Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017;21(4):404-412.
doi: 10.1007/s12603-016-0809-8.

Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial

G Misciagna  1 , M Del Pilar Díaz, D V Caramia, C Bonfiglio, I Franco, M R Noviello, M Chiloiro, D I Abbrescia, A Mirizzi, M Tanzi, M G Caruso, M Correale, R Reddavide, R Inguaggiato, A M Cisternino, A R Osella
Affiliations
Randomized Controlled Trial

Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial

G Misciagna et al. J Nutr Health Aging. 2017.

Abstract

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common form of liver disease worldwide affecting all ages and ethnic groups and it has become a consistent threat even in young people. Our aim was to estimate the effect of a Low Glycemic Index Mediterranean Diet (LGIMD) on the NAFLD score as measured by a Liver Ultrasonography (LUS).

Design: NUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14.

Setting/participants: 98 men and women coming from Putignano (Puglia, Southern Italy) were drawn from a previous randomly sampled population-based study and identified as having moderate or severe NAFLD.

Intervention: The intervention strategy was the assignment of a LGIMD or a control diet.

Outcome measures: The main outcome measure was NAFLD score, defined by LUS.

Results: After randomization, 50 subjects were assigned to a LGIMD and 48 to a control diet. The study lasted six months and all participants were subject to monthly controls/checks. Adherence to the LGIMD as measured by Mediterranean Adequacy Index (MAI) showed a median of 10.1. A negative interaction between time and LGIMD on the NAFLD score (-4.14, 95% CI -6.78,-1.49) was observed, and became more evident at the sixth month (-4.43, 95%CI -7.15, -1.71). A positive effect of the interaction among LGIMD, time and age (Third month: 0.07, 95% CI 0.02, 0.12; Sixth month: 0.08, 95% CI 0.03,0.13) was also observed.

Conclusions: LGIMD was found to decrease the NAFLD score in a relatively short time. Encouraging those subjects who do not seek medical attention but still have NAFLD to follow a LGIMD and other life-style interventions, may reduce the degree of severity of the disease. Dietary intervention of this kind, could also form the cornerstone of primary prevention of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease.

Trial registration: ClinicalTrials.gov NCT01798719.

Keywords: Hepatic steatosis; Mediterranean diet; low glycemic index Mediterranean diet.

PubMed Disclaimer

Conflict of interest statement

ARO has no conflict of interest to declare. GM has no conflict of interest to declare. DMdP has no conflict of interest to declare. DVC has no conflict of interest to declare. CB has no conflict of interest to declare. IF has no conflict of interest to declare. MRN has no conflict of interest to declare. MC has no conflict of interest to declare. DIA has no conflict of interest to declare. AM has no conflict of interest to declare. MT has no conflict of interest to declare. MGC has no conflict of interest to declare. MC has no conflict of interest to declare. RR has no conflict of interest to declare. RI has no conflict of interest to declare. AMC has no conflict of interest to declare. All authors declare that this study was funded by a research grant from the Italian Ministry of Health. Role of the funding source: none.

Figures

Figure 1
Figure 1
NutriEpa Flow Diagram. Putignano (BA), Italy, 2011
Figure 2
Figure 2
Effect and Contrast of LIGMD vs Control Diet (with 95% CI) on NAFLD Score. NutriEpa. Putignano (BA), Italy, 2011
See this image and copyright information in PMC

References

    1. Loria P, Adinolfi LE, Bellentani S, et al. Practice guidelines for the diagnosis and management of nonalcoholic fatty liver disease. A Decalogue from the Italian Association for the Study of the Liver (AISF) Expert Committee. Dig Liver Dis. 2010;42:272–282. - PubMed
    1. Bedogni G, Miglioli L, Masutti F, et al. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005;42:44–52. 10.1002/hep.20734 PubMed PMID: 15895401. - DOI - PubMed
    1. Kotronen A, Juurinen L, Hakkarainen A, et al. Liver fat is increased in type 2 diabetes patients and underestimated by serum alanine aminotransferase compared with equally obese nondiabetic subjects. Diabetes Care. 2008;31:165–169. 10.2337/dc07-1463 PubMed PMID: 17934148. - DOI - PubMed
    1. Zoppini G, Fedeli U, Gennaro N, et al. Mortality from chronic liver diseases in diabetes. Am J Gastroenterol. 2014;109:1020–1025. 10.1038/ajg.2014.132 PubMed PMID: 24890439. - DOI - PubMed
    1. Angelico F, Del Ben M, Conti R, et al. Insulin resistance, the metabolic syndrome, and nonalcoholic fatty liver disease. J Clin Endocrinol Metab. 2005;90:1578–1582. 10.1210/jc.2004-1024 PubMed PMID: 15598693. - DOI - PubMed

Uncited references

    1. Bedogni G, Bellentani S. Fatty liver disease: how frequent is it and why? Ann Hepatol. 2004;3:63–65. PubMed PMID: 15257248. - PubMed
    1. Bazzano LA, Hu T, Reynoldas K, et al. Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Ann Intern Med. 2014;161:309–318. 10.7326/M14-0180 PubMed PMID: 25178568, PMCID 4428290. - DOI - PMC - PubMed

Publication types

MeSH terms

Associated data