MEDITERRANEAN-STYLE DIET FOR NONALCOHOLIC FATTY LIVER DISEASE. LITERATURE REVIEW
Introduction. Nonalcoholic fatty liver disease (NAFLD) is a common disease associated with metabolic syndrome and characterised by fat accumulation in hepatocytes. The prevalence of NAFLD in adults is estimated to be 25%–30% in the general population.
This review aimed to investigate the effect of the Mediterranean diet on non-alcoholic fatty liver disease and its metabolic complications.
Search Strategy: English-written articles in peer-reviewed journals were identified by searching PubMed from 2017 to 2024. The search strategy combined words from the following concepts: Mediterranean diet, metabolic syndrome, non-alcoholic fatty liver disease, lipid profile, and liver function. Inclusion criteria: Evidence level A, B publications: meta-analyses, systematic reviews, cohort and cross-sectional studies. Exclusion criteria: expert opinion in the form of short communications, promotional articles.
The results show that the Mediterranean diet has a positive effect on the lipid profile, helps in the regression of liver fibrosis and inflammation, and improves metabolic parameters such as insulin resistance. Moreover, the reported beneficial effects (antioxidant, anti-inflammatory) of Mediterranean-style diets provide high levels of phytochemicals, including dietary polyphenols.
Conclusions. The Mediterranean diet should be recommended for patients with nonalcoholic fatty liver disease. In case of updating the Kazakhstani clinical protocol for nonalcoholic fatty liver disease. The Mediterranean diet should be involved as a Public Health measure.
Venera S. Rakhmetova – professor, Astana Medical University, Department of Internal Medicine, Kazakhstan phone: +7 701 185 5557, e-mail: venerarakhmetova@gmail.com, https://orcid.org/0000-0001-5721-6409
Saule M. Sarkulova – professor, Astana Medical University, Department of Internal Medicine, Kazakhstan, phone:87079333993, e-mail: saule_sark@mail.ru, https://orcid.org/0009-0002-1033-1685
Gulmira A. Derbissalina – associate professor, head, Astana Medical University, Department of General Medical Practice with a course in evidence-based medicine, Kazakhstan, phone: +77013469331, e-mail: derbissalina.g@amu.kz https://orcid.org/0000-0003-3704-5061
Gulnar G. Bedelbaeva - professor, head, Asfendiyarov Kazakh National Medical University, Department of Therapeutic Disciplines at the Institute of Continuing Education, Kazakhstan, phone:+7-777-228-1581, e-mail: bedelbaeva@mail.ru, https://orcid.org/0009-0002-1033-1685
Liana M. Amirkhanova - Resident gastroenterologist-hepatologist, Astana Medical University, Kazakhstan, phone: 87015552558, e-mail: miirbolovna@gmail.com, https://orcid.org/0009-0005-5951-7340
Corresponding author:
Dariga S. Smailova – PhD, associate professor, Asfendiyarov Kazakh National Medical University, Kazakhstan
Mailing Address: Kazakhstan, Almaty city, Tole bi str.94
E-mail: dari190490@gmail.com
Tel.: 8 705 555 84 68
1. Abbate M. et al. Energy Expenditure Improved Risk Factors Associated with Renal Function Loss in NAFLD and MetS Patients. Nutrients. 2021. № 2 (13). P. 1–24.
2. Abdallah J. et al. Effects of anti-inflammatory dietary patterns on non-alcoholic fatty liver disease: a systematic literature review. European Journal of Nutrition. 2023. № 4 (62). P. 1563.
3. Abdelmalek M.F. Nonalcoholic fatty liver disease: another leap forward. Nature Reviews. Gastroenterology & Hepatology. 2021. № 2 (18). P. 85.
4. Abenavoli L. et al. Effect of Mediterranean Diet and Antioxidant Formulation in Non-Alcoholic Fatty Liver Disease: A Randomized Study. Nutrients. 2017. № 8 (9). P.870.
5. Abenavoli L. et al. Health benefits of Mediterranean diet in nonalcoholic fatty liver disease. Expert review of gastroenterology & hepatology. 2018. № 9 (12). P. 873–881.
6. Adam R., Karam V. et al. Annual Report of the European Liver Transplant Registry (ELTR)—50-Year Evolution of Liver Transplantation. Transpl. Int. 2018. №31. P.1293–1317.
7. Andreo-López M.C., Contreras-Bolívar V., et al. Influence of the Mediterranean Diet on Healthy Aging. Int J Mol Sci. 2023. №24(5). P.4491.
8. Barber T.M. et al. The Effects of the Mediterranean Diet on Health and Gut Microbiota. Nutrients. 2023. № 9 (15). P. 2150.
9. Basu R. et al. Nonalcoholic Fatty Liver Disease: Review of Management for Primary Care Providers. Mayo Clinic Proceedings. 2022. № 9 (97). P. 1700–1716.
10. Battistella S., D'Arcangelo F. et al. Liver transplantation for non-alcoholic fatty liver disease: indications and post-transplant management. Clin Mol Hepatol. 2023. №29.P.S286-S301.
11. Berná G. et al. The role of nutrition in non-alcoholic fatty liver disease: Pathophysiology and management. Liver International. 2020. № S1 (40). P. 102–108.
12. Bhandari P., Sapra A. Low Fat Diet. BMJ. 2023. № 7289 (322). P. 804.
13. Biolato M. et al. Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease. World Journal of Gastroenterology. 2019. № 4 (25). P. 509.
14. Bo’ C. Del et al. Overview of Human Intervention Studies Evaluating the Impact of the Mediterranean Diet on Markers of DNA Damage. Nutrients. 2019. № 2 (11).P.391.
15. Bo’ C. Del et al. Does the Mediterranean Diet Have Any Effect on Lipid Profile, Central Obesity and Liver Enzymes in Non-Alcoholic Fatty Liver Disease (NAFLD) Subjects? A Systematic Review and Meta-Analysis of Randomized Control Trials. Nutrients 2023, Vol. 15, Page 2250. 2023. № 10 (15). P. 2250.
16. Chiarioni G. et al. Vegan Diet Advice Might Benefit Liver Enzymes in Nonalcoholic Fatty Liver Disease: an Open Observational Pilot Study. Journal of Gastrointestinal and Liver Diseases. 2021. № 1 (30). P. 81–87.
17. Chooi Y.C. et al. Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease: the TANGO randomized controlled trial. The American journal of clinical nutrition. 2024. № 3 (119). P. 788–799.
18. Dernini S. et al. Med Diet 4.0: the Mediterranean diet with four sustainable benefits. Public Health Nutrition. 2016. № 7 (20). P. 1322.
19. Dyńka D. et al. Beneficial Effects of the Ketogenic Diet on Nonalcoholic Fatty Liver Disease (NAFLD/MAFLD). Journal of Clinical Medicine. 2024. № 16 (13). P. 4857.
20. Eslamparast T., Tandon P., Raman M. Dietary Composition Independent of Weight Loss in the Management of Non-Alcoholic Fatty Liver Disease. Nutrients. 2017. № 8 (9).P.800.
21. George E.S. et al. Impact of a Mediterranean diet on hepatic and metabolic outcomes in non-alcoholic fatty liver disease: The MEDINA randomised controlled trial. Liver international : official journal of the International Association for the Study of the Liver. 2022. № 6 (42). P. 1308–1322.
22. Golabi P. et al. Causes of death in patients with Non-alcoholic Fatty Liver Disease (NAFLD), alcoholic liver disease and chronic viral Hepatitis B and C. Annals of hepatology. 2022. № 1 (27).P.100556.
23. Hadefi A., Arvanitakis M., Trépo E., Zelber-Sagi S. Dietary strategies in non-alcoholic fatty liver disease patients: From evidence to daily clinical practice, a systematic review. United European Gastroenterol J. 2023 №11(7). P.663-689.
24. He Q.J. et al. Recent advances in age-related metabolic dysfunction-associated steatotic liver disease. World Journal of Gastroenterology. 2024. № 7 (30). P. 652.
25. Iqbal U. et al. The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease. Medicines (Basel, Switzerland). 2019. № 1 (6). P. 41.
26. Katsagoni C.N. et al. Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean lifestyle: a randomised controlled clinical trial. The British journal of nutrition. 2018. № 2 (120). P. 164–175.
27. Khalatbari-Soltani S. et al. The association between adherence to the Mediterranean diet and hepatic steatosis: cross-sectional analysis of two independent studies, the UK Fenland Study and the Swiss CoLaus Study. BMC medicine. 2019. № 1 (17).P.19.
28. Kiani A.K. et al. Modern vision of the Mediterranean diet. Journal of Preventive Medicine and Hygiene. 2022. № 2 Suppl 3 (63). P. E36.
29. Kim H.Y. Recent advances in nonalcoholic fatty liver disease metabolomics. Clinical and Molecular Hepatology. 2021. № 4 (27). P. 553.
30. Lazarus J.V. et al. Advancing the global public health agenda for NAFLD: a consensus statement. Nature Reviews Gastroenterology and Hepatology. 2022. № 1 (19). P. 60–78.
31. Lazarus J.V. et al. The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge? Journal of Hepatology. 2022. № 4 (76). P. 771–780.
32. Loomba R. et al. Expert Panel Review to Compare FDA and EMA Guidance on Drug Development and Endpoints in Nonalcoholic Steatohepatitis. Gastroenterology. 2021. № 3 (162). P. 680.
33. Manikat R., Nguyen M.H. Nonalcoholic fatty liver disease and non-liver comorbidities. Clinical and Molecular Hepatology. 2023. № Suppl (29). P. s86.
34. Mantovani A. et al. Nonalcoholic fatty liver disease increases risk of incident chronic kidney disease: A systematic review and meta-analysis. Metabolism: Clinical and Experimental. 2018. (79).P. 64–76.
35. Marin-Alejandre B.A. et al. The Metabolic and Hepatic Impact of Two Personalized Dietary Strategies in Subjects with Obesity and Nonalcoholic Fatty Liver Disease: The Fatty Liver in Obesity (FLiO) Randomized Controlled Trial. Nutrients. 2019. № 10 (11).
36. Marrone G. et al. Vegan Diet Health Benefits in Metabolic Syndrome. Nutrients. 2021. № 3 (13). C. 1–24.
37. Mazza E., Ferro Y., et al. Mediterranean Diet In Healthy Aging. J Nutr Health Aging. 2021. №25(9). С.1076-1083.
38. McGaugh E., Barthel B. A Review of Ketogenic Diet and Lifestyle. Missouri Medicine. 2022. № 1 (119). C. 84.
39. Mirizzi A. et al. Effects of Some Food Components on Non-Alcoholic Fatty Liver Disease Severity: Results from a Cross-Sectional Study. Nutrients. 2019. № 11 (11).P.2744
40. Montemayor S. et al. Effect of Dietary and Lifestyle Interventions on the Amelioration of NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study. Nutrients. 2022. № 11 (14). P.2223
41.Montemayor S., García S., et al. Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review. Nutrients. 2023. №15(18). P. 3987.
42. Nani A. et al. Antioxidant and Anti-Inflammatory Potential of Polyphenols Contained in Mediterranean Diet in Obesity: Molecular Mechanisms. Molecules. 2021. № 4 (26). P. 985.
43. Naureen Z. et al. Foods of the Mediterranean diet: lacto-fermented food, the food pyramid and food combinations. Journal of Preventive Medicine and Hygiene. 2022. № 2 Suppl 3 (63). P. E28.
44. Pafili K., Roden M. Nonalcoholic fatty liver disease (NAFLD) from pathogenesis to treatment concepts in humans. Molecular Metabolism. 2020. (50). P. 101122.
45. Pani A. et al. Inositol and Non-Alcoholic Fatty Liver Disease: A Systematic Review on Deficiencies and Supplementation // Nutrients. 2020. № 11 (12). P. 1–13.
46. Paternostro R., Trauner M. Current treatment of non-alcoholic fatty liver disease. Journal of internal medicine. 2022. № 2 (292). P. 190–204.
47. Pouwels S., Sakran N., et al. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord. 2022. 22(1). P.63.
48. Properzi C. et al. Ad Libitum Mediterranean and Low-Fat Diets Both Significantly Reduce Hepatic Steatosis: A Randomized Controlled Trial. Hepatology (Baltimore, Md.). 2018. № 5 (68). P. 1741–1754.
49. Romero-Gómez M., Zelber-Sagi S., Trenell M. Treatment of NAFLD with diet, physical activity and exercise. Journal of Hepatology. 2017. № 4 (67). P. 829–846.
50. Rong L. et al. Advancements in the treatment of non-alcoholic fatty liver disease (NAFLD). Frontiers in Endocrinology. 2023. (13). P. 1087260.
51. Sangouni A.A. et al. Dietary approaches to stop hypertension (DASH) diet improves hepatic fibrosis, steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: a randomized controlled trial. European journal of nutrition. 2024. № 1 (63). P. 95–105.
52. Scoditti E., Tumolo M.R., Garbarino S. Mediterranean Diet on Sleep: A Health Alliance. Nutrients. 2022. 14(14). P. 2998.
53. Serra-Majem L. et al. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Molecular Aspects of Medicine. 2019. (67). P. 1–55.
54. Sotos-Prieto M. et al. Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain. Cardiovascular Diabetology. 2021. № 1 (20). P. 5.
55. Stefan N., et al. global view of the interplay between non-alcoholic fatty liver disease and diabetes. The Lancet Diabetes and Endocrinology. 2022. № 4 (10). P. 284–296.
56. Targher G., Byrne C.D., Tilg H. NAFLD and increased risk of cardiovascular disease: Clinical associations, pathophysiological mechanisms and pharmacological implications. Gut. 2020. № 9 (69). P. 1691–1705.
57. Teng M.L.P. et al. Global incidence and prevalence of nonalcoholic fatty liver disease. Clinical and Molecular Hepatology. 2022. № Suppl (29). P. S32.
58. Toi P.L. et al. Preventive Role of Diet Interventions and Dietary Factors in Type 2 Diabetes Mellitus: An Umbrella Review. Nutrients. 2020. № 9 (12). P. 2722.
59. Torres-Peña J.D. et al. Different Dietary Approaches, Non-Alcoholic Fatty Liver Disease and Cardiovascular Disease: A Literature Review. Nutrients. 2023. № 6 (15).P.1483.
60. Torres M.C.P. et al. Mediterranean Diet and NAFLD: What We Know and Questions That Still Need to Be Answered. Nutrients. 2019. № 12 (11). P. 2971.
61. Tsigalou C. et al. Mediterranean Diet as a Tool to Combat Inflammation and Chronic Diseases. An Overview. Biomedicines. 2020. № 7 (8).P.201.
62. Varkaneh H.K. et al. Low fat diet versus low carbohydrate diet for management of non-alcohol fatty liver disease: A systematic review. Frontiers in Nutrition. 2022. (9).P. 987921.
63. Vilar-Gomez E., Nephew L.D., Vuppalanchi R., Gawrieh S., et al. High-quality diet, physical activity, and college education are associated with low risk of NAFLD among the US population. Hepatology. 2022. №75(6). P.1491-1506.
64. Younossi Z.M. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol. 2019. №70(3). P.531-544.
65. Wajsbrot N.B. et al. Non-alcoholic fatty liver disease and the impact of genetic, epigenetic and environmental factors in the offspring. World Journal of Gastroenterology. 2022. № 25 (28). P. 2890.
66. Watanabe M. et al. Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature. Obesity Reviews. 2020. № 8 (21).P.e13024
67. Wong V.W.S. et al. High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis. Gut. 2011. № 6 (60). P. 829–836.
68. Xiao M.L. et al. Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower presence of non-alcoholic fatty liver disease in middle-aged and elderly adults. Public health nutrition. 2020. № 4 (23). P. 674–682.
69. Zeng C., Chen M. Progress in Nonalcoholic Fatty Liver Disease: SIRT Family Regulates Mitochondrial Biogenesis. Biomolecules. 2022. № 8 (12).P. 1079.
70. Zielińska M. et al. The Mediterranean Diet and the Western Diet in Adolescent Depression-Current Reports. Nutrients. 2022. № 20 (14). P. 4390.
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Rakhmetova V.S., Sarkulova S.M., Derbissalina G.A., Bedelbaeva G.G., Amirkhanova L.M., Smailova D.S. Mediterranean-style diet for nonalcoholic fatty liver disease. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (3), pp. 267-274. doi 10.34689/SH.2025.27.3.028Похожие публикации:
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