Mediterranean Diet and Fatty Liver Risk in a Population of Overweight Older Italians: A Propensity Score-Matched Case-Cohort Study

Abstract

Hepatic steatosis, often known as fatty liver, is the most common hepatic disease in Western countries. The latest guidelines for the treatment of nonalcoholic fatty liver disease emphasize lifestyle measures, such as changing unhealthy eating patterns. Using a propensity score-matching approach, this study investigated the effect of adhering to a Mediterranean diet (MedDiet) on fatty liver risk in an older population (≥65 years) from Southern Italy. We recruited 1.403 subjects (53.6% men, ≥65 years) who completed a food frequency questionnaire (FFQ) and underwent clinical assessment between 2015 and 2018. For the assessment of the liver fat content, we applied the Fatty Liver Index (FLI). To evaluate the treatment effect of the MedDiet, propensity score matching was performed on patients with and without FLI > 60. After propensity score-matching with the MedDiet pattern as treatment, we found a higher consumption of red meat (p = 0.04) and wine (p = 0.04) in subjects with FLI > 60. Based on the FLI, the inverse association shown between adherence to the MedDiet and the risk of hepatic steatosis shows that the MedDiet can help to prevent hepatic steatosis. Consuming less red and processed meat, as well as alcoholic beverages, may be part of these healthy lifestyle recommendations.

Mediterranean Diet: A Tool to Break the Relationship of Atrial Fibrillation with the Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease

“…Although there are some diets useful to achieve these therapeutic goals (DASH diet, ketogenic diet, intermittent fasting diet) [ 85 ], Med-Diet plays a role in prevention of hepatic steatosis [ 94 ]. For instance, the high content of PUFAs could reduce insulin resistance and intrahepatic triglyceride content, thereby improving NAFLD [ 92 ].…”

Alcohol-related liver disease: also a question of what you drink?

“…Interestingly, while lowering the relative risk (RR) of all-cause mortality, consuming alcohol with food, it did not have an association with the risk of liver cirrhosis. In this study, it was also shown, that daily alcohol intake was associated with a higher liver cirrhosis risk with no further distinguishment regarding type of alcoholic drink [42]. Results of a recently published analysis focusing on the Mediterranean diet and fatty liver risk in overweight older Italians revealed that individuals with a fatty liver index > 60 had a higher intake of wine [43] and consumed alcohol at a higher percentage over an extended period of time.…”

“…Indeed, in this study, it was reported that a 1 L increase in spirits consumption is associated with a 35.2% increase in cirrhosis mortality rate. Results of a recent prospective cohort study of UK Biobank participants excluding abstainers and individuals with previous cancers, liver cirrhosis, and stroke as well as myocardial infarcts suggested that spirit drinking as well as beer and cider drinkers were at higher risk of liver cirrhosis (spirits: HR 1.48; 95% CI 1.08-2.03; beer/cider: 1.36; 95% CI 1.06-1.74) compared to red wine drinkers after adjusting for the average weekly alcohol consumption [42]. Interestingly, while lowering the relative risk (RR) of all-cause mortality, consuming alcohol with food, it did not have an association with the risk of liver cirrhosis.…”

The Effect of Milk Thistle, Green Tea, and Cinnamon Beverages on Liver Enzymes of Operating Room Anesthesia Personnel

“…In our study, there were no statistically significant differences between all four groups regarding weight and body mass index. Regarding fatty liver, overweight and the importance of the role of body mass index (BMI) have been demonstrated in many studies (35)(36)(37).…”