A Mediterranean diet may reduce liver fat and insulin resistance in patients with NAFLD Original paper

Insulin resistance is strongly associated with the development and progression of nonalcoholic fatty liver disease (NAFLD). According to some evidence, a Mediterranean diet (Med-Diet) reduces hepatic fat content and improves insulin resistance in patients with NAFLD, but conflicting evidence also exists.

This meta-analysis of 6 randomized controlled trials investigated the effects of the Med-Diet on hepatic steatosis and insulin resistance in 250 patients (average age of 33–56) with NAFLD in Western countries.

The outcomes assessed were BMI, waist circumference, fatty liver index (FLI), homeostatic model assessment of insulin resistance (HOMA-IR), liver stiffness, and alanine aminotransferase (ALT, a marker of liver function).

The Med-Diet significantly reduced FLI and HOMA-IR. There were no other differences between groups.

This study has many limitations. Notably, the sample size was small, the included studies were of relatively short duration (6 weeks to 6 months), and there was heterogeneity among studies with respect to patient comorbidities at baseline, the method used to diagnose NAFLD, and the dietary interventions. Furthermore, there was significant publication bias for the FLI. For these reasons, the results should be interpreted with caution.