Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial.

INTRODUCTION: Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common form of liver disease worldwide affecting all ages and ethnic groups and it has become a consistent threat even in young people. Our aim was to estimate the effect of a Low Glycemic Index Mediterranean Diet (LGIMD) on the NAFLD score as measured by a Liver Ultrasonography (LUS). DESIGN: NUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14. SETTING/PARTICIPANTS: 98 men and women coming from Putignano (Puglia, Southern Italy) were drawn from a previous randomly sampled population-based study and identified as having moderate or severe NAFLD. INTERVENTION: The intervention strategy was the assignment of a LGIMD or a control diet. OUTCOME MEASURES: The main outcome measure was NAFLD score, defined by LUS. RESULTS: After randomization, 50 subjects were assigned to a LGIMD and 48 to a control diet. The study lasted six months and all participants were subject to monthly controls/checks. Adherence to the LGIMD as measured by Mediterranean Adequacy Index (MAI) showed a median of 10.1. A negative interaction between time and LGIMD on the NAFLD score (-4.14, 95% CI -6.78,-1.49) was observed, and became more evident at the sixth month (-4.43, 95%CI -7.15, -1.71). A positive effect of the interaction among LGIMD, time and age (Third month: 0.07, 95% CI 0.02, 0.12; Sixth month: 0.08, 95% CI 0.03,0.13) was also observed. CONCLUSIONS: LGIMD was found to decrease the NAFLD score in a relatively short time. Encouraging those subjects who do not seek medical attention but still have NAFLD to follow a LGIMD and other life-style interventions, may reduce the degree of severity of the disease. Dietary intervention of this kind, could also form the cornerstone of primary prevention of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease.

Dietary polyunsatured fatty acids (PUFA) differentially modulate melamine-induced preneoplastic urothelial proliferation and apoptosis in mice.

A number of experimental and epidemiological studies indicate that dietary polyunsaturated fatty acids (PUFA) play a modulatory role in the development of several cancers. However, literature on the importance of dietary PUFA in urinary-tract tumourigenesis is scarce, and even contradictory. Therefore, our purpose was to evaluate comparatively, several urothelial cellular parameters linked to neoplasia when 180 BALB/c mice were initiated with the tumourigenic agent melamine and fed with two amounts of different PUFA. In experiment 1, mice were fed with 6% of fish oil (enriched in n-3 PUFA, FO), corn oil (enriched in n-6, CO) and olein (enriched in n-9, an EFA deficiency inducer) formulae plus two chow-fed control lots with (CM) and without (C) melamine treatment. In experiment 2, each of the three varieties of PUFA were offered at 10%. Following 18-22 weeks of melamine treatment, animals were autopsied. The liver fatty acid profile showed a close correlation with the dietary sources, exhibiting in the O group macroscopic and biochemical EFA-deficient (EFAD) characteristics. The frequency of simple urothelial hyperplasias (H) and dysplasia/carcinoma in situ (D/CIS) was significantly lower in the FO group, whereas both types of lesions increased in the CO and O groups, compared to the C and CM mice. Increased proliferation and abnormal luminal localized mitosis were more frequently recorded in EFAD mice, whereas abnormal apoptotic/mitosis ratio increased in both olein- and corn-oil-fed animals. This study shows that dietary PUFA modulate differentially normal and pre-neoplastic proliferation when induced by the tumorigenic agent melamine. Fish oil, rich in n-3 fatty acids, exhibits a clear antipromoting activity, whereas the role of n-6 and n-9 PUFA derivatives needs further research.