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Effect of dietary and lifestyle interventions on the amelioration of NAFLD in patients with metabolic syndrome: the FLIPAN Study |
Montemayor S, Bouzas C, Mascaro CM, Casares M, Llompart I, Abete I, Angullo-Martinez E, Zulet MA, Martinez JA, Tur JA |
Nutrients 2022 May;14(11):2223 |
clinical trial |
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: Adults with fatty liver present unusual glycaemia and lipid metabolism; as a result, non-alcoholic fatty liver disease (NAFLD) is now considered as part of the metabolic syndrome (MetS). OBJECTIVE: To assess the 6- and 12-month effects of customized hypocaloric dietary and enhanced physical activity intervention on intrahepatic fat contents and progression of NAFLD, in patients with MetS. DESIGN: Cross-sectional study in 155 participants (40 to 60 years old) from Balearic Islands and Navarra (Spain) with a diagnosis of NAFLD and MetS, and BMI (body mass index) between 27 and 40 kg/m2; patients were randomized in a 1:1:1 ratio to either Conventional Diet, Mediterranean diet (MD) high meal frequency, and MD-physical activity groups. METHODS: Dietary intake was assessed using a validated food frequency questionnaire. Adherence to Mediterranean diet, anthropometrics, physical activity, and biochemical parameters (fasting glucose, glycated hemoglobin, bilirubin, aspartate aminotransferase, alanine aminotransferase (ALT), gamma-glu-tamyl transferase, uric acid, urea, creatinine, albumin, total cholesterol, high-density lipoprotein cholesterol (HDL-cholesterol) and triglycerides) were also assessed. RESULTS: Subjects with NAFLD and MetS had reduced intrahepatic fat contents, and liver stiffness, despite the intervention the participants went through. All participants ameliorated BMI, insulin, Hb1Ac, diastolic blood pressure, HDL-cholesterol, and ALT, and improved consumption of total energy, fish, and legumes. Participants in the MD HMF group improved waist circumference. CONCLUSIONS: Customized hy-pocaloric dietary and enhanced physical activity interventions may be useful to ameliorate NAFLD.
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