Adherence to a Mediterranean diet may improve serum adiponectin in adults with nonalcoholic fatty liver disease: The MEDINA randomized controlled trial

Anjana Reddy; Paul Della Gatta; Shaun Mason; Amanda J Nicoll; Marno Ryan; Catherine Itsiopoulos; Gavin Abbott; Nathan A Johnson; Siddharth Sood; Stuart K Roberts; Elena S George; Audrey C Tierney

doi:10.1016/j.nutres.2023.09.005

Adherence to a Mediterranean diet may improve serum adiponectin in adults with nonalcoholic fatty liver disease: The MEDINA randomized controlled trial

Nutr Res. 2023 Nov:119:98-108. doi: 10.1016/j.nutres.2023.09.005. Epub 2023 Sep 12.

Authors

Affiliations

¹ School of Allied Health, Human Services and Sport, La Trobe University, Australia; Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia.
² Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
³ Department of Gastroenterology, Eastern Health, Box Hill, Australia.
⁴ Department of Gastroenterology and Hepatology, St Vincent's Hospital, Fitzroy, Australia.
⁵ School of Allied Health, Human Services and Sport, La Trobe University, Australia; School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.
⁶ Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia.
⁷ The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia.
⁸ Department of Gastroenterology, Melbourne Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Parkville, Australia.
⁹ Department of Gastroenterology, Alfred Health, Prahran, Australia; Central Clinical School, Monash University, Clayton, Australia.
¹⁰ School of Allied Health, Human Services and Sport, La Trobe University, Australia; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia. Electronic address: elena.george@deakin.edu.au.
¹¹ School of Allied Health, Human Services and Sport, La Trobe University, Australia; School of Allied Health, Health Implementation Science and Technology Research Cluster, Health Research Institute, University of Limerick, Ireland.

PMID: 37801761
DOI: 10.1016/j.nutres.2023.09.005

Abstract

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.

Keywords: Adiponectin; Diet intervention; Inflammation; Mediterranean diet; Nonalcoholic fatty liver disease.

Publication types

Randomized Controlled Trial
Multicenter Study

MeSH terms

Adiponectin
Adult
Diet, Mediterranean*
Female
Humans
Inflammation
Leptin
Male
Middle Aged
Non-alcoholic Fatty Liver Disease*

Substances

Adiponectin
Leptin