Mediterranean Diet and Non-alcoholic Fatty Liver Disease

Yıl 2024, , 22 - 30, 31.01.2024

Atilla Bektas , Meltem Ulusoy

https://doi.org/10.55665/troiamedj.1363991

Öz

The Mediterranean lifestyle and nutrition of the 1950s and early 1960s are the main elements of the “Mediterranean Diet”. The principal aspects of this diet include high consumption of olive oil, legumes, whole grains, fruits, and vegetables; moderate to high consumption of fish; moderate consumption of poultry and dairy products coupled with physical and social activities. The diet usually also includes low consumption of meat and dessert. Mediterranean diet promotes a healthy life style by reducing obesity, cardiovascular diseases, diabetes, neurodegenerative diseases and non-alcoholic fatty liver disease (NAFLD). Thus, chronic diseases, many types of cancer and deaths related to these diseases are reduced in people who follow the Mediterranean diet. However, as the population living in the Mediterranean region today abandons their traditional eating habits and adopts a Western type of diet, they will be at increased risk of catching NAFLD and other chronic diseases. NAFLD is one of the most common liver diseases in the world, and poses an important health problem that can follow either a benign course, or progress to chronic liver disease, cirrhosis or liver cancer. An evidence-based medicine with proven efficacy is not yet present in the specific treatment for NAFLD. The change in diet and life style is of great importance in NAFLD treatment. In relation to this, a healthy diet practice such as the Mediterranean diet could play a fundamental role in the prevention and healing of metabolic disorders such as NAFLD.

Anahtar Kelimeler

Non-alcoholic Fatty Liver Disease, Mediterranean diet, Liver Cirrhosis, Nutritional and Metabolic Diseases

Akdeniz diyeti ve Non alkolik yağlı karaciğer hastalığı

Öz

1950’ler ve 1960’ların başlarındaki Akdeniz yaşam tarzı ve beslenme şekli ‘‘Akdeniz diyeti’’ kapsamına girmektedir. Bu diyetin temel yönleri, yüksek miktarda zeytinyağı, baklagiller, tam tahıllar, meyve ve sebzeler; orta ile yüksek miktarda balık ve orta düzeyde kümes hayvanı, süt ürünleri tüketimleriyle birlikte fiziksel ve sosyal aktivitelerin birleştirilmesidir. Genellikle az miktarda et ve tatlı tüketimi içermektedir Akdeniz diyeti’nin kişide sağlıklı olma halini artırdığını; obeziteyi, kalp-damar hastalığını, diyabeti, nörodejeneratif hastalıkları ve non-alkolik yağlı karaciğer hastalığını (NAYKH) azalttığını göstermektedir. Böylece Akdeniz diyeti uygulayan kişilerde, kronik hastalıklar, birçok kanser türlerini ile bu hastalıklara bağlı ölümler azalmaktadır. Bununla beraber Akdeniz bölgesinde yaşayan nüfus bugün geleneksel beslenme alışkanlıklarını terk edip, batı tipi beslenme tarzına geçmektedir. Bu da NAYKH ve diğer kronik hastalıklar için risk yaratmaktadır. NAYKH, dünyadaki en yaygın karaciğer hastalıklarından biri olup, benign bir seyir izleyebileceği gibi kronik karaciğer hastalığı, siroz veya karaciğer kanserine ilerleme riski de taşıyan önemli bir sağlık sorunudur. NAYKH tedavisinde diyet ve yaşam tarzı değişikliğinin önemi büyüktür. Bu bağlamda Akdeniz diyeti gibi sağlıklı bir beslenme paterni uygulaması, NAYKH gibi metabolik bozuklukların önlenmesi ve iyileştirilmesinde önemli rol oynamaktadır.

Anahtar Kelimeler

non alkolik yağlı karaciğer hastalığı, Akdeniz diyeti, karaciğer sirozu, Beslenme ve metabolizma hastalıkları

Kaynakça

• [1] Zadák Z, Hyspler R, Tichá A, Solichová D, Bláha V, Melichar B. Polyunsaturated fatty acids, phytosterols and cholesterol metabolism in the Mediterranean diet. Acta Medıca-Hradec Kralove. 2006;49(1):23-76.
• [2] Dernini S, Berry EM. Mediterranean diet: from a healthy diet to a sustainable dietary pattern. Front Nutr. 2015;2(15):1-7.
• [3] Radd-Vagenas S, Kouris-Blazos A, Singh MF, Flood VM. Evolution of Mediterranean diets and cuisine: concepts and definitions. Asia Pac J Clin Nutr. 2017;26(5):749-63.
• [4] United Nations Educational, Scientific and Cultural Organization (UNESCO). Mediterranean diet. UNESCO 2010 https://ich.unesco.org/en/RL/mediterranean-diet-00884 Accessed: 10.06.2023.
• [5] Benyaich A. The effects of the mediterranean diet on chronic diseases: cardiovascular diseases, oxidative stress, dyslipidemia, diabetes mellitus, blood pressure, cancer, neurodegenerative disease and obesity. J Appl Adv Res. 2017;2(6):333-55.
• [6] Willett WC, Sacks F, Trichopoulou A, et al., Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995; 61(6):1402-06.
• [7] Billingsley HE. Carbone S. The antioxidant potential of the Mediterranean diet in patients at high cardiovascular risk: an in-depth review of the PREDIMED. Nutr diabetes. 2018;8(1):13-21.
• [8] Burlingame B, Gitz V, Meybeck A. Mediterranean food consumption patterns: diet, environment, society, economy and health. A White Paper Priority 5 of Feeding Knowledge Programme, Expo Milan. CIHEAM-IAMB, Bari/FAO, Rome. 2015.
• [9] El-Kader SMA, El-Den Ashmawy EMS. Non-alcoholic fatty liver disease: The diagnosis and management. World J Hepatol. 2015;7(6):846-58.
• [10] Bektaş A, Ulusoy M, Dağalp K. Ursodeoksikolik asit, diyabetik olmayan, alkol dışı karaciğer yağlanması tedavisinde yer almalı mı? Konuralp Med J. 2020;12(1):44-9
• [11] Bektaş A. Yüksek Serum otoantikor seviyesi ile seyreden non-alkolik steatohepatit olgusu. Ankara EAH Tıp Dergisi. 2021;54(2):352-5.
• [12] Anania C, Perla FM. Olivero F, et al. Mediterranean diet and non-alcoholic fatty liver disease. World J Gastroenterol. 2018;24 (19): 2083-94.
• [13] Kitade H, Chen G, Ni Y, Ota T. Non-alcoholic fatty liver disease and insulin resistance: new insights and potential new treatments. Nutr. 2017;9(4):387-400.
• [14] Santoleri D, Titchenell PM. Resolving the paradox of hepatic insulin resistance. Cell Mol Gastroenterol Hepatol. 2019;7(2):447-56.
• [15] Petta S, Gastaldelli A, Rebelos E, et al. Pathophysiology of non-alcoholic fatty liver disease. Int J Mol Sci. 2016;17(12):2082-108.
• [16] Manne V, Handa P, Kowdley KV. Pathophysiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. Clin Liver Dis. 2018;22(1):23-37.
• [17] Moh Moh MA, Jung CH, Lee B, et al. Association of glucagon-to-insulin ratio and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Diabetes Vasc Dis Res. 2019;16(2):186-95.
• [18] Saltzman ET, Palacios T, Thomsen M, et al. Intestinal microbiome shifts, dysbiosis, inflammation, and non-alcoholic fatty liver disease. Front Microbiol. 2018;(9):61-72.
• [19] Tan X, Liu Y, Long J, et al. Trimethylamine N‐Oxide Aggravates Liver Steatosis through Modulation of Bile Acid Metabolism and Inhibition of Farnesoid X Receptor Signaling in Non-alcoholic Fatty Liver Disease. Mol Nutr Food Res. 2019;63 (17):1-10.
• [20] Godos J, Federico A, Dallio M, et al. Mediterranean diet and non-alcoholic fatty liver disease: Molecular mechanisms of protection. Int J Food Sci Nutr. 2017;68(1):18-27
• [21] Masarone M, Rosato V, Dallio M, et al. Role of oxidative stress in pathophysiology of non-alcoholic fatty liver disease. Oxidative Med Cell Longevity. 2018;1-14.
• [22] Perdomo CM, Frühbeck G, Escalada J. Impact of nutritional changes on non-alcoholic fatty liver disease. Nutr. 2019;11(3):677-91.
• [23] Bektas A, Ulusoy M, Bektaş V. Health halo effect of food labels. J Food. 2020;45(3), 590-9.
• [24] Montemayor S, Mascaró CM, Ugarriza L, et al. Adherence to mediterranean diet and NAFLD in patients with metabolic syndrome: The FLIPAN study. Nutrients. 2022;14(15),3186-98.
• [25] Meir AY, Rinott E, Tsaban G, et al. Effect of green-Mediterranean diet on intrahepatic fat: the DIRECT PLUS randomised controlled trial. Gut. 2021;70(11), 2085-95.
• [26] George ES, Reddy A, Nicoll AJ, et al. Impact of a Mediterranean diet on hepatic and metabolic outcomes in non‐alcoholic fatty liver disease: The MEDINA randomised controlled trial. Liver International. 2022;42(6), 1308-1322.
• [27] Franco I, Bianco A, Mirizzi A, et al. Physical activity and low glycemic index Mediterranean diet: Main and modification effects on NAFLD score. Results from a randomized clinical trial. Nutrients. 2021;13(1), 66-90.
• [28] Marin-Alejandre BA, Abete I, Cantero I, et al. The metabolic and hepatic impact of two personalized dietary strategies in subjects with obesity and nonalcoholic fatty liver disease: the fatty liver in obesity (FLiO) randomized controlled trial. Nutrients. 2019;11(10), 2543-59.
• [29] Pintó X, Fanlo-Maresma M, Corbella E. Et al. A Mediterranean diet rich in extra-virgin olive oil is associated with a reduced prevalence of nonalcoholic fatty liver disease in older individuals at high cardiovascular risk. The Journal of nutrition. 2019;149(11), 1920-1929
• [30] Curci R, Bianco A, Franco I, et al. Lifestyle Modification: Evaluation of the Effects of Physical Activity and Low-Glycemic-Index Mediterranean Diet on Fibrosis Score. Nutrients. 2023;15(16), 3520-35.
• [31] Properzi C, O'Sullivan TA, Sherriff JL, et al. Ad libitum Mediterranean and low‐fat diets both significantly reduce hepatic Steatosis: a randomized controlled trial. Hepatology. 2018;68(5), 1741-1754.
• [32] Marin‐Alejandre BA, Cantero I, Perez‐Diaz‐del‐Campo N, et al. Effects of two personalized dietary strategies during a 2‐year intervention in subjects with nonalcoholic fatty liver disease: a randomized trial. Liver International. 2021;41(7), 1532-1544.
• [33] Kontogianni MD, Tileli N, Margariti A, et al. Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease. Clin Nutr. 2014;33(4):678-83.
• [34] Trovato FM, Catalano D, Martines GF, et al. Mediterranean diet and non-alcoholic fatty liver disease: the need of extended and comprehensive interventions. Clin Nutr. 2015; 34(1):86-8.
• [35] Gelli C, Tarocchi M, Abenavoli L, et al. Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease. World J Gastroenterol. 2017;23(17):3150-62.
• [36] Baratta F, Pastori D, Polimeni L, et al. Adherence to mediterranean diet and non-alcoholic fatty liver disease: effect on insulin resistance. Am J Gastroenterol. 2017;112(12):1832-9.
• [37] Katsagoni CN, Papatheodoridis GV, Ioannidou P, et al. Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean life style: a randomised controlled clinical trial. Br J Nutr. 2018;120(2):164-75.
• [38] Plauth M, Bernal W, Dasarathy S, et al. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr. 2019;38(2):485-521.
• [39] Bakır T. NASH’te Beslenme – Akdeniz Diyeti. 16. Hepato-Gastroenteroloji Kongresi. 2019, October 18-20; Girne/KKTC.
• [40] Akhlaghi M, Ghasemi-Nasab M, Riasatian, M. Mediterranean diet for patients with non-alcoholic fatty liver disease, a systematic review and meta-analysis of observational and clinical investigations. J Diabetes Metab Disord. 2020;19(1):575-84.
• [41] Meir AY, Rinott E, Tsaban G, et al. Effect of green-Mediterranean diet on intrahepatic fat: the DIRECT PLUS randomised controlled trial. Gut, 2021;70(11):2085-95.
• [42] Zelber-Sagi S, Bugianesi E, Newsome P, Ratzlu V. EASL Policy Statement on Food, obesity and Non-Alcoholic Fatty Liver Disease (NAFLD). EASL. 2019. https://easl.eu/wp-content/uploads/2019/04/EASL-Policy-statement-on-Food-obesity-and-Non-Alcoholic-Fatty-Liver-Disease.pdf Accessed:12 March 2023
• [43] Haigh L, Kirk C, El Gendy K, et al. The effectiveness and acceptability of Mediterranean diet and calorie restriction in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis. Clin Nutr. 2022; 41(9):1913-31.