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Effect of a low glycemic index Mediterranean diet on non-alcoholic fatty liver disease. A randomized controlled clinici trial

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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.

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Authors and Affiliations

  1. Laboratory of Epidemiology and Biostatistics, IRCCS Saverio de Bellis, Via Turi 27, 70013, Castellana Grotte (BA), Italy

    G. Misciagna, D. V. Caramia, C. Bonfiglio, I. Franco, D. I. Abbrescia, A. Mirizzi, M. Tanzi & Alberto Rubén Osella

  2. Department of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Castellana Grotte (BA), Italy

    M. R. Noviello & M. Chiloiro

  3. Laboratory of Biochemical Nutrition, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Castellana Grotte (BA), Italy

    M. G. Caruso

  4. Clinical Nutrition Outpatient Clinic, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Castellana Grotte (BA), Italy

    M. G. Caruso, R. Reddavide, R. Inguaggiato & A. M. Cisternino

  5. Laboratory of Clinical Chemistry, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Castellana Grotte (BA), Italy

    M. Correale

  6. Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET y Facultad de Ciencias Médicas., Universidad Nacional de Córdoba, Córdoba, Argentina

    M. del Pilar Díaz

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  1. G. Misciagna
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  2. M. del Pilar Díaz
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  3. D. V. Caramia
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  4. C. Bonfiglio
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  5. I. Franco
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  6. M. R. Noviello
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  7. M. Chiloiro
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  8. D. I. Abbrescia
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  9. A. Mirizzi
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  10. M. Tanzi
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  11. M. G. Caruso
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  16. Alberto Rubén Osella
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Correspondence to Alberto Rubén Osella.

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Misciagna, G., del Pilar Díaz, M., Caramia, D.V. et al. Effect of a low glycemic index Mediterranean diet on non-alcoholic fatty liver disease. A randomized controlled clinici trial. J Nutr Health Aging 21, 404–412 (2017). https://doi.org/10.1007/s12603-016-0809-8

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