Increased Adherence to the Mediterranean Diet after Lifestyle Intervention Improves Oxidative and Inflammatory Status in Patients with Non-Alcoholic Fatty Liver Disease

Margalida Monserrat-Mesquida; Magdalena Quetglas-Llabrés; Cristina Bouzas; Sofía Montemayor; Catalina M Mascaró; Miguel Casares; Isabel Llompart; Lucía Ugarriza; J Alfredo Martínez; Josep A Tur; Antoni Sureda

doi:10.3390/antiox11081440

Increased Adherence to the Mediterranean Diet after Lifestyle Intervention Improves Oxidative and Inflammatory Status in Patients with Non-Alcoholic Fatty Liver Disease

Antioxidants (Basel). 2022 Jul 25;11(8):1440. doi: 10.3390/antiox11081440.

Authors

Margalida Monserrat-Mesquida^{1

2

3}, Magdalena Quetglas-Llabrés^{1

2}, Cristina Bouzas^{1

2

3}, Sofía Montemayor^{1

3}, Catalina M Mascaró^{1

3}, Miguel Casares⁴, Isabel Llompart^{1

2

3

5}, Lucía Ugarriza^{1

2

6}, J Alfredo Martínez^{7

8}, Josep A Tur^{1

2

3}, Antoni Sureda^{1

2

3}

Affiliations

¹ Research Group in Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain.
² Health Research Institute of Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
³ CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
⁴ Radiodiagnosis Service, Red Asistencial Juaneda, 07011 Palma de Mallorca, Spain.
⁵ Clinical Analysis Service, University Hospital Son Espases, 07198 Palma de Mallorca, Spain.
⁶ Camp Redó Primary Health Care Center, 07010 Palma de Mallorca, Spain.
⁷ Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, 28049 Madrid, Spain.
⁸ Department of Nutrition, Food Sciences, and Physiology, University of Navarra, 31008 Pamplona, Spain.

Abstract

Background: A Mediterranean diet (MedDiet) is recommended as a therapy for non-alcoholic fatty liver disease (NAFLD) because there is no specific pharmacological treatment for this disease.

Objective: To assess the relationship between the adherence to the Mediterranean diet and the intrahepatic fat content (IFC), levels of oxidative stress, and inflammation biomarkers after a 6-month lifestyle intervention in NAFLD patients.

Methods: Patients diagnosed with NAFLD (n = 60 adults; 40-60 years old) living in the Balearic Islands, Spain, were classified into two groups, according to the adherence to the MedDiet after 6 months of lifestyle intervention. Anthropometry, blood pressure, IFC, maximal oxygen uptake, and pro/antioxidant and inflammatory biomarkers were measured in plasma and in PBMCs before and after the intervention.

Results: Reductions in weight, body mass index, IFC, blood pressure levels, circulating glucose, glycosylated hemoglobin, and markers of liver damage-aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and cytokeratin 18 (CK-18)-were observed after the intervention. The highest reductions were observed in the group with the best adherence to the MedDiet. A significant improvement in cardiorespiratory fitness was also observed in the group with a higher adherence. The activities of catalase in plasma and catalase and superoxide dismutase in blood mononuclear cells increased only in the group with a higher adherence, as well as the catalase gene expression in the blood mononuclear cells. The plasma levels of malondialdehyde and myeloperoxidase decreased, and resolvin-D1 increased in both groups after the intervention, whereas interleukin-6 levels decreased only in the group with a higher adherence to the MedDiet.

Conclusions: A greater adherence to the MedDiet is related to greater improvements in IFC, cardiorespiratory fitness, and pro-oxidative and proinflammatory status in NAFLD patients after a 6-month nutritional intervention based on the MedDiet.

Keywords: Mediterranean diet; aerobic capacity; fatty liver; inflammation; oxidative stress.

Abstract

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