Aliaa Abdel Moneim^1,, Dalia I Tayel¹, Ahmed Zeid², Olfat Darwish¹, Khaled Matrawy³, Mohamed Eid⁴

Nonalcoholic fatty liver disease (NAFLD) is related to lifestyle practices including dietary intake and sedentary lifestyle. The common treatment is directed towards weight loss, which is usually difficult to be achieved or maintained. Therefore, a nutritional intervention program aiming at improving the metabolic health not only focusing on weight loss was conducted. Total of 110 patients referred to the hepatology outpatient clinic in the Main Alexandria University Hospital were selected based on ultrasound examination. Data about dietary intake, habits, and practices, and lifestyle practices were collected. Body composition measurements, laboratory investigations, clinical examination and measuring liver fat by ultrasound were assessed. A Mediterranean diet reduced in total carbohydrates, very low in refined sugars, rich in vegetables, moderate in fruits and low fat dairy, with more incorporation of fish, legumes, olive oil, nuts and seeds; was used for 12 weeks and different exercise advices were provided to patients. A significant reduction in the amount of liver fat, together with improvement in lipid profile, liver enzymes, blood pressure, fasting blood glucose and waist circumference were reported. The criteria of metabolic syndrome and gastrointestinal tract symptoms were improved among the majority of patients, with moderate reduction in body weight 5-6%. Liver fat content estimated by ultrasound was associated with the amount of dietary fat and carbohydrate intake, eating meals at irregular times, and unhealthy cooking methods. Nutrition intervention with Mediterranean diet has significant positive impact on metabolic health of NAFLD patients.

NAFLD, Mediterranean diet, liver enzymes, exercise, metabolic health, lifestyle, carbohydrates, follow up study