Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease
Abstract
Background & aims Nutrition has been proposed as a potential environmental factor affecting the risk of non-alcoholic fatty liver disease (NAFLD). In the present study, the impact of adherence to the Mediterranean diet (MD) on the presence and severity of NAFLD was explored.Methods Seventy-three consecutive adult patients with recent NAFLD diagnosis were included. Adherence to the MD was estimated with MedDietScore. Demographic and anthropometric data, body composition analysis and several biochemical and inflammatory markers were estimated. Liver stiffness measurements by transient elastography were available in 58 patients and liver biopsies in 34 patients. Fifty-eight patients were matched with 58 healthy controls in terms of age, sex and body mass index.Results MedDietScore was negatively correlated to patients' serum alanine aminotransferase (p = 0.03) and insulin levels (p = 0.001), insulin resistance index (p = 0.005) and severity of steatosis (p = 0.006) and positively to serum adiponectin levels (p = 0.04). Patients with non-alcoholic steatohepatitis (NASH) exhibited lower adherence to MD (29.3 ± 3.2 vs. 34.1 ± 4.4, p = 0.004) compared to those with simple fatty liver. Logistic regression analysis revealed that one unit increase in the MedDietScore was associated with 36% lower likelihood of having NASH (odds ratio: 0.64, 95% confidence interval: 0.45-0.92), after adjusting for sex and abdominal fat level. No difference in the MedDietScore was observed between patients and controls.Conclusions Higher adherence to the Mediterranean diet is not associated with lower likelihood of having NAFLD, but it is associated with less degree of insulin resistance and less severe liver disease among patients with NAFLD.
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Cross-sectional and longitudinal reports evidenced a lower likelihood of NASH in patients who were adherent to the Mediterranean diet.
“Cross-sectional and longitudinal reports evidenced a lower likelihood of NASH in patients who were adherent to the MedDiet [75,76], whereas randomized controlled crossover trials defined the superiority of this diet in the improvement of insulin sensitivity, metabolic parameters and steatosis over low-fat ones [77,78].”
From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [76]
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- Authors
- Kontogianni, M. D., Tileli, N., Margariti, A., Georgoulis, M., Deutsch, M., Tiniakos, D., Fragopoulou, E., Zafiropoulou, R., Manios, Y., & Papatheodoridis, G.
- Affiliations
- Harokopio University of Athens (GR)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Kontogianni, Meropi D.
- Tileli, Nafsika
- Margariti, Aikaterini
- Georgoulis, Michael
- Deutsch, Melanie
- Tiniakos, Dina
- Fragopoulou, Elisabeth
- Zafiropoulou, Rodessa
- Papatheodoridis, George
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 33
- Issue
- 4
- Pages
- 678-683
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2026099877
- Cited by
- 221
- References
- 34
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 15 · 2023: 19 · 2022: 24 · 2021: 22 · 2020: 25 · 2019: 24 · 2018: 20 · 2017: 21 · 2016: 13 · 2015: 5 · 2014: 11 · 2013: 2
- FWCI
- 7.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- Mediterranean diet, non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, dietary adherence, MedDietScore, insulin resistance, steatosis severity, adiponectin, alanine aminotransferase, liver stiffness
- MeSH terms
- Adolescent, Adult, Aged, Alanine Transaminase, Body Composition, Body Height, Body Weight, Cross-Sectional Studies, Female, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Motor Activity, Patient Compliance, Body Mass Index, Logistic Models, Case-Control Studies, Diet, Mediterranean, Adiponectin, Waist Circumference, Young Adult, Non-alcoholic Fatty Liver Disease
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