Does higher adherence to a Mediterranean diet improve markers of antioxidant status in the context of nonalcoholic fatty liver disease? Original paper

In this secondary analysis of a randomized controlled trial in participants with nonalcoholic fatty liver disease, higher adherence to a Mediterranean diet was associated with greater weight loss, as well as improvements in markers of liver health and antioxidant status.

Whether adherence to a Mediterranean diet is associated with improvements biomarkers of cardiometabolic health in the context of nonalcoholic fatty liver disease (NAFLD).

The outcomes assessed were BMI, liver fat, fasting glucose, HbA1c, blood lipids, liver enzymes (ALT, AST, and GGT), blood pressure, C-reactive protein, cytokeratin 18 (a biomarker of liver health), and markers of antioxidant status and oxidative stress (e.g., malondialdehyde, superoxide dismutase activity, glutathione reductase, total glutathione, catalase).

40 participants (ages 40–60) with NAFLD who lived in Spain.

Data were analyzed from a 2-year randomized controlled trial in which some of the participants were assigned to consume a Mediterranean diet. Adherence to a Mediterranean diet was evaluated using a validated questionnaire, and the participants were categorized into groups based on their score (i.e., high or low adherence).

Adherence to a Mediterranean diet increased in both groups during the intervention compared to baseline, but reductions in weight, BMI, liver fat, cytokeratin 18 (indicating an improvement in liver health), and AST were greater in the high adherence group than the low adherence group. The reduction in weight was clinically meaningful.

There were also improvements in markers of antioxidant status and oxidative stress in the high adherence group compared to the low adherence group. Levels of catalase, superoxide dismutase, glutathione reductase, and total glutathione in red blood cells increased, and the level of malondialdehyde in red blood cells decreased.