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Effects of Mediterranean Diet in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Randomized Controlled Trials
Abstract
Abstract We conducted a meta-analysis to investigate the effects of the Mediterranean Diet (Med-Diet) on hepatic steatosis and insulin resistance in patients with nonalcoholic fatty liver disease (NAFLD). Six randomized controlled trials were selected for the meta-analysis (sample size: 250 participants). In the meta-analysis, there was no significant difference in body mass index and waist circumference between the Med-Diet and control groups. Med-Diet significantly reduced fatty liver index (FLI) compared with the control diet (standard mean difference [SMD]: –1.06; 95% CI: –1.95 to –0.17; p = 0.02). Med-Diet significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR) compared with the control diet (SMD: –0.34; 95% CI: –0.65 to –0.03; p = 0.03). Similarly, a meta-regression analysis using age showed that Med-Diet significantly reduced FLI and HOMA-IR (95% CI: –0.956 to –0.237, p = 0.001 and 95% CI: –0.713 to –0.003, p = 0.048, respectively). This meta-analysis demonstrated that Med-Diet improved hepatic steatosis and insulin resistance in patients with NAFLD. Thus, Med-Diet is a beneficial pharmaconutritional therapy in patients with NAFLD.
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“There is limited data on long-term dietary interventions in MASLD since study durations range from 2-24 months. 283 -285”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [285]
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“However, the Mediterranean diet seems to have added value for liver lipid reduction and cardiometabolic health and may be easier to maintain in the long-term. 285,287”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [285]
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Metadata
- Authors
- Kawaguchi, T., Charlton, M., Kawaguchi, A., Yamamura, S., Nakano, D., Tsutsumi, T., Zafer, M., & Torimura, T.
- Affiliations
- Kurume University (JP)
- University of Chicago (US)
- Saga University (JP)
- Corresponding author
- Charlton, Michael
- ORCID
- Venue
- Seminars in Liver Disease
- Publisher
- Georg Thieme Verlag KG
- Published
- 2021-06-19
- Volume
- 41
- Issue
- 03
- Pages
- 225-234
- ISSN
- 0272-8087 (ISSN-L)
- 1098-8971
- OpenAlex
- W3171675307
- Cited by
- 122
- References
- 48
- Citations by year
- 2026: 29 · 2025: 36 · 2024: 21 · 2023: 19 · 2022: 14 · 2021: 3
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Liver Disease (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Agency for Medical Research and Development (JP20fk0210040)
- 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 › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- Mediterranean diet, non-alcoholic fatty liver disease, hepatic steatosis, insulin resistance, fatty liver index, HOMA-IR, dietary intervention
- MeSH terms
- Humans, Insulin Resistance, Regression Analysis, Randomized Controlled Trials as Topic, Diet, Mediterranean, Non-alcoholic Fatty Liver Disease
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