Effects of two personalized dietary strategies during a 2-year intervention in subjects with nonalcoholic fatty liver disease: A randomized trial
Bertha A. Marin-Alejandre
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorIrene Cantero
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorNuria Perez-Diaz-del-Campo
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorJose I. Monreal
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Clinical Chemistry Department, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorMariana Elorz
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorJose I. Herrero
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
Search for more papers by this authorAlberto Benito-Boillos
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorJorge Quiroga
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorAna Martinez-Echeverria
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
Search for more papers by this authorJuan I. Uriz-Otano
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
Search for more papers by this authorMaria P. Huarte-Muniesa
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
Search for more papers by this authorJosep A. Tur
Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), Palma, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Search for more papers by this authorJose A. Martinez
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Search for more papers by this authorItziar Abete
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Search for more papers by this authorCorresponding Author
Maria A. Zulet
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Correspondence
Maria A. Zulet, 1Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.
Email: [email protected]
Search for more papers by this authorBertha A. Marin-Alejandre
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorIrene Cantero
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorNuria Perez-Diaz-del-Campo
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Search for more papers by this authorJose I. Monreal
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Clinical Chemistry Department, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorMariana Elorz
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorJose I. Herrero
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
Search for more papers by this authorAlberto Benito-Boillos
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorJorge Quiroga
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
Department of Internal Medicine, Clinica Universidad de Navarra, Pamplona, Spain
Search for more papers by this authorAna Martinez-Echeverria
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
Search for more papers by this authorJuan I. Uriz-Otano
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
Search for more papers by this authorMaria P. Huarte-Muniesa
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
Search for more papers by this authorJosep A. Tur
Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), Palma, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Search for more papers by this authorJose A. Martinez
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Search for more papers by this authorItziar Abete
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Search for more papers by this authorCorresponding Author
Maria A. Zulet
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
Correspondence
Maria A. Zulet, 1Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain.
Email: [email protected]
Search for more papers by this authorItziar Abete and Maria A. Zulet contributed equally.
Trial registration number: NCT03183193 (www.clinicaltrials.gov).
Funding information
This research was funded by the Health Department of the Government of Navarra (61/2015), CIBERobn (Physiopathology of Obesity and Nutrition) (CB12/03/3002), Fundació La Marató de TV3 (201630.10). BAM-A. was supported by predoctoral research grant from Consejo Nacional de Ciencia y Tecnología (CONACYT) y el Estado de Michoacán (440104/2016).
Abstract
Background and objectives
Nonalcoholic fatty liver disease (NAFLD) management is focused on lifestyle modifications, but long-term maintenance is a challenge for many individuals. This study aimed to evaluate the long-term effects of two personalized energy-restricted dietary strategies on weight loss, metabolic and hepatic outcomes in overweight/obese subjects with NAFLD.
Methods
Ninety-eight subjects from the Fatty Liver in Obesity (FLiO) study (NCT03183193) were randomly assigned to the American Heart Association (AHA) or the FLiO dietary group in a 2-year controlled trial. Anthropometry, body composition (DXA), biochemical parameters and hepatic status (ultrasonography, Magnetic Resonance Imaging, and elastography) were assessed at baseline, 6, 12 and 24 months.
Results
Both the AHA and FLiO diets significantly reduced body weight at 6 (−9.7% vs −10.1%), 12 (−6.7% vs −9.6%), and 24 months (−4.8% vs −7.6%) with significant improvements in body composition, biochemical and liver determinations throughout the intervention. At the end of the follow-up, the FLiO group showed a greater decrease in ALT, liver stiffness and Fatty Liver Index, among others, compared to AHA group, although these differences were attenuated when the analyses were adjusted by weight loss percentage. The FLiO group also showed a greater increase in adiponectin compared to AHA group.
Conclusions
The AHA and FLiO diets were able to improve body weight and body composition, as well as metabolic and hepatic status of participants with overweight/obesity and NAFLD within a 2-year follow-up. These findings show that both strategies are suitable alternatives for NAFLD management. However, the FLiO strategy may provide more persistent benefits in metabolic and hepatic parameters.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
Data available on request due to privacy/ethical restrictions.
Supporting Information
| Filename | Description |
|---|---|
| liv14818-sup-0001-TableS1-S4.docxWord document, 30 KB | Table S1-S4 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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