A recent study published in Nutrients has uncovered a significant link between adherence to the Mediterranean diet (MD) and a reduced risk of type-2 diabetes mellitus (T2DM) in patients with metabolic dysfunction-associated fatty liver disease (MAFLD), particularly in men without weight gain.
MAFLD, previously known as non-alcoholic fatty liver disease (NAFLD), is characterized by excess liver fat and metabolic dysfunction, increasing the risk of liver-related mortality and morbidity, as well as T2DM. The Mediterranean diet, known for its high intake of fruits, vegetables, cereals, olive oils, and fish, and moderate intake of dairy, red wine, and eggs, has been clinically validated to reduce the risk and progression of several metabolic conditions, including T2DM and MAFLD.
Researchers conducted a secondary analysis of a long-term follow-up period of 7.5 years, using data from a population-based diabetes study comprising 5,072 adults recruited from the National Health System in Spain. Participants were divided into ‘no weight increment’ and ‘weight increment’ subcohorts based on their weight changes over the follow-up period. MAFLD was diagnosed using the fatty liver index (FLI), with values exceeding 60 considered confirmatory for the disease.
Of the 5,072 participants, 714 met the study’s inclusion criteria, with a mean age of 52. The study cohort was predominantly male, with a high prevalence of metabolic disorders at study initiation. Over the 7.5-year follow-up period, 52.8% of participants maintained or reduced their weight, and 98 developed T2DM, with 70 reporting low MD diet adherence. Logistic regression analyses revealed that MD adherence was associated with a significantly lower risk of T2DM, independent of age and sex.
Adherence to the MD was inversely associated with new cases of T2DM, particularly in subjects without weight gain at follow-up, showing 2.17 to 2.9 times less likelihood of developing T2DM compared to those with low adherence. The study suggests that long-term and consistent MD intake can significantly reduce the risk of T2DM in individuals with preexisting MAFLD.
Conclusion
The study concludes that long-term adherence to the Mediterranean diet can significantly reduce the risk of T2DM in patients with MAFLD, especially in men without weight gain. However, further research is needed to confirm the efficacy of the MD in individuals outside the Mediterranean region and to compare its health benefits with other healthy dietary patterns.
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