Estudios científicos

Influence of lifestyle factors and staple foods from the Mediterranean diet on non-alcoholic fatty liver disease among older individuals with metabolic syndrome features.

Abstract:

Objective: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver morbidity. This condition often is accompanied by obesity, diabetes, and metabolic syndrome (MetS). The aim of this study was to evaluate the connection between lifestyle factors and NAFLD in individuals with MetS.

Methods: A cross-sectional study with 328 participants (55-75 y of age) diagnosed with MetS participating in the PREDIMED-Plus trial was conducted. NAFLD status was evaluated using the non-invasive hepatic steatosis index (HSI). Sociodemographic, clinical, and dietary data were collected. Adherence to the Mediterranean diet (mainly assessed by the consumption of olive oil, nuts, legumes, whole grain foods, fish, vegetables, fruits, and red wine) and physical activity were assessed using validated questionnaires.

Results: Linear regression analyses revealed that HSI values tended to be lower with increasing physical activity tertiles (T2, β = -1.47; 95% confidence interval [CI], -2.73 to -0.20; T3, β = -1.93; 95% CI, -3.22 to -0.65 versus T1, Ptrend = 0.001) and adherence to the Mediterranean diet was inversely associated with HSI values: (moderate adherence β = -0.70; 95% CI, -1.92 to 0.53; high adherence β = -1.57; 95% CI, -3.01 to -0.13 versus lower, Ptrend = 0.041). Higher tertiles of legume consumption were inversely associated with the highest tertile of HSI (T2, relative risk ratio [RRR], 0.45; 95% CI, 0.22-0.92; P = 0.028; T3, RRR, 0.48; 95% CI, 0.24-0.97; P = 0.041 versus T1).

Conclusion: Physical activity, adherence to the Mediterranean diet, and consumption of legumes were inversely associated with a non-invasive marker of NAFLD in individuals with MetS. This data can be useful in implementing precision strategies aimed at the prevention, monitoring, and management of NAFLD.

Comentarios divulgativos:

Mantener un estilo de vida saludable es clave para la prevención de patologías como la enfermedad de hígado graso no alcohólico, tal como muestran los resultados de este estudio transversal. En los mayores (55-75 años) con síndrome metabólico, el riesgo de desarrollar la enfermedad de hígado graso no alcohólico aumenta cuando son sedentarios y tienen una baja adherencia a la Dieta Mediterránea. Brevemente, la Dieta Mediterránea se caracteriza por el consumo de aceite de oliva, como principal fuente de grasa, por la ingesta de frutos secos, de hortalizas y frutas, de legumbres, cereales integrales, y por un consumo moderado de pescado y vino junto con las comidas. Un consumo elevado de legumbres mejora la salud hepática.

En relación al vínculo entre el consumo bajo-moderado de vino y la enfermedad de hígado graso no alcohólico, la evidencia disponible es controvertida. Los autores del estudio probaron si sus resultados cambiaban cuando se excluía del análisis el consumo moderado de vino, sin embargo, no observaron diferencias, es decir, seguir una Dieta Mediterránea, con o sin un consumo moderado de vino, se asociaba con un menor riesgo de desarrollar la enfermedad de hígado graso no alcohólico. Otras investigaciones observan que la relación del consumo moderado con esta enfermedad depende de las características individuales, así pues, son necesarios estudios en humanos de calidad, para entender el efecto del consumo moderado en la salud hepática.