Aiming at investigating the potential effect of minimal dietary changes in NAFLD patients with non-significant fibrosis, 55 patients with NAFLD were enrolled in a randomized controlled clinical trial. Patients were assigned into two isocaloric dietary treatment groups for 24 weeks: (a) nutritional counseling (Control arm, N = 27), (b) nutritional counseling with currants included (two fruit servings, 36 g per day), substituting snacks of similar caloric content (Currant arm, N = 28). Clinical tests, anthropometrics, inflammatory and oxidative stress markers were conducted pre- and post-intervention. A total of 50 patients completed the trial. Significant differences between the two arms post-intervention were observed in fasting glucose and in IL-6 levels, these being significantly decreased only in Currant patients. Body weight, BMI, HbA, CRP and EUS values decreased in both arms, differences being insignificant between the two arms post-intervention. Participants in the Currant arm had significantly reduced total body fat, WC and trunk fat. Ultrasound scanning improved significantly in patients snacking currants daily. Also, volunteers enrolled in the Currant arm showed a reduced intake of saturated fatty acids. Because BW regulation has been officially recognised as a treatment approach in NAFLD an additional analysis was repeated in patients adhering to this. Post-intervention, the decrease in IL-6 and in fasting glucose was significantly higher in Currant patients who lost BW compared to their counterparts in the Control arm. Conclusively, minimal modifications in snacking choices, such as the inclusion of dried grapes in diet, are beneficial in NAFLD patients with non-significant fibrosis.

Objective:To summarize the recent scientific evidence regarding the wellness-promoting capacity of the Mediterranean lifestyle (ML), with a special focus on physical, social and environmental wellness.Design:Narrative review of English-language publications in PubMed, Scopus and Embase, from 1 January 2010 to 31 October 2018.Setting:Prospective cohort studies, interventional studies, meta-analyses and reviews of those investigating the effect of at least one component of the ML on wellness parameters.Participants:General population.Results:Although an explicit definition of ML is missing, compliance with various combinations of its components improves metabolic health and protects against or ameliorates disease state. However, there is heterogeneity in the healthy behaviours that the ML-focused studies include in their design and the way these are assessed. Also, despite that features of the ML could contribute to other wellness dimensions, there are no studies exploring the effect this healthy lifestyle could confer to them.Conclusions:Chronic lifestyle diseases are of multifactorial aetiology and they warrant multifaceted approaches targeting the general way of living. ML, if thoroughly evaluated, can provide a valuable tool to holistically promote health and wellness.

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Our results show that GCKR rs1260326 T-allele is associated with better response of NAFLD patients to nutritional treatment regarding fasting blood glucose, but not oxLDL levels. Despite this important finding in the field of nutrigenetics, it is tricky to generalize this effect unless larger studies are conducted.

Liver fatty acid‐binding protein (LFABP) functions both in intracellular lipid trafficking in liver and small intestine, and in systemic energy homeostasis regulation. We found that despite the marked obesity of high fat‐fed LFABP null (LFABP‐/‐) mice compared to their wild‐type (WT) counterparts, they display a ‘metabolically healthy obese’ (MHO) phenotype characterized by normoglycemia and normoinsulinemia, increased spontaneous physical activity, and a resistance to high‐fat diet (HFD)‐induced decline in exercise capacity. They also display increased muscle fatty acid oxidation suggesting that adipose tissue lipolysis is enhanced. To gain insight into the effects of Lfabp ablation on the quality of adipose tissue, we determined the mass and cellularity of the inguinal (iWAT) and epididymal (eWAT) white adipose tissues. LFABP‐/‐ mice fed HFD for 12 weeks weighed 23.7% more (BW, g: 41.7 LFABP‐/‐ vs 33.7 WT, p=0.006, n=5) and their fat pads tended to be heavier (iWAT, g: 1.1 LFABP‐/‐ vs 0.8 WT, p=0.060, n=5; eWAT, g: 1.4 LFABP‐/‐ vs 1.8 WT, p=0.065, n=5). Intriguingly, as shown in Figure 1, adipocyte size of iWAT adipocytes is smaller than that of the WT mice (44.6pL LFABP‐/‐ vs 188.1pL WT per cell, p=0.009, n=5). Adipocyte number was substantially increased in the iWAT of LFABP‐/‐ (23.6 LFABP‐/‐ vs 4.6 WT x 106, p=0.001, n=5). In contrast, the eWAT adipocyte size in the LFABP‐/‐ is comparable to WT (210pL LFABP‐/‐ vs 268 pL WT per cell, p=0.293, n=5), and eWAT fat cell number was highly variable and trended higher in the LFABP‐/‐ mice (9.8 LFABP‐/‐ vs 4.7 WT x 106, p=0.059, n=5). Because LFABP is not expressed in adipose tissue, our data suggest that its ablation promotes interorgan signaling that may limit hypertrophy and drive hyperplasia in expansion of potentially metabolically beneficial subcutaneous iWAT. More studies are warranted to elucidate the marked differences in cell size and the apparent depot‐dependent effects of LFABP‐/‐ deficiency, as well as the mechanisms by which it modulates adipocyte growth and function.

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