Non Alcoholic Fatty Liver Disease (NAFLD) is the most prevalent liver disease globally. Lifestyle modification including diet is the mainstay of therapeutic management, however, there is lack of evidence supporting a preferred... [ view full abstract ]
Non Alcoholic Fatty Liver Disease (NAFLD) is the most prevalent liver disease globally. Lifestyle modification including diet is the mainstay of therapeutic management, however, there is lack of evidence supporting a preferred diet prescription. 'MEDINA' aims to determine the efficacy of a Mediterranean Diet (MD) and Low Fat Diet (LFD) on liver outcome measures and insulin resistance in NAFLD.
Patients with NALFD were randomised to a MD or LFD for 3months. Magentic Resonance Spectroscopy (MRS) and FibroscanTM were used to measure intrahepatic lipids (IHL) and liver stiffness (LSM), respectively. Insulin resistance was determined using homeostatic model of assessment (HOMA-IR).
Results are presented for the first 25 patients (52% females); 11 were randomised to the MD (mean age 55.7 ± 12.3 years, BMI 32.9 ± 6.3kg/m2) and 12 to LFD (49.6 ± 15.9 years, BMI 32.4 ± 8.0 kg/m2). There were no significant differences between groups at baseline. IHL reduced in the MD; (15.0 ± 7.2 to 13.2 ± 6.9%, p=0.263) and increased in the LFD (9.6 ± 11.9 to 9.8 ± 14.8%, p= 0.241). LSM was unchanged in the MD (8.9± 4.8 kPa to 9.0± 6.3kPa p=0.656) and decreased significantly in the LFD (10.4 ± 2.4 kPa to 9.5 ± 10.8kPa p=0.022). HOMA-IR reduced, albeit non significantly in both the LFD and MD (5.3 ± 3.5 to 4.7 ± 5.0, p=0.065 and 5.3 ± 3.8 to 4.7 ± 2.6, p= 0.760 respectively). Body weight significantly reduced in the LFD (89.6 ± 26.0kg to 83.0 ± 17.7kg, p=0.045) with a non-significant increase in the MD (106.5 ± 17kg to 107.1 ± 17.4kg, p=0.929).
Preliminary findings indicate that a MD may reduce IHL in NAFLD. A LFD resulted in weight loss and a reduction in LSM. Both diets reduced insulin resistance. Larger cohorts are required to attain power to verify these findings.
