Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean lifestyle: a randomised controlled clinical trial

Jun 28, 2018The British journal of nutrition

Mediterranean lifestyle improves health measures in people with non-alcoholic fatty liver disease: a controlled clinical trial

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Abstract

In a trial with 63 participants, 88.8% completed the study on the effects of Mediterranean diet and lifestyle interventions for non-alcoholic fatty liver disease.

Both the Mediterranean diet group and the Mediterranean lifestyle group experienced greater weight reduction and higher adherence to the Mediterranean diet compared to the control group.
The Mediterranean lifestyle group showed a significant increase in vigorous exercise and mid-day rest compared to both other groups.
Participants in the Mediterranean lifestyle group had significant improvements in liver enzyme levels and liver stiffness compared to the control group.
The Mediterranean diet group improved liver stiffness but did not show significant changes in liver enzyme levels compared to the control group.
Weight loss combined with lifestyle changes may provide a treatment option for patients with non-alcoholic fatty liver disease.

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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 participants completed the study. On the basis of intention-to-treat analysis, both MDG and MLG showed greater weight reduction and higher adherence to MD compared with the CG (all P<0·05) at the end of intervention. In addition, MLG increased vigorous exercise compared with the other two study groups (P<0·001) and mid-day rest/naps compared with CG (P=0·04). MLG showed significant improvements in ALT levels (i.e. ALT<40 U/l (P=0·03) and 50 % reduction of ALT levels (P=0·009)) and liver stiffness (P=0·004) compared with CG after adjusting for % weight loss and baseline values. MDG improved only liver stiffness compared with CG (P<0·001) after adjusting for the aforementioned variables. Small changes towards the Mediterranean lifestyle, along with weight loss, can be a treatment option for patients with NAFLD.

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Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean lifestyle: a randomised controlled clinical trial

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