Non-alcoholic fatty liver disease (NAFLD) has become a major global health burden, leading to increased risk for cirrhosis, hepatocellular carcinoma, type-2 diabetes and cardiovascular disease.
Lifestyle intervention aiming at weight reduction is the most established treatment.
However, changing the dietary composition even without weight loss can also reduce steatosis and improve metabolic alterations as insulin resistance and lipid profile.
Dr Shira Zelber-Sagi and colleagues review the epidemiological evidence, and the plausible molecular mechanisms by which the Mediterranean diet as a whole and each of its components can be of benefit in NAFLD.
|The Mediterranean diet has an established superiority in long term weight reduction over low fat diet|
The Mediterranean diet pattern has been proposed as appropriate for this goal, and was recommended as the diet of choice for the treatment of NAFLD by the EASL-EASD-EASO Clinical Practice Guidelines.
The team report that the Mediterranean diet has an established superiority in long term weight reduction over low fat diet, but it improves metabolic status and steatosis even without it.
However, the researchers observed that the effect on liver inflammation and fibrosis was tested only in few observational studies with positive results.
Furthermore, considering the strong association between NAFLD and diabetes and CVD, the Mediterranean diet has a highly established advantage in prevention of these diseases, demonstrated in randomized clinical trials.
Dr Zelber-Sagi's team concludes, "The individual components of the Mediterranean diet such as olive oil, fish, nuts, whole grains, fruits, and vegetables, have been shown to beneficially effect or negatively correlate with NAFLD, while consumption of components that characterize a Western dietary pattern as soft drinks, fructose, meat and saturated fatty acids have been shown to have detrimental association with NAFLD."