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Meta-Analysis
. 2023 May 9;15(10):2250.
doi: 10.3390/nu15102250.

Does the Mediterranean Diet Have Any Effect on Lipid Profile, Central Obesity and Liver Enzymes in Non-Alcoholic Fatty Liver Disease (NAFLD) Subjects? A Systematic Review and Meta-Analysis of Randomized Control Trials

Cristian Del Bo'  1 , Simone Perna  1 , Sabika Allehdan  2 , Ayesha Rafique  2 , Sara Saad  2 , Fahad AlGhareeb  2 , Mariangela Rondanelli  3   4 , Reema F Tayyem  5 , Mirko Marino  1 , Daniela Martini  1 , Patrizia Riso  1
Affiliations
Meta-Analysis

Does the Mediterranean Diet Have Any Effect on Lipid Profile, Central Obesity and Liver Enzymes in Non-Alcoholic Fatty Liver Disease (NAFLD) Subjects? A Systematic Review and Meta-Analysis of Randomized Control Trials

Cristian Del Bo' et al. Nutrients. .

Abstract

The effectiveness of the Mediterranean diet (MD) in non-alcoholic fatty liver disease (NAFLD) subjects has been evaluated in several randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to evaluate the overall effects of MD intervention in a cohort of NAFLD patients targeting specific markers such as central obesity, lipid profile, liver enzymes and fibrosis, and intrahepatic fat (IHF). Google Scholar, PubMed, and Scopus were explored to collect relevant studies from the last 10 years. RCTs with NAFLD subjects were included in this systematic review with a mean intervention duration from 6 weeks to 1 year, and different intervention strategies, mainly including energy restriction MD (normal or low glycaemic index), low-fat MD with increased monounsaturated and polyunsaturated fatty acids, and increased exercise expenditure. The outcomes measured in this meta-analysis were gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), total cholesterol (TC), waist circumference (WC), and liver fibrosis. Ten randomized controlled trials, which involved a total of 737 adults with NAFLD, were included. According to the results, the MD seems to decrease the liver stiffness (kPa) by -0.42 (CI95% -0.92, 0.09) (p = 0.10) and significantly reduce the TC by -0.46 mg/dl (CI95% -0.55, -0.38) (p = 0.001), while no significant findings were documented for liver enzymes and WC among patients with NAFLD. In conclusion, the MD might reduce indirect and direct outcomes linked with NAFLD severity, such as TC, liver fibrosis, and WC, although it is important to consider the variations across trials. Further RCTs are necessary to corroborate the findings obtained and provide further evidence on the role of the MD in the modulation of other disorders related to NAFLD.

Keywords: Mediterranean diet; human interventions; lipid profile; liver function; nonalcoholic fatty liver disease.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the study selection process.
Figure 2
Figure 2
Effect of MD on ALT [39,40,41,44,45,46].
Figure 3
Figure 3
The effect of the MD on GGT [39,40,41,44,45].
Figure 4
Figure 4
The effect of the MD on liver stiffness [39,40,41,44].
Figure 5
Figure 5
The effect of the MD on TC [39,40,42,44,45,48].
Figure 6
Figure 6
The effect of the MD on WC. Abbreviations: SD: standard deviation; mean: mean difference changes pre-post [39,40,41,44,45,46,48].
Figure 7
Figure 7
Risk of bias summary.
See this image and copyright information in PMC

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