The effect of a Mediterranean diet vs. a low-fat diet on non-alcoholic fatty liver disease in children: a randomized trial

Abstract

Non-alcoholic fatty liver disease (NAFLD) is becoming ever more common in children, due to the increasing global prevalence of obesity. The first-line treatment consists of weight loss through a combination of a healthy diet and exercise. The objective of this study was to determine the effects of a Mediterranean Diet or a low-fat diet on reducing hepatic steatosis and insulin resistance in children with NAFLD. This 12-week randomised clinical trial was conducted with children aged 9–17 years diagnosed with NAFLD and randomised into either a Mediterranean Diet or a low-fat diet group. By the end of the study, hepatic steatosis had decreased significantly in both groups (p < 0.001). Liver enzymes also improved significantly, while significant decreases were observed in insulin resistance in both groups, although this decrease was greater in the Mediterranean Diet group (p = 0.010). This study demonstrated that a decrease in hepatic steatosis and an improvement in insulin sensitivity can be achieved with both a Mediterranean Diet and a low-fat diet over 12 weeks, with no significant decrease in the energy required for growth, in children with NAFLD.

Keywords:

• Obesity
• non-alcoholic fatty liver disease
• Mediterranean diet
• low-fat diet
• randomised controlled trial

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

The study was approved by the ethical committee of the University of Health Sciences Antalya Education and Research Hospital. Written informed consent was obtained from all patients who participated in this study.

Author contributions

Ulas Emre Akbulut, Ishak Abdurrahman Isik, Atike Atalay, Ali Eraslan, and Emin Durmus collaborated on the design and conception, and writing of the study, on analysis and data interpretation, and on reviewing the final version. Sinem Turkmen and Aziz Selcuk Yurttas collaborated on the conception and design of the study, analysis, and data interpretation.