅25–1⋅97). High adherence to the MED diet was associated with a 64 % reduction in NAFLD odds before some anthropometric variable adjustments. However, further prospective studies are required, particularly in BMI-stratified models.

Crosstalk between dietary patterns, obesity and nonalcoholic fatty liver disease

“…The observational studies on the association between MD and NAFLD are summarized in Table 1 . A reverse association between high adherence to MD and NAFLD odds, even after adjusting for some confounders such as age, sex, diabetes, physical activity, energy intake, smoking status and supplements use was seen in two case-control studies[ 40 , 41 ] and one cross-sectional study[ 42 ]. It should be highlighted that higher consumption of nuts, fruits and vegetables, legumes and fish as well as lower intake of meat were reported to be protective against NAFLD[ 43 ].…”

“…However, Entezari et al [ 40 ] observed that the reverse relationship between adherence to MD and odds of NAFLD disappeared after controlling for the anthropometric variables (body mass index and waist-to-hip ratio), which means that the MD may improve fatty liver by body weight modification, modulation of lipid profile and inflammatory markers. Although Kontogianni et al [ 44 ] did not find a significant difference between NAFLD patients and controls in terms of adherence to the MD, higher adherence to this diet was inversely associated with alcoholic steatohepatitis.…”

“…For example, polyphenols present in olive oil, such as oleuropein, hydroxytyrosol and tyrosol, have important antioxidant and anti-inflammatory effects[ 51 ]. The high content of dietary fiber both in soluble and insoluble forms in the MD is associated with a decrease in serum TGs and blood glucose[ 40 ]. The beneficial effect of the MD on NAFLD progression is also linked with an absence of added sugars and fructose in this diet.…”

Adherence to a Traditional Mexican Diet Is Associated with Lower Hepatic Steatosis in US-Born Hispanics of Mexican Descent with Overweight or Obesity

“…The literature on diet and NAFLD for Hispanic individuals is sparse and further limited for Hispanics of Mexican descent, making the direct comparison of results challenging. The majority of studies have evaluated dietary patterns like the DASH pattern [56][57][58], Mediterranean pattern [25,57,[59][60][61], or variations of the Healthy Eating Index [56,59], in predominantly NHW populations [25,[59][60][61][62], with few among diverse populations [56][57][58]. In these studies, NAFLD-related outcomes have varied with outcomes including liver fat [25,59], liver damage [60], liver enzymes [26,60], and odds or the risk for NAFLD [56,58,61,62].…”

Relationship between the Mediterranean diet and risk of hepatic fibrosis in patients with non-alcoholic fatty liver disease: A cross-sectional analysis of the RaNCD cohort

“…A high intake of whole grains, fruits, vegetables, seafood, beans, nuts, and olive oils characterizes this dietary pattern. Many observational studies revealed that adherence to the MedDiet is negatively associated with the serum levels of liver enzymes, the onset and severity of hepatic steatosis, and the presence of NASH in patients with NAFLD (6)(7)(8). In line with these efforts, several clinical trials showed that the MedDiet can substantially improve liver enzymes, hepatic steatosis, and insulin sensitivity in patients with NAFLD (9)(10)(11).…”