Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinical Trial
Journal: The Journal of Nutrition, Health & Aging
Study Title: Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial
Key Finding: This randomized controlled trial demonstrated that a low-glycemic-index diet significantly reduces hepatic fat content and severity. It underscores how stabilizing postprandial glucose and lowering insulin resistance directly supports the reduction of fat accumulation in liver tissue.
Link: https://pubmed.ncbi.nlm.nih.gov/28346567/
Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial
G Misciagna 1, M Del Pilar Dรญaz, D V Caramia, C Bonfiglio, I Franco, M R Noviello, M Chiloiro, D I Abbrescia, A Mirizzi, M Tanzi, M G Caruso, M Correale, R Reddavide, R Inguaggiato, A M Cisternino, A R Osella
Affiliations Expand
- PMID:ย 28346567
- PMCID:ย PMC12879795
- DOI:ย 10.1007/s12603-016-0809-8
Abstract
Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common form of liver disease worldwide affecting all ages and ethnic groups and it has become a consistent threat even in young people. Our aim was to estimate the effect of a Low Glycemic Index Mediterranean Diet (LGIMD) on the NAFLD score as measured by a Liver Ultrasonography (LUS).
Design: NUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14.
Setting/participants: 98 men and women coming from Putignano (Puglia, Southern Italy) were drawn from a previous randomly sampled population-based study and identified as having moderate or severe NAFLD.
Intervention: The intervention strategy was the assignment of a LGIMD or a control diet.
Outcome measures: The main outcome measure was NAFLD score, defined by LUS.
Results: After randomization, 50 subjects were assigned to a LGIMD and 48 to a control diet. The study lasted six months and all participants were subject to monthly controls/checks. Adherence to the LGIMD as measured by Mediterranean Adequacy Index (MAI) showed a median of 10.1. A negative interaction between time and LGIMD on the NAFLD score (-4.14, 95% CI -6.78,-1.49) was observed, and became more evident at the sixth month (-4.43, 95%CI -7.15, -1.71). A positive effect of the interaction among LGIMD, time and age (Third month: 0.07, 95% CI 0.02, 0.12; Sixth month: 0.08, 95% CI 0.03,0.13) was also observed.
Conclusions: LGIMD was found to decrease the NAFLD score in a relatively short time. Encouraging those subjects who do not seek medical attention but still have NAFLD to follow a LGIMD and other life-style interventions, may reduce the degree of severity of the disease. Dietary intervention of this kind, could also form the cornerstone of primary prevention of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease.
Trial registration: ClinicalTrials.gov NCT01798719.
Keywords: Hepatic steatosis; Mediterranean diet; low glycemic index Mediterranean diet.
Conflict of interest statement
ARO has no conflict of interest to declare. GM has no conflict of interest to declare. DMdP has no conflict of interest to declare. DVC has no conflict of interest to declare. CB has no conflict of interest to declare. IF has no conflict of interest to declare. MRN has no conflict of interest to declare. MC has no conflict of interest to declare. DIA has no conflict of interest to declare. AM has no conflict of interest to declare. MT has no conflict of interest to declare. MGC has no conflict of interest to declare. MC has no conflict of interest to declare. RR has no conflict of interest to declare. RI has no conflict of interest to declare. AMC has no conflict of interest to declare. All authors declare that this study was funded by a research grant from the Italian Ministry of Health. Role of the funding source: none.
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References
- Loria P, Adinolfi LE, Bellentani S, et al. Practice guidelines for the diagnosis and management of nonalcoholic fatty liver disease. A Decalogue from the Italian Association for the Study of the Liver (AISF) Expert Committee. Dig Liver Dis. 2010;42:272โ282. –ย PubMed
- Bedogni G, Miglioli L, Masutti F, et al. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005;42:44โ52.ย 10.1002/hep.20734ย PubMed PMID: 15895401. –ย DOIย –ย PubMed
- Kotronen A, Juurinen L, Hakkarainen A, et al. Liver fat is increased in type 2 diabetes patients and underestimated by serum alanine aminotransferase compared with equally obese nondiabetic subjects. Diabetes Care. 2008;31:165โ169.ย 10.2337/dc07-1463ย PubMed PMID: 17934148. –ย DOIย –ย PubMed
- Zoppini G, Fedeli U, Gennaro N, et al. Mortality from chronic liver diseases in diabetes. Am J Gastroenterol. 2014;109:1020โ1025.ย 10.1038/ajg.2014.132ย PubMed PMID: 24890439. –ย DOIย –ย PubMed
- Angelico F, Del Ben M, Conti R, et al. Insulin resistance, the metabolic syndrome, and nonalcoholic fatty liver disease. J Clin Endocrinol Metab. 2005;90:1578โ1582.ย 10.1210/jc.2004-1024ย PubMed PMID: 15598693. –ย DOIย –ย PubMed
Show all 50 references
Uncited references
- Bedogni G, Bellentani S. Fatty liver disease: how frequent is it and why? Ann Hepatol. 2004;3:63โ65. PubMed PMID: 15257248. –ย PubMed
- Bazzano LA, Hu T, Reynoldas K, et al. Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Ann Intern Med. 2014;161:309โ318.ย 10.7326/M14-0180ย PubMed PMID: 25178568, PMCIDย 4428290. –ย DOIย –ย PMCย –ย PubMed

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