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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
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Free article
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.
Free article

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.

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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.

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