Key result
A 12-week Mediterranean diet significantly increased serum adiponectin from baseline (P=0.016), but a low-fat diet produced a greater decrease in leptin (-1.20 vs 0.64 ng/mL, P=0.010).
Why the study?
Chronic low-grade inflammation drives NAFLD progression, and the Mediterranean diet is recognized for improving metabolic and hepatic outcomes, but its effect compared to a low-fat diet on inflammatory markers needed determination.
Does an ad libitum Mediterranean diet improve inflammatory markers in adults with nonalcoholic fatty liver disease compared to a low-fat diet?
RCT (n=42)
randomized
Yes
Does an ad libitum Mediterranean diet improve inflammatory markers in adults with nonalcoholic fatty liver disease compared to a low-fat diet?
Absolute Event Rate: 0.64% vs -1.2%
p-value: p=0.010
A Mediterranean diet improves serum adiponectin in adults with NAFLD without weight loss, while a low-fat diet reduces leptin, highlighting differential metabolic effects of dietary interventions.
MedDiet selectively raised adiponectin in NAFLD; extends RCT evidence for its anti-inflammatory effects independent of weight loss.
Nonalcoholic fatty liver disease (NAFLD) affects approximately 30% of adults worldwide, with chronic low-grade inflammation being a key pathophysiological feature of progression. The Mediterranean diet (MedDiet) is recognized for improving metabolic and hepatic outcomes in people with diabetes and NAFLD, in part, via anti-inflammatory properties. The aim of this study was to determine the effect of an ad libitum MedDiet versus low-fat diet (LFD) on inflammatory markers in adults with NAFLD. It was hypothesized that the MedDiet, and its individual components, would improve inflammation. This multicenter, randomized controlled trial, randomized participants to a MedDiet or LFD intervention for 12 weeks. Primary outcomes included change from baseline to 12 weeks for serum high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, adiponectin, leptin, and resistin. Forty-two participants (60% female; age 52.3 ± 12.6 years; body mass index, 32.2 ± 6.2 kg/m²) were randomized to the MedDiet (n = 19) or low-fat diet (n = 23). At 12 weeks, the LFD showed a greater decrease in leptin compared with the MedDiet (-1.20 ± 3.9 ng/mL vs 0.64 ± 3.5 ng/mL, P = .010). Adiponectin significantly improved within the MedDiet (13.7 ± 9.2 µg/mL to 17.0 ± 12.5 µg/mL, P = .016), but not within the LFD group. No statistically significant changes were observed for other inflammatory markers following the MedDiet or LFD. Adherence to the MedDiet significantly improved in both study arms, although greater improvements were seen in the MedDiet group. Adiponectin significantly improved following a Mediterranean diet intervention, in the absence of weight loss. The low-fat diet did not elicit improvements in inflammatory markers. High-quality clinical trials appropriately powered to inflammatory markers are required in this population.
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Reddy et al. (2023) conducted an RCT in nonalcoholic fatty liver disease (n=42). Mediterranean diet vs. low-fat diet was evaluated on change from baseline to 12 weeks for serum high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, adiponectin, leptin, and resistin (p=0.010). A 12-week Mediterranean diet significantly increased serum adiponectin from baseline (P=0.016), but a low-fat diet produced a greater decrease in leptin (-1.20 vs 0.64 ng/mL, P=0.010).
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