Reply to Alvarez Stehle, E. Comment on “Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771” (original) (raw)

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Insulin resistance and obesity-related inflammatory status, associated with genetic, dietary, and lifestyle factors, are involved in its pathogenesis. There is no consensus concerning the pharmacological treatment of NAFLD. However, the international guidelines agree to define a dietetic nutritional management to achieve weight loss, as an essential component of any therapeutic strategy. Areas covered: An overview on the beneficial effects of the Mediterranean diet in the prevention and treatment of NAFLD. Expert commentary: On the basis of its components, the literature reports the beneficial effects of the Mediterranean diet in preventing major chronic diseases, including obesity, diabetes, cardiovascular diseases, and some forms of cancers. In recent years, a growing body of evidence has supported the idea that the Mediterranean diet, associated with physical activity and cognitive behavior thera...

Background: Elevated fasting remnant cholesterol (REM-C) levels have been associated with an increased cardiovascular risk in patients with metabolic syndrome (Mets) and Non-Alcoholic Fatty Liver Disease (NAFLD). We aimed to estimate the effect of different diets on REM-C levels in patients with MetS, as well as the association between NAFLD and REM-C. Methods: This is a secondary analysis of the MEDIDIET study, a parallel-arm Randomized Clinical Trial (RCT). We examined 237 people with MetS who underwent Liver Ultrasound (LUS) to assess the NAFLD score at baseline, 3-, and 6-months follow-up. Subjects were randomly assigned to the Mediterranean diet (MD), Low Glycemic Index diet (LGID), or Low Glycemic Index Mediterranean diet (LGIMD). REM-C was calculated as [total cholesterol–low density lipoprotein cholesterol (LDL-C)–high density lipoprotein cholesterol (HDL-C)]. Results: REM-C levels were higher in subjects with moderate or severe NAFLD than in mild or absent ones. All diets h...

BackgroundDespite evidence supporting the beneficial effects of the Mediterranean diet (MedDiet) on hepatic steatosis in subjects with non-alcoholic fatty liver disease (NAFLD), the relationship of the MedDiet with hepatic fibrosis is as yet unclear. The aim of the present study was to explore this association in Iranian adults with NAFLD.MethodsThis cross-sectional study included 3,325 subjects with NAFLD from the Ravansar Noncommunicable Disease (RaNCD) cohort. Dietary intake data were collected by a validated food frequency questionnaire (FFQ). The MedDiet score was computed based on a nine-point scale constructed by Trichopoulou et al. Fatty liver index (FLI) and fibrosis-4 (FIB-4) index were used to predict hepatic steatosis and fibrosis in the population. Multivariate regression models were applied to determine associations.ResultsSubjects in the highest tertile of MedDiet score had a higher platelet and a lower weight, total cholesterol (TC), LDL-c, and FLI than those in the ...

Lifestyle interventions remain the cornerstone therapy for non-alcoholic fatty liver disease (NAFLD). This randomised controlled single-blind clinical trial investigated the effect of Mediterranean diet (MD) or Mediterranean lifestyle, along with weight loss, in NAFLD patients. In all, sixty-three overweight/obese patients (50 (sd 11) years, BMI=31·8 (sd 4·5) kg/m2, 68 % men) with ultrasonography-proven NAFLD (and elevated alanine aminotransferase (ALT) and/or γ-glutamyl transpeptidase (GGT) levels) were randomised to the following groups: (A) control group (CG), (B) Mediterranean diet group (MDG) or (C) Mediterranean lifestyle group (MLG). Participants of MDG and MLG attended seven 60-min group sessions for 6 months, aiming at weight loss and increasing adherence to MD. In the MLG, additional guidance for increasing physical activity and improving sleep habits were given. Patients in CG received only written information for a healthy lifestyle. At the end of 6 months, 88·8 % of par...