Published online May 21, 2018. doi: 10.3748/wjg.v24.i19.2083
Peer-review started: March 29, 2018
First decision: April 19, 2018
Revised: April 27, 2018
Accepted: May 5, 2018
Article in press: May 5, 2018
Published online: May 21, 2018
Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common chronic liver disease, and is characterized by a wide spectrum of fat-liver disorders that can result in severe liver disease and cirrhosis. Inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. Currently, there is no consensus concerning the pharmacological treatment of NAFLD. However, lifestyle interventions based on exercise and a balanced diet for quality and quantity, are considered the cornerstone of NAFLD management. Mediterranean diet (MD), rich in polyunsaturated fats, polyphenols, vitamins and carotenoids, with their anti-inflammatory and anti-oxidant effects, has been suggested to be effective in preventing cardiovascular risk factors. In adults, MD has also been demonstrated to be efficacious in reducing the risk of metabolic syndrome. However, few studies are available on the effects of the MD in both adult and pediatric subjects with NAFLD. Thus, the aims of the present narrative review are to analyze the current clinical evidence on the impact of MD in patients with NAFLD, and to summarize the main mechanisms of action of MD components on this condition.
Core tip: Lifestyle interventions based on exercise and a balanced diet, are considered the cornerstone of nonalcoholic fatty liver disease (NAFLD) management. The Mediterranean diet (MD), low in saturated fats and animal protein, high in antioxidants and fibers, and with an adequate omega-3 to omega-6 fatty balance, has been suggested to be effective in NAFLD. Although the results from the available studies are encouraging, there is still need of trials with larger sample size, along with the standardization of the criteria to evaluate adherence to the diet, before including the MD as a therapeutic dietary pattern in NAFLD.