Calorie-Restricted Mediterranean and Low-Fat Diets Affect Fatty Acid Status in Individuals with Nonalcoholic Fatty Liver Disease

Abstract

Lifestyle modifications are the main support of nonalcoholic fatty liver disease (NAFLD) therapy. Weight loss is one of the primary goals in NAFLD, but the effects of different calorie-restricted diets remain unclear. Thus, we evaluated the effects of two calorie-restricted diets—the Mediterranean diet (Med diet) and low-fat diet—on liver status, cardiometabolic markers, and fatty acid profiles in patients with NAFLD. Twenty-four overweight/moderately obese men were randomly assigned to consume one of these diets. Lipid levels, glucose, insulin, liver enzymes, steatosis, and fatty acid profiles of serum and erythrocytes phospholipids were assessed. After 3 months, all participants had a significant weight loss (>9%), with improvements in waist circumference, body fat %, index of visceral adiposity (VAI), lipid accumulation product, fatty liver (FLI), and hepatic steatosis (HSI) index (p < 0.001). Both diets significantly lowered triglycerides, total and LDL-cholesterol, liver enzymes, fasting glucose, insulin, and HOMA-IR index. Fatty acid profiles were enhanced after both diets, with a significantly decreased n-6/n-3 ratio. Participants on the Med diet had higher levels of HDL-cholesterol and monounsaturated and n-3 docosahexaenoic acids in serum phospholipids and lower levels of saturated fatty acids, triglycerides, TG/HDL ratio, and FLI when compared to participants on the low-fat diet. Our results indicate that dietary patterns and calorie restriction represent central therapeutic issues in the improvement of obesity-related cardiometabolic alterations that are involved in the mechanism of hepatic steatosis. The Med diet may contribute to disease treatment even more than the low-fat diet since it leads to decreased saturated and increased monounsaturated and n-3 polyunsaturated fatty acid status and improved FLI in NAFLD patients.

Effects of Mediterranean Diet or Low-Fat Diet on Blood Fatty Acids in Patients with Coronary Heart Disease. A Randomized Intervention Study

“…This study shows that, in patients with CHD, diet Mediterranean-ness exerts some distinctive favorable effects on the blood FA profile beyond those that may be obtained with a “prudent” LFD. Though the magnitude of dietary-induced changes in the distribution of individual FA in blood is relatively small, it is in line with that observed in previous studies [ 15 , 20 ]. Both diets reduced total SFA, and particularly palmitic acid (16:0) (borderline change with LFD), which is the most abundant blood SFA and that which accounted for the major difference in terms of blood SFAs between patients with CHD and healthy subjects in case-control studies [ 12 , 13 , 21 , 22 ].…”

Mediterranean Diet: The Beneficial Effects of Lycopene in Non-Alcoholic Fatty Liver Disease

“…The study results indicated a statistically significant reduction in NAFLD score after 45 days of treatment in every treated group except in group 1. In a study conducted by Ristic-Medic et al, 24 overweight or moderately obese men were causally assigned to two groups and treated with MD or a low-fat diet, respectively [ 30 ]. After the treatment, all participants had a significant weight loss (>9%) with improvements in waist circumference and visceral adiposity index (VAI).…”

Effects of Dietary α-Linolenic Acid Treatment and the Efficiency of Its Conversion to Eicosapentaenoic and Docosahexaenoic Acids in Obesity and Related Diseases

“…Although Ristic-Medic et al did not evaluate the effects of ALA treatment on NAFLD parameters in obese patients, they have revealed that there is a significant connection between changes in n−3 PUFA status and parameters of lipid accumulation in obesity during calorie-restricted diets. Finally, the authors observed that participants on the Mediterranean diet had higher levels of DHA in serum phospholipids compared to subjects on the low-fat diet, indicating that n−3 PUFA status analysis could be of critical importance for clarifying the effects of n−3 PUFAs in NAFLD [ 104 ].…”