• G Misciagna, M Del Pilar Díaz, D V Caramia, C Bonfiglio, I Franco, M R Noviello, M Chiloiro, D I Abbrescia, A Mirizzi, M Tanzi, M G Caruso, M Correale, R Reddavide, R Inguaggiato, A M Cisternino, and A R Osella.
• Alberto Rubén Osella, PhD, Laboratory of Epidemiology and Biostatistics, IRCCS Saverio de Bellis, Via Turi 27, 70013 Castellana Grotte (BA), Italy, Tel: +39 0804994655, Fax: +39 0804994650, e-mail: arosella@irccsdebellis.it.
• J Nutr Health Aging. 2017 Jan 1; 21 (4): 404-412.

IntroductionNon-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).DesignNUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14.Setting/Participants98 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.InterventionThe intervention strategy was the assignment of a LGIMD or a control diet.Outcome MeasuresThe main outcome measure was NAFLD score, defined by LUS.ResultsAfter 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.ConclusionsLGIMD 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.

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