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Clin Nutr. 2014 Aug;33(4):678-83. doi: 10.1016/j.clnu.2013.08.014. Epub 2013 Sep 7.

Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease.

Author information

1
Department of Nutrition & Dietetics, Harokopio University, El. Venizelou 70, Kallithea, 17671 Athens, Greece. Electronic address: mkont@hua.gr.
2
Department of Nutrition & Dietetics, Harokopio University, El. Venizelou 70, Kallithea, 17671 Athens, Greece. Electronic address: nafsika.tileli@gmail.com.
3
2nd Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Greece. Electronic address: katerina.marg@gmail.com.
4
Department of Nutrition & Dietetics, Harokopio University, El. Venizelou 70, Kallithea, 17671 Athens, Greece. Electronic address: mihalis.georgoulis@gmail.com.
5
2nd Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Greece. Electronic address: meladeut@gmail.com.
6
Laboratory of Histology & Embryology, Medical School, National & Kapodistrian University of Athens, Greece. Electronic address: dtiniak@med.uoa.gr.
7
Department of Nutrition & Dietetics, Harokopio University, El. Venizelou 70, Kallithea, 17671 Athens, Greece. Electronic address: efragop@hua.gr.
8
2nd Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Greece. Electronic address: rodza@mycosmos.gr.
9
Department of Nutrition & Dietetics, Harokopio University, El. Venizelou 70, Kallithea, 17671 Athens, Greece. Electronic address: manios@hua.gr.
10
2nd Department of Internal Medicine, Athens University Medical School, Hippokration Hospital of Athens, Greece. Electronic address: gepapath@med.uoa.gr.

Abstract

BACKGROUND & AIMS:

Nutrition has been proposed as a potential environmental factor affecting the risk of non-alcoholic fatty liver disease (NAFLD). In the present study, the impact of adherence to the Mediterranean diet (MD) on the presence and severity of NAFLD was explored.

METHODS:

Seventy-three consecutive adult patients with recent NAFLD diagnosis were included. Adherence to the MD was estimated with MedDietScore. Demographic and anthropometric data, body composition analysis and several biochemical and inflammatory markers were estimated. Liver stiffness measurements by transient elastography were available in 58 patients and liver biopsies in 34 patients. Fifty-eight patients were matched with 58 healthy controls in terms of age, sex and body mass index.

RESULTS:

MedDietScore was negatively correlated to patients' serum alanine aminotransferase (p = 0.03) and insulin levels (p = 0.001), insulin resistance index (p = 0.005) and severity of steatosis (p = 0.006) and positively to serum adiponectin levels (p = 0.04). Patients with non-alcoholic steatohepatitis (NASH) exhibited lower adherence to MD (29.3 ± 3.2 vs. 34.1 ± 4.4, p = 0.004) compared to those with simple fatty liver. Logistic regression analysis revealed that one unit increase in the MedDietScore was associated with 36% lower likelihood of having NASH (odds ratio: 0.64, 95% confidence interval: 0.45-0.92), after adjusting for sex and abdominal fat level. No difference in the MedDietScore was observed between patients and controls.

CONCLUSIONS:

Higher adherence to the Mediterranean diet is not associated with lower likelihood of having NAFLD, but it is associated with less degree of insulin resistance and less severe liver disease among patients with NAFLD.

KEYWORDS:

Inflammatory markers; Liver biopsy; Mediterranean diet; Transient elastography

PMID:
24064253
DOI:
10.1016/j.clnu.2013.08.014
[Indexed for MEDLINE]

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