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cohort·nutrition, clinical nutrition, gastroenterology, endocrinology, dietetics·PMC10055888

Role of Nutrition in the Etiopathogenesis and Prevention of Nonalcoholic Fatty Liver Disease (NAFLD) in a Group of Obese Adults

Medicina · 8 authors, 3 centres

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TL;DR

This prospective cohort study monitored 22 obese or overweight patients with hepatic steatosis for six months on a Mediterranean-diet-based low-calorie intervention. Greater adherence to the Mediterranean diet, measured by the Mediterranean Adequacy Index, was significantly inversely associated with serum ALT transaminase levels.

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This prospective cohort study enrolled 22 obese or overweight teetotal nonsmoking adults with ultrasound-confirmed hepatic steatosis after screening for cognitive normality via the MoCA. Patients were placed on a low-calorie diet of 1300–1400 kcal (20% protein, 25% lipids, 55% carbohydrates) aligned with Mediterranean diet principles and monitored for six months. Dietary adherence was quantified using the Mediterranean Adequacy Index (MAI). Results showed significant clinical variable changes between baseline and six months (p < 0.01) and a significant negative correlation between serum ALT transaminases and the MAI (r = −0.48; p = 0.02), indicating that greater Mediterranean diet adherence was associated with lower ALT levels. No significant improvement in cognitive performance was observed. The study found no significant cognitive improvement between T0 and T1. Findings suggest that Mediterranean diet adherence may be inversely related to a marker of liver damage in obese individuals with steatosis.

STUDY TYPE

cohort

SPECIALTY

nutrition

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ORIGINAL PAPER

PMC10055888

Role of Nutrition in the Etiopathogenesis and Prevention of Nonalcoholic Fatty Liver Disease (NAFLD) in a Group of Obese Adults

Medicina

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ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is liver damage characterized by an accumulation of triglycerides in hepatocytes of >5% (due to an alteration of the balance of the lipid metabolism in favour of lipogenesis compared to lipolysis) that is not induced by the consumption of alcohol. The pathology includes simple steatosis and nonalcoholic steatohepatitis, or NASH (steatosis associated with microinflammatory activities), which can evolve in 15% of subjects with hepatic fibrosis to cirrhosis and the development of hepatocellular carcinoma. The aim of this study is to report the role of macro- and micronutrients in the pathogenesis and prevention of NAFLD in obese subjects. A total of 22 obese or overweight patients with hepatic steatosis were monitored periodically, evaluating their eating habits, fasting glycaemia, lipid picture, liver enzymes, anthropometric parameters, nutrition status, liver ultrasound, oxidative stress, and adherence to the Mediterranean diet. A statistical analysis shows a significant positive relationship between total cholesterol and the Mediterranean adequacy index (MAI) (r = −0.57; p = 0.005) and a significant negative relationship between ALT transaminases and the MAI (r = −0.56; p = 0.007). Nutrition and diet are important factors in the pathogenesis and prevention of NAFLD. The dietary model, based on the canons of the Mediterranean diet, prevents and reduces the accumulation of fat in hepatocytes. Therefore, in agreement with other studies in the literature, we can state that a dietary model characterized by foods rich in fibre, carotenoids, polyphenols, ω3 fatty acids, folic acid, and numerous other molecules is inversely correlated with the serum levels of ALT transaminases, an enzyme whose level increases when the liver is damaged and before the most obvious symptoms of organ damage appear.

CITATION EXPORT

Daniela Metro, Martina Buda, Luigi Manasseri et al.. Role of Nutrition in the Etiopathogenesis and Prevention of Nonalcoholic Fatty Liver Disease (NAFLD) in a Group of Obese Adults. Medicina. (2023). https://doi.org/10.3390/medicina59030638

AUTHORS

8 · 3 CENTRES

Daniela Metro, Martina Buda, Luigi Manasseri, Francesco Corallo, Davide Cardile, Viviana Lo Buono, Angelo Quartarone, Lilla Bonanno

1Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
2Department Oncological D.A.I., UOC of General Surgery—Oncology, 98125 Messina, Italy
3IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy

EDITOR / REVIEWER

Ludovico Abenavoli