Abstract
Background Associated with epidemics of obesity, nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide. The cornerstone of therapy for NAFLD is lifestyle intervention, mainly focused on weight loss. Significant weight loss results from energy-restricted diets, regardless of macronutrient distribution. An anti-inflammatory diet was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. This study aims to evaluate the effect of an energy-reduced anti-inflammatory diet on liver status in younger adults with obesity after a 6-month follow-up. Methods A two-arm randomized controlled trial surveyed 81 participants' (mean age, 43 years) anthropometric and body composition changes. Metabolic status was determined with glycaemic and lipid status, inflammatory status with hs-CRP, IL-6, and TNF-α, and liver status with liver enzymes, NAFLD-FLS, FLI, and FIB-4 indices. The inflammatory potential of the diet was assessed by the Dietary Inflammatory Index, DII®. Results Energy-restricted anti-inflammatory diet resulted in significant weight loss (−7.1%, p < 0.001), in reducing the visceral adiposity (−22.3%, p < 0.001), metabolic (HOMA-IR, −15.5%; total cholesterol, −5.3%; LDL-C, −4.6%; triglycerides, −12.2%), and inflammatory biomarkers (hs-CRP, −29.5%; IL-6, −18.2%; TNF-α, −34.2%), with significant improvement of liver parameters (NAFLD-FLS, −143.4%; FLI, −14.3%; FIB-4, −2.5%). Conclusion The study showed the effectiveness of the anti-inflammatory diet with significant improvement of liver parameters in younger adults with obesity, which may reinforce the effectiveness of nutrition-based lifestyle programs, with an anti-inflammatory dietary approach for the treatment and resolution of NAFLD.
Highlights
In obesity, the accumulation of fat in the liver is associated with insulin resistance and subacute liver inflammation [1,2]. e most common subtype of liver fat accumulation is a nonalcoholic fatty liver disease (NAFLD), which progresses in individuals without excessive alcohol consumption, strong genetic predispositions, or use of steatogenic medication [3]
According to ATTICA study results, an anti-inflammatory diet was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome [17]. e PREDIMED substudy [16] reinforced the concept that obesity is associated with liver damage and revealed that the consumption of a proinflammatory dietary pattern might contribute to obesity and fatty liver disease features. e authors suggested that a well-designed precision diet containing acknowledged anti-inflammatory dietary components could prevent and ameliorate obesityrelated nonalcoholic fatty liver manifestations [16]
After the study presentation and baseline assessments, the recruited participants were randomly assigned to the anti-inflammatory diet (AID) group or the control diet (CD) group using a web-based randomization system, administrated by trained medical personnel not engaged in any other study procedure. e study was conducted between March and October 2019 at Clinical Hospital Centre Rijeka, Croatia, previously approved by the ethics committee of the Clinical Hospital Centre Rijeka
Summary
Associated with epidemics of obesity, nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide. e cornerstone of therapy for NAFLD is lifestyle intervention, mainly focused on weight loss. Is study aims to evaluate the effect of an energy-reduced anti-inflammatory diet on liver status in younger adults with obesity after a 6-month follow-up. Energy-restricted anti-inflammatory diet resulted in significant weight loss (− 7.1%, p < 0.001), in reducing the visceral adiposity (− 22.3%, p < 0.001), metabolic (HOMA-IR, − 15.5%; total cholesterol, − 5.3%; LDL-C, − 4.6%; triglycerides, − 12.2%), and inflammatory biomarkers (hs-CRP, − 29.5%; IL-6, − 18.2%; TNF-α, − 34.2%), with significant improvement of liver parameters (NAFLD-FLS, − 143.4%; FLI, − 14.3%; FIB-4, − 2.5%). E study showed the effectiveness of the anti-inflammatory diet with significant improvement of liver parameters in younger adults with obesity, which may reinforce the effectiveness of nutrition-based lifestyle programs, with an anti-inflammatory dietary approach for the treatment and resolution of NAFLD Conclusion. e study showed the effectiveness of the anti-inflammatory diet with significant improvement of liver parameters in younger adults with obesity, which may reinforce the effectiveness of nutrition-based lifestyle programs, with an anti-inflammatory dietary approach for the treatment and resolution of NAFLD
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