Mediterranean Diet and Fatty Liver Risk in a Population of Overweight Older Italians: A Propensity Score-Matched Case-Cohort Study.

Roberta Zupo,Sara De Nucci,Mauro Mastronardi,Vito Guerra,Francesco Panza,Rossella Donghia,Rossella Tatoli,Sarah Tirelli,Madia Lozupone,Ilaria Bortone,Rodolfo Sardone,Viviana Giannoccaro,Fabio Castellana,Annamaria Sila,Gianluigi Giannelli,Luisa Lampignano,Giovanni De Pergola

doi:10.3390/nu14020258

Abstract

Hepatic steatosis, often known as fatty liver, is the most common hepatic disease in Western countries. The latest guidelines for the treatment of nonalcoholic fatty liver disease emphasize lifestyle measures, such as changing unhealthy eating patterns. Using a propensity score-matching approach, this study investigated the effect of adhering to a Mediterranean diet (MedDiet) on fatty liver risk in an older population (≥65 years) from Southern Italy. We recruited 1.403 subjects (53.6% men, ≥65 years) who completed a food frequency questionnaire (FFQ) and underwent clinical assessment between 2015 and 2018. For the assessment of the liver fat content, we applied the Fatty Liver Index (FLI). To evaluate the treatment effect of the MedDiet, propensity score matching was performed on patients with and without FLI > 60. After propensity score-matching with the MedDiet pattern as treatment, we found a higher consumption of red meat (p = 0.04) and wine (p = 0.04) in subjects with FLI > 60. Based on the FLI, the inverse association shown between adherence to the MedDiet and the risk of hepatic steatosis shows that the MedDiet can help to prevent hepatic steatosis. Consuming less red and processed meat, as well as alcoholic beverages, may be part of these healthy lifestyle recommendations.

Highlights

Fatty liver (FL), termed as hepatic steatosis (HS), is the most prominent liver disease in western countries [1], affecting up to 34 per cent of the general population and up to 70% per cent of obese people in industrialized countries [2,3,4]
This study aimed to investigate the effect of adherence to a Mediterranean diet (MedDiet) on fatty liver in a cohort of older people from Southern Italy, using a propensity score-matching approach
We found a higher prevalence of hypertension (p = 0.003), diabetes (p = 0.05), metabolic syndrome (p < 0.001), dementia (p = 0.01) and multimorbidity status (p = 0.003) in the group with a higher risk of non-alcoholic fatty liver disease (NAFLD)

Summary

Introduction

Fatty liver (FL), termed as hepatic steatosis (HS), is the most prominent liver disease in western countries [1], affecting up to 34 per cent of the general population and up to 70% per cent of obese people in industrialized countries [2,3,4]. This condition is characterized by pathological changes of the liver, featuring fatty infiltration of liver parenchyma 4.0/). The dietary approach reflects prevailing patterns in the Mediterranean Sea area [8]

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Discussion

Conclusion