The Effect of Low Glycemic Index Mediterranean Diet and Combined Exercise Program on Metabolic-Associated Fatty Liver Disease: A Joint Modeling Approach

Curci, Ritanna; Bianco, Antonella; Franco, Isabella; Campanella, Angelo J.; Mirizzi, Antonella; Sorino, Paolo; Fucilli, Fabio; Giovanni, Giuseppe Di; Giampaolo, Nicola; Pesole, Pasqua Letizia; Osella, Alberto Rubén

doi:10.3390/jcm11154339

Cited by 7 publications

(7 citation statements)

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“…This nding is consistent with previous studies and suggests that these individuals are potential targets for future health education and behavioral interventions 8 . Currently, lifestyle interventions for MAFLD patients focus on diet and/or exercise among studies 30,31 , but the combined effect of all lifestyle behavioral interventions in MAFLD remains unclear. Considering these results, we recommend implementing interventions that promote multiple healthy lifestyles simultaneously.…”

Section: Discussionmentioning

confidence: 99%

Clustering of lifestyle behaviors and analysis of their associations with MAFLD: a cross- sectional study of 196515 in China

Zhou

Gong

et al. 2022

Preprint

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Introduction The aggregation of lifestyle behaviors and their association with metabolic associated fatty liver disease (MAFLD) remains unclear. We identified lifestyle patterns and investigated their association with MAFLD in a sample of Chinese adults who underwent annual physical examinations. Methods Annual physical examination data of Chinese adults from January 2016 to December 2020 was used in this study. We created a scoring system for lifestyle items combining statistical method (Multivariate analysis of variance) and clinical expertise’s opinion (Delphi method). Subsequently, principal components analysis and two-step cluster analysis were implemented to derive lifestyle patterns of men and women. Binary logistic regression analysis was used to explore the prevalence risk of MAFLD among lifestyle patterns stratified by gender. Results A total of 196,515 subjects were included in the analysis. Based on the defined lifestyle scoring system, nine and four lifestyle patterns were identified for men and women, respectively, which included “healthy or unhealthy” patterns and mixed patterns containing a combination of healthy and risky lifestyle behaviors. This study showed that subjects with an unhealthy or mixed pattern had a differentially higher risk of developing MAFLD than subjects with a relatively healthy pattern, especially among men. Conclusions Clusters of unfavorable behaviors are more prominent in men when compared to women. Lifestyle patterns, as the important factors influencing the development of MAFLD, show significant gender differences in the risk of MAFLD. There is a strong need for future research to develop targeted MAFLD interventions based on the identified behavioral clusters by gender stratification.

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Section: Discussionmentioning

confidence: 99%

Clustering of lifestyle behaviors and analysis of their associations with MAFLD: a cross- sectional study of 196515 in China

Zhou

Gong

et al. 2022

Preprint

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“…Blood samples and anthropometric measurements (weight, height, waist circumference) were collected by trained staff using standardized methods. More details are given in our previous study [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

“…The muscle-building part of the training was divided into three levels of difficulty (basic, intermediate, and advanced) [ 14 ]. The work intensity varied progressively from 65% to 75% of the 1RM.…”

Section: Methodsmentioning

confidence: 99%

Diet and Exercise Exert a Differential Effect on Glucose Metabolism Markers According to the Degree of NAFLD Severity

et al. 2023

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Background: Non-Alcoholic Fatty Liver Disease (NAFLD) and Type 2 Diabetes (T2D) are highly prevalent diseases worldwide. Insulin Resistance (IR) is the common denominator of the two conditions even if the precise timing of onset is unknown. Lifestyle change remains the most effective treatment to manage NAFLD. This study aimed to estimate the effect of the Low Glycemic Index Mediterranean Diet (LGIMD) and exercise (aerobic and resistance) over a one-year period on the longitudinal trajectories of glucose metabolism regulatory pathways. Materials and Methods: In this observational study, 58 subjects (aged 18–65) with different degrees of NAFLD severity were enrolled by the National Institute of Gastroenterology—IRCCS “S. de Bellis”, to follow a 12-month program of combined exercise and diet. Results: The mean age was 55 ± 7 years old. Gender was equally distributed among NAFLD categories. There was a statistically significant main effect of time for glycosylated hemoglobin (Hb1Ac) over the whole period (−5.41, 95% CI: −7.51; −3.32). There was a steady, statistically significant decrease of HbA1c in participants with moderate and severe NAFLD whereas this effect was observed after the 9th month in those with mild NAFLD. Conclusions: The proposed program significantly improves glucose metabolism parameters, especially HbA1c.

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“…However, Curci et al, recorded improvement in metabolic-associated fatty liver disease with a low GI Mediterranean diet and a combined exercise program for 12 months [70]. Other studies on low GI Mediterranean diet in patients with moderate or severe NAFLD also reported reduction in NAFLD scores [71] [72].…”

Section: Benefits Of Low Glycemic Index Foods: Clinical Evidencesmentioning

confidence: 99%

A Review on the Role of Low Glycemic Index Foods for Glycemic Control in Chronic Liver Disease

Bhoite¹,

Joshi²,

Pratti³

et al. 2023

FNS

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Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation and destruction of liver parenchyma. The development of glucose intolerance and hepatogenous diabetes (HD) in patients with CLD is an inevitable event. Diabetes and CLD can coexist, and function synergistically to cause unfavorable clinical consequences, including poor treatment outcomes and frequent hospitalization. The complications associated with liver disease (malnutrition, hypoglycemia, acute kidney injury, lactic acidosis, etc.) and lack of guidelines limit pharmacological management of HD. Dietary recommendations by The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines (2019), suggested weight reducing hypocaloric diet along with adequate branched-chain amino acid (BCAA) and micronutrient consumption to improve steatosis and insulin sensitivity in patients with CLD. Dietary glycemic index controls prognosis of obesity, non-alcoholic fatty liver disease (NAFLD) and diabetes. The importance of low GI diet in reducing fasting blood glucose, hepatic glucose influx and fat accumulation, thereby improving weight loss and NAFLD score, is being published in patients with diabetes or liver disease. Several countries have already incorporated GI into their national health policies, for identification of the nutrient value, resulting in establishment of worldwide GI and glycemic load tables for specific food items. However, the apparent complexity of GI and lack of low GI meal choices need to be resolved in order to enhance patient's quality of life, health and well-being. Low GI nutritional supplements, comprising of balanced proportion of carbohydrate, protein, BCAAs, fibers and micronutrients, may reduce the complexity related to dietary management of HD. The review summarizes the importance of nutritional management in HD with focus on low GI diet in people with CLD.

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The Effect of Low Glycemic Index Mediterranean Diet and Combined Exercise Program on Metabolic-Associated Fatty Liver Disease: A Joint Modeling Approach

Cited by 7 publications

References 50 publications

Clustering of lifestyle behaviors and analysis of their associations with MAFLD: a cross- sectional study of 196515 in China

Clustering of lifestyle behaviors and analysis of their associations with MAFLD: a cross- sectional study of 196515 in China

Diet and Exercise Exert a Differential Effect on Glucose Metabolism Markers According to the Degree of NAFLD Severity

A Review on the Role of Low Glycemic Index Foods for Glycemic Control in Chronic Liver Disease

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