A Mediterranean and low‐fat dietary intervention in non‐alcoholic fatty liver disease patients: Exploring participant experience and perceptions about dietary change

Abstract

Background: A Mediterranean diet (MD) appears to be beneficial in nonalcoholic fatty liver disease (NAFLD) patients in Mediterranean countries; however, the acceptability of a MD in non-Mediterranean populations has not been thoroughly explored. The present study aimed to explore the acceptability through understanding the barriers and enablers of the MD and low-fat diet (LFD) interventions as perceived by participating Australian adults from multicultural backgrounds with NAFLD. Methods: Semi-structured telephone interviews were performed with 23 NAFLD trial participants at the end of a 12-week dietary intervention in a multicentre, parallel, randomised clinical trial. Data were analysed using thematic analysis. Results: Participants reported that they enjoyed taking part in the MD and LFD interventions and perceived that they had positive health benefits from their participation. Compared with the LFD, the MD group placed greater emphasis on enjoyment and intention to maintain dietary changes. Novelty, convenience and the ability to swap food/meals were key enablers for the successful implementation for both of the dietary interventions. Flavour and enjoyment of food, expressed more prominently by MD intervention participants, were fundamental components of the diets with regard to reported adherence and intention to maintain dietary change. Conclusions: Participants randomised to the MD reported greater acceptability of the diet than those randomised to the LFD, predominantly related to perceived novelty and palatability of the diet.

Barriers to lifestyle modification in patients with non-alcoholic fatty liver disease: a scoping review

“…All 12 included studies were published after 2017 and were written in English 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ) . Among the included studies, seven used qualitative methods 20 , 21 , 22 , 25 , 27 , 29 , 31 ) , four used quantitative methods 23 , 26 , 28 , 30 ) , and one used mixed methods 24 ) .…”

“…All 12 included studies were published after 2017 and were written in English 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ) . Among the included studies, seven used qualitative methods 20 , 21 , 22 , 25 , 27 , 29 , 31 ) , four used quantitative methods 23 , 26 , 28 , 30 ) , and one used mixed methods 24 ) . Four studies were published in the United Kingdom 21 , 24 , 25 , 29 ) , four in the United States 23 , 26 , 30 , 31 ) , and one each in Australia 22 ) , India 20 ) , South Korea 27 ) , and Ireland 28 ) .…”

“…Among the included studies, seven used qualitative methods 20 , 21 , 22 , 25 , 27 , 29 , 31 ) , four used quantitative methods 23 , 26 , 28 , 30 ) , and one used mixed methods 24 ) . Four studies were published in the United Kingdom 21 , 24 , 25 , 29 ) , four in the United States 23 , 26 , 30 , 31 ) , and one each in Australia 22 ) , India 20 ) , South Korea 27 ) , and Ireland 28 ) . The number of patients with NAFLD ranged from 12 to 414 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ) .…”

“…Four studies were published in the United Kingdom 21 , 24 , 25 , 29 ) , four in the United States 23 , 26 , 30 , 31 ) , and one each in Australia 22 ) , India 20 ) , South Korea 27 ) , and Ireland 28 ) . The number of patients with NAFLD ranged from 12 to 414 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ) . Nine studies reported the mean age, which ranged from 41.1 to 58.9 years 20 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 ) .…”

Knowledge, Attitudes, and Behaviours Concerning the Mediterranean Diet Among Older Adults in Australia

“…Despite this growing body of evidence, the Mediterranean diet is not routinely used in practice for chronic disease management [ 10 ]. While adherence has been shown to be feasible and acceptable for adults in non-Mediterranean countries [ 11 ], adoption of the Mediterranean diet in the general population is low [ 12 ].…”