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Cited by 778Liver Disease Diagnosis and TreatmentNutritional Studies and DietDiet, Metabolism, and Disease

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The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease

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Ryan, Marno C., Itsiopoulos, Catherine, Thodis, Tania, Ward, Glenn, Trost, Nicholas, Hofferberth, Sophie, O’Dea, Kerin, Desmond, Paul V., Johnson, Nathan A., Wilson, Andrew M.·2013·Journal of Hepatology
DOI 10.1016/j.jhep.2013.02.012
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Abstract

Background & aims Non-alcoholic fatty liver disease (NAFLD) affects up to 30% of the population and signifies increased risk of liver fibrosis and cirrhosis, type 2 diabetes, and cardiovascular disease. Therapies are limited. Weight loss is of benefit but is difficult to maintain. We aimed at examining the effect of the Mediterranean diet (MD), a diet high in monounsaturated fatty acids, on steatosis and insulin sensitivity, using gold standard techniques.Methods Twelve non-diabetic subjects (6 Females/6 Males) with biopsy-proven NAFLD were recruited for a randomised, cross-over 6-week dietary intervention study. All subjects undertook both the MD and a control diet, a low fat-high carbohydrate diet (LF/HCD), in random order with a 6-week wash-out period in- between. Insulin sensitivity was determined with a 3-h hyperinsulinemic-euglycemic clamp study and hepatic steatosis was assessed with localized magnetic resonance (1)H spectroscopy ((1)H-MRS).Results At baseline, subjects were abdominally obese with elevated fasting concentrations of glucose, insulin, triglycerides, ALT, and GGT. Insulin sensitivity at baseline was low (M=2.7 ± 1.0 mg/kg/min(-1)). Mean weight loss was not different between the two diets (p=0.22). There was a significant relative reduction in hepatic steatosis after the MD compared with the LF/HCD: 39 ± 4% versus 7 ± 3%, as measured by (1)H-MRS (p=0.012). Insulin sensitivity improved with the MD, whereas after the LF/HCD there was no change (p=0.03 between diets).Conclusions Even without weight loss, MD reduces liver steatosis and improves insulin sensitivity in an insulin-resistant population with NAFLD, compared to current dietary advice. This diet should be further investigated in subjects with NAFLD.

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  1. Elhayany, 2010, A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study, Diabetes Obes Metab, 12, 204, 10.1111/j.1463-1326.2009.01151.x · DOI · Paper page

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Metadata

Authors
Ryan, M. C., Itsiopoulos, C., Thodis, T., Ward, G., Trost, N., Hofferberth, S., O’Dea, K., Desmond, P. V., Johnson, N. A., & Wilson, A. M.
Affiliations
  • St Vincent's Hospital Melbourne (AU)
  • La Trobe University (AU)
  • University of South Australia (AU)
  • The University of Sydney (AU)
Corresponding author
Ryan, Marno C.
ORCID
Venue
Journal of Hepatology
Publisher
Elsevier BV
Published
2013-07
Volume
59
Issue
1
Pages
138-143
ISSN
0168-8278 (ISSN-L)
DOI
10.1016/j.jhep.2013.02.012
OpenAlex
W2053985254
Cited by
778
References
46
Citations by year
2026: 39 · 2025: 59 · 2024: 66 · 2023: 90 · 2022: 66 · 2021: 71 · 2020: 77 · 2019: 70 · 2018: 69 · 2017: 52 · 2016: 50 · 2015: 26 · 2014: 29 · 2013: 12
FWCI
28.42
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders
National Health and Medical Research Council
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
Mediterranean diet, non-alcoholic fatty liver disease, hepatic steatosis, insulin sensitivity, monounsaturated fatty acids, low-fat high-carbohydrate diet, dietary intervention, hyperinsulinemic-euglycemic clamp, 1H magnetic resonance spectroscopy, weight loss, insulin resistance
MeSH terms
Adult, Aged, Fatty Liver, Female, Humans, Insulin Resistance, Magnetic Resonance Imaging, Male, Middle Aged, Pilot Projects, Glucose Clamp Technique, Cross-Over Studies, Diet, Mediterranean, Lipid Metabolism, Obesity, Abdominal, Non-alcoholic Fatty Liver Disease

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