The Effects of Extra Virgin Olive Oil on Alanine Aminotransferase, Aspartate Aminotransferase, and Ultrasonographic Indices of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Patients Undergoing Low Calorie Diet

Circulating microRNA panels in subjects with metabolic dysfunction-associated steatotic liver disease after following a 2-year dietary intervention

PURPOSE

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) affects one-third of the global population. Despite its high prevalence, there is a lack of minimally non-invasive diagnostic methods to assess this condition. This study explores the potential of circulating microRNAs (miRNAs) as diagnostic biomarkers for MASLD after a 2-year nutritional intervention.

METHODS

Fifty-five subjects with steatosis (MASLD group) from the Fatty Liver in Obesity (FLiO) study (NCT03183193) were analyzed at baseline and after 6, 12 and 24 months. Participants were classified into two groups: those who still had steatosis after the intervention (unhealthy group) and those in whom steatosis had disappeared (healthy group). Hepatic status was evaluated through magnetic resonance imaging (MRI), ultrasonography, elastography and serum transaminases. Circulating miRNA levels were measured by RT-PCR.

RESULTS

The dietary intervention was able to modulate the expression of circulating miRNAs after 6, 12, and 24 months. Logistic regression analyses revealed that the most effective panels for diagnosing whether MASLD has disappeared after the nutritional intervention included miR15b-3p, miR126-5p and BMI (AUC 0.68) at 6 months, miR29b-3p, miR122-5p, miR151a-3p and BMI (AUC 0.85) at 12 months and miR21-5p, miR151a-3p and BMI at 24 months (AUC 0.85).

CONCLUSIONS

Circulating miRNAs were useful in predicting MASLD in subjects with overweight or obesity after following a weight-loss oriented nutritional intervention. These findings highlight the potential role of miRNAs in diagnosing MASLD and underscore the importance of precision nutrition in managing and determining MASLD.

CLINICAL TRIAL REGISTRATION

Trial registration number: NCT03183193 (www.

CLINICALTRIALS

gov).

Exploring the Cardiovascular Benefits of Extra Virgin Olive Oil: Insights into Mechanisms and Therapeutic Potential

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, driven by complex interactions among genetic, environmental, and lifestyle factors, with diet playing a pivotal role. Extra Virgin Olive Oil (EVOO), a cornerstone of the Mediterranean diet (MedDiet), is a plant-based fat that has garnered attention for its robust cardiovascular benefits, which are attributed to its unique composition of monounsaturated fatty acids (MUFAs), particularly oleic acid (OA); and bioactive polyphenols, such as Hydroxytyrosol (HT) and oleocanthal. These compounds collectively exert antioxidant, anti-inflammatory, vasodilatory, and lipid-modulating effects. Numerous clinical and preclinical studies have demonstrated that EVOO's properties reduce major modifiable cardiovascular risk factors, including hypertension, dyslipidemia, obesity, and type 2 diabetes. EVOO also promotes endothelial function by increasing nitric oxide (NO) bioavailability, thus favoring vasodilation, lowering blood pressure (BP), and supporting vascular integrity. Furthermore, it modulates biomarkers of cardiovascular health, such as C-reactive protein, low-density lipoprotein (LDL) cholesterol, and NT-proBNP, aligning with improved hemostatic balance and reduced arterial vulnerability. Emerging evidence highlights its interaction with gut microbiota, further augmenting its cardioprotective effects. This review synthesizes current evidence, elucidating EVOO's multifaceted mechanisms of action and therapeutic potential. Future directions emphasize the need for advanced extraction techniques, nutraceutical formulations, and personalized dietary recommendations to maximize its health benefits. EVOO represents a valuable addition to dietary strategies aimed at reducing the global burden of cardiovascular diseases.

Effect of Indo-Mediterranean diet versus calorie-restricted diet in children with non-alcoholic fatty liver disease: A pilot randomized control trial

BACKGROUND

Dietary interventions and increased physical activity are the cornerstones for management of the paediatric non-alcoholic fatty liver disease (NAFLD). Though, no specific diet has been proven superior, Indo-Mediterranean diet (IMD) has shown promise in adult literature. Thus, we aimed to compare the effect of IMD and a standard calorie-restricted diet (CRD) in Indian overweight children and adolescents with biopsy-proven NAFLD.

METHODS

Thirty-nine consecutive biopsy-proven NAFLD children between the ages of 8 and 18 years were randomized into either IMD or CRD for 180 days, and various parameters were evaluated at baseline and then after 180 days (NCT05073588).

RESULTS

A total of 34 subjects (18 in IMD and 16 in CRD group) completed the study. There was a significantly higher decrease in controlled attenuation parameter (CAP) values (as a marker of hepatic steatosis; on transient elastography) (95% CI: 4.2-73.4, p = 0.042), weight (95% CI: 0.75-5.5, p = 0.046) and body mass index (BMI) (95% CI: 0.21-2.05, p = 0.014) (but not in Pediatric NAFLD Fibrosis Index or PNFI; as a marker of hepatic fibrosis) in IMD group compared to the CRD group. Liver stiffness measurement, serum cholesterol and low-density lipoprotein levels and HOMA-IR decreased only in the IMD group (p < 0.001). Our statistical model showed that delta-Weight was the only independent variable associated with delta-CAP.

CONCLUSION

Both IMD and CRD can improve the various anthropometric, clinical, imaging and biochemical parameters but IMD was superior to CRD in terms of reducing CAP values and weight/BMI over 180 days in overweight/obese NAFLD children.

Extra Virgin Olive Oil Reduces the Risk of Non-Alcoholic Fatty Liver Disease in Females but Not in Males: Results from the NUTRIHEP Cohort

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. One way to resolve this reversible condition is by making dietary changes. Extra virgin olive oil (EVOO) is often associated with an improvement in this disease. The aim of this study was to explore the protective role of EVOO on NAFLD conditions, stratified by gender.

METHODS

The study cohort included 1426 participants assessed in the second recall of the NUTRIHEP cohort (2014-2018), subdivided by gender and dividing the EVOO intake into quartiles of daily gram intake.

RESULTS

The results indicated a protective role of the last quartile of EVOO only for female subjects, OR = 0.43, p = 0.02, 0.21 to 0.85 at 95% C.I., whereas in the male sub-cohort, the effect was not statistically significant.

CONCLUSIONS

The protective role of EVOO is different between genders. This difference has not been explored in the literature, so we conclude that this is one of the few papers in the literature to evaluate a gender difference in the intestinal absorption of humans based on an epidemiological study.

Extra Virgin Olive Oil and Metabolic Diseases

Over the last few decades, metabolic syndrome coexisting with cardiovascular disease has evolved into a pandemic, making the need for more food-oriented therapeutic approaches and a redefinition of lifestyle imperative, with the Mediterranean diet being the linchpin of this effort. Extra virgin olive oil (EVOO), the key pillar of the Mediterranean diet and one of the most notorious edible oils worldwide, owes its popularity not only to its characteristic aromas and taste but mainly to a series of beneficial health attributes including anti-diabetic, hypolipidemic, anti-hypertensive and anti-obesity actions. In this narrative review, we aimed to illustrate and enlighten EVOO's metabolic properties through a pathogenetic approach, investigating its potential role in metabolic and cardiovascular health.

7-Hydroxyflavone improves nonalcoholic fatty liver disease by acting on STK24

The escalating incidence of nonalcoholic fatty liver disease (NAFLD) is closely associated with a high-fat diet, leading to a decline in quality of life and significant health impairment. 7-Hydroxyflavone (7-HY) is a flavonoid known for its anti-inflammatory, anticarcinogenic, and antioxidant effects. This study aims to assess the ameliorative effects of 7-HY on NAFLD induced by a high-fat diet and elucidate underlying mechanisms. Oleic acid/palmitic acid-induced HepG2 cells and C57BL/6 mice on a high-fat diet were utilized as in vitro and in vivo models. In animal experiments, 7-HY was utilized as a dietary supplement. The 15-week in vivo experiment monitored body weight, body fat percentage, glucose tolerance, insulin tolerance, and metabolic indexes. Commercial kits assessed triglyceride (TG) and total cholesterol levels in cells, liver tissue, and blood. Discovery Studio identified potential targets of 7-HY, compared with NAFLD-associated targets in the GeneCards database. Results indicated 7-HY mitigated fat accumulation, hepatic steatosis, and oxidative stress induced by a high-fat diet. Furthermore, 7-HY showed potential efficacy in ameliorating abnormal glucose metabolism and promoting energy metabolism. Reverse target finding and molecular docking demonstrated a robust interaction between 7-HY and serine/threonine kinase 24 (STK24). Subsequent experimental results confirmed 7-HY's ability to inhibit TG deposition in HepG2 cells through interaction with STK24. In conclusion, 7-HY demonstrated the capacity to alleviate high-fat diet-induced NAFLD, presenting a novel strategy for the prevention and treatment of NAFLD.

The Role of Antioxidants in the Treatment of Metabolic Dysfunction-Associated Fatty Liver Disease: A Systematic Review

Non-alcoholic fatty liver disease (NAFLD) is a global public health problem that causes liver-related morbidity and mortality. It is also an independent risk factor for non-communicable diseases. In 2020, a proposal was made to refer to it as "metabolic dysfunction-associated fatty liver disease (MAFLD)", with concise diagnostic criteria. Given its widespread occurrence, its treatment is crucial. Increased levels of oxidative stress cause this disease. This review aims to evaluate various studies on antioxidant therapies for patients with MAFLD. A comprehensive search for relevant research was conducted on the PubMed, SCOPUS, and ScienceDirect databases, resulting in the identification of 87 studies that met the inclusion criteria. In total, 31.1% of human studies used natural antioxidants, 53.3% used synthetic antioxidants, and 15.5% used both natural and synthetic antioxidants. In human-based studies, natural antioxidants showed 100% efficacy in the treatment of MAFLD, while synthetic antioxidants showed effective results in only 91% of the investigations. In animal-based research, natural antioxidants were fully effective in the treatment of MAFLD, while synthetic antioxidants demonstrated effectiveness in only 87.8% of the evaluations. In conclusion, antioxidants in their natural form are more helpful for patients with MAFLD, and preserving the correct balance of pro-oxidants and antioxidants is a useful way to monitor antioxidant treatment.

The Effects of Olive Oil Consumption on Biochemical Parameters and Body Mass Index of People with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disorder, is closely associated with insulin resistance, obesity, and metabolic syndromes. A body of research has proposed that olive oil, a basic component of the Mediterranean diet with antioxidant and anti-inflammatory properties, may alleviate metabolic disturbances and retard the progression of NAFLD. We conducted a systematic review and meta-analysis to assess the effectiveness of olive oil intake in people with NAFLD. We systematically searched the major electronic databases (PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials), as well as grey literature sources, to identify randomized controlled trials (RCTs) investigating the effects of olive oil consumption on biochemical and anthropometric parameters of individuals with NAFLD. The quality of the studies was evaluated using the risk-of-bias tool 2.0 (RoB 2). The mean difference (MD) and the 95% confidence interval (CI) were calculated using fixed-effects and random-effects models. Seven RCTs involving 515 subjects were included in the analysis. In the random-effects model, no statistically significant differences were identified with respect to alanine transaminase (MD = -1.83 IU/L, 95% CI: -5.85, 2.19 IU/L, p = 0.37, I2 = 69%) and aspartate transaminase (MD = -1.65 IU/L, 95% CI: -4.48, 1.17 IU/L, p = 0.25, I2 = 72%) levels or waist circumference values (MD = -0.23 cm, 95% CI: -1.23, 0.76 cm, p = 0.65, I2 = 0%). However, a significant effect on body mass index was observed (MD = -0.57 kg/m2, 95% CI: -1.08, -0.06 kg/m2, p = 0.03, I2 = 51%) for subjects who received olive oil compared to those who received an alternative diet or placebo. The findings of the present meta-analysis suggest a modestly positive impact of olive oil intake on body weight in people with NAFLD.

Immunomodulatory Role of Plants and Their Constituents on the Management of Metabolic Disorders: An Evidence-Based Review

The relationship between the immune system and metabolic diseases is complex and increasingly recognized as critical to understanding conditions like obesity, diabetes, and cardiovascular diseases. Modulation of the immune system in patients with metabolic disorders can offer several potential benefits. While the salutary impact of plant-derived bioactive compounds on metabolic and immune functions is acknowledged, there is a paucity of comprehensive reviews on the multifaceted and synergistic mechanisms through which these effects are mediated. This review elucidates the therapeutic potential of phytochemical formulations in ameliorating metabolic disorders and delineates their mechanistic implications on relevant biomarkers and immune modulation. Our analysis reveals a predominance of plant species, including Boswellia serrata, Cinnamomum cassia, Citrus bergamia, Coffea arabica, Ficus racemosa, Momordica charantia, Morus Alba, and Trigonella foenum-graecum, that have undergone clinical evaluation and have been substantiated to confer both metabolic and immunological benefits. The phytoconstituents contained in these plants exert their effects through a range of mechanisms, such as improving glucose regulation, reducing inflammatory responses, and modulating immune system. As such, these findings hold considerable promise for clinical and therapeutic translation and necessitate further empirical validation through randomized controlled trials and mechanistic elucidations to affirm the safety and efficacy of herbal formulations.

Effect of Extra Virgin Olive Oil on Anthropometric Indices, Inflammatory and Cardiometabolic Markers: a Systematic Review and Meta-Analysis of Randomized Clinical Trials

BACKGROUND

A large body of literature associated extra virgin olive oil (EVOO) consumption with low risk of cardiovascular disease and mortality. However, findings from clinical trials related to EVOO consumption on blood pressure, lipid profile, and anthropometric and inflammation parameters are not univocal.

OBJECTIVES

The aim of this systematic review and meta-analysis was to evaluate the effect of EVOO consumption on cardiometabolic risk factors and inflammatory mediators.

METHODS

We searched PubMed/MEDLINE, Scopus, and Cochrane up through 31 March, 2023, without any particular language limitations, in order to identify randomized controlled trials (RCTs) that examined the effects of EVOO consumption on cardiometabolic risk factors, inflammatory mediators, and anthropometric indices. Outcomes were summarized as standardized mean difference (SMD) with 95% confidence intervals (CIs) estimated from Hedge's g and random-effects modeling. Heterogeneity was assessed by Cochran Q-statistic and quantified (I2).

RESULTS

Thirty-three trials involving 2020 participants were included. EVOO consumption was associated with a significant decrease in insulin (n = 10; SMD: -0.28; 95% CI: -0.51, -0.05; I2 = 48.57%) and homeostasis model assessment of insulin resistance levels (HOMA-IR) (n = 9; SMD: -0.19; 95% CI: -0.35, -0.03; I2 = 00.00%). This meta-analysis indicated no significant effect of consuming EVOO on fasting blood glucose, triglycerides, total cholesterol, low density lipoproteins, very low density lipoproteins, high density lipoproteins, Apolipoprotein (Apo) A-I and B, lipoprotein a, blood pressure, body mass index, waist circumference, waist to hip ratio, C-reactive protein, interleukin-6, interleukin-10, and tumor necrosis factor α levels (P > 0.05).

CONCLUSIONS

The present evidence supports a beneficial effect of EVOO consumption on serum insulin levels and HOMA-IR. However, larger well-designed RCTs are still required to evaluate the effect of EVOO on cardiometabolic risk biomarkers. This study was registered in PROSPERO as CRD42023409125.

Fatty acid composition but not quantity is an important indicator of non-alcoholic fatty liver disease: a systematic review

BACKGROUND

There is still paucity on the effects of dietary and supplemental fatty acid on non-alcoholic fatty liver disease (NAFLD). The aim of this review is to systematically review and summarise the effect of fatty acids intake on liver-related outcomes in adult patients with NAFLD.

METHODS

The review was conducted using Cochrane CENTRAL Library, Scopus, Embase, MEDLINE, PubMed, and Web of Science. A total of 2786 records were identified, and of these, 36 studies (31 were randomised control trials (RCTs), and 5 were case-control studies) were included. Quality assessment was conducted using the Revised Cochrane Risk of Bias tool and Joanna Briggs Institute checklists.

RESULTS

Of 36 articles, 79% of RCTs and 66% of case-control studies had a low risk of bias. Potential heterogeneity has been observed in assessment of liver-related outcomes. According to the RCTs, there was moderate evidence (3/6 studies) that a diet characterised by a high MUFA, PUFA and low SFA showed reduced liver fat and stiffness. The using of culinary fats that are high in MUFA (4/6 studies) reduces liver steatosis. n-3 PUFA supplementation in combination with a hypocaloric or heart healthy diet with a low SFA improved liver enzyme level (5/14 studies) and steatosis score (3/14 studies).

CONCLUSIONS

Effects on NAFLD parameters, including liver fat content (assessed via magnetic resonance imaging/spectroscopy), stiffness and steatosis score (assessed by ultrasonography), were primarily related to fatty acid composition independent of energy intake. Further investigation is needed to determine the mechanism of specific fatty acid on the accumulation of liver fat.

Dietary strategies in non-alcoholic fatty liver disease patients: From evidence to daily clinical practice, a systematic review

Lifestyle modification comprising calorie restriction (CR) and increased physical activity enabling weight loss is the first-line of treatment for non-alcoholic fatty liver disease (NAFLD). However, CR alone is not optimal and evidence suggests that dietary pattern and composition are also critical in NAFLD management. Accordingly, high consumption of red and processed meat, saturated fat, added sugar, and sweetened beverages are associated with an increased risk of developing NAFLD and hepatocellular carcinoma, while other foods and compounds such as fish, olive oil, and polyphenols are, in contrast, beneficial for metabolic disorders. Therefore, several dietary interventions have been studied in order to determine which strategy would be the most beneficial for NAFLD. The evidence regarding the effectiveness of different dietary interventions such as low carbohydrate/low-fat diet, time-restricted eating diet, CR, and the well-studied Mediterranean diet is summarized.

Role of microRNA in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): a comprehensive review

Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver condition that affects people who do not overconsume alcohol. Uncertainties exist over how microRNAs (miRNAs) in the blood and liver relate to NAFLD. The aim of this narrative review was to investigate the role of miRNAs in the onset and progression of non-alcoholic steatohepatitis (NASH) from NAFLD, and explore their potential as diagnostic tools and treatment targets for NAFLD patients. Liver miRNA-34a levels were found to accurately represent the degree of liver damage, with lower levels suggesting more damage. In patients with NAFLD and severe liver fibrosis, higher levels of miRNA-193a-5p and miRNA-378d were found. Moreover, miRNA-34a, miRNA-122, and miRNA-192 levels might aid in differentiating NASH from NAFLD. Similar to this, miRNA-21 and miRNA-27 levels in rats were able to distinguish between steatosis and steatohepatitis. High-fat diets enhanced the expression of 15 distinct miRNAs in rats, and there were substantial differences in the miRNA expression patterns between obese and lean people. The results from the present review imply that miRNA microarrays and sequencing may be helpful diagnostic tools, and miRNAs may be a possible treatment target for patients with NAFLD.

Is There More to Olive Oil than Healthy Lipids?

The Mediterranean diet is a healthy dietary pattern whose main characteristic is olive oil consumption. The potential health benefits of olive oil have been extensively investigated and the present review provides the more recent clinical evidence supporting the positive impact of olive oil intake on human health. PubMed (n = 227) and Scopus (n = 308) databases were searched for published clinical studies in English over the past six years (October 2016 to December 2022), following key word searches of "olive oil" and "health". Major findings associated olive oil with antioxidant and anti-inflammatory effects, improvement in endothelial function and lipid profile, prevention of obesity, diabetes, cardiovascular and neurodegenerative diseases, and modulation of the gut microbiota. These benefits are attributed to the nutritional composition of olive oil, which has a high content of monounsaturated fatty acids (MUFA) (oleic acid in particular) and minor compounds such as polyphenols (oleuropein and hydroxytyrosol). Although additional research continues to be required, the more recently generated evidence supports the potential of olive oil to contribute beneficially to health and to the prevention and management of a variety of non-communicable diseases, as a consequence of the synergism between its components' complexity.

The effect of a fruit-rich diet on liver biomarkers, insulin resistance, and lipid profile in patients with non-alcoholic fatty liver disease: a randomized clinical trial

BACKGROUND

Despite confirmed dietary approaches to improve the Non-Alcoholic Fatty Liver Disease (NAFLD), the effect of fruits on NAFLD is not clear. The present study aimed to investigate the effect of a fruit rich diet (FRD) on liver steatosis, liver enzymes, Insulin resistance, and lipid profile in patients with NAFLD.

METHODS

Eighty adults with NAFLD participated in this randomized controlled trial. The participants were randomly assigned to the FRD group with consumption of at least 4 servings of fruits daily or the control group with fruits consumption of less than 2 servings/day. The grade of steatosis, serum levels of liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose, and homeostatic model assessment for insulin resistance (HOMA-IR) were measured at the baseline and at the end of the study.

RESULTS

After 6 months of intervention, the FRD group had significantly higher BMI (31.40 ± 2.61 vs. 25.68 ± 2.54, p < .001), WC (113.5 ± 10.7 vs. 100.5 ± 7.5, p < .001), the grade of steatosis, ALT (89.1 ± 92.9 vs. 32.0 ± 19.2, p < .001), AST (74.5 ± 107.8 vs. 24.0 ± 8.5, p < .001), ALP (273.4 ± 128.5 vs. 155.0 ± 43.9, p < .001), GGT (92.7 ± 16.2 vs. 21.2 ± 7.7, p < .001), TC (206.1 ± 40.5 vs. 172.7 ± 42.4, p < .01), LDL (126.9 ± 32.3 vs. 99.8 ± 29.8, p < .001), glucose (115.5 ± 30.0 vs. 97.7 ± 19.0, p < .01), and insulin resistance (7.36 ± 4.37 vs. 2.66 ± 1.27, p < .001), and lower HDL (41.4 ± 8.9 vs. 53.8 ± 15.1, p < .001) compared to the control group. Adjusting for BMI and calorie intake did not change the results.

CONCLUSION

The results of the present study indicated that consumption of fruits more than 4 servings/day exacerbates steatosis, dyslipidemia, and glycemic control in NAFLD patients. Further studies are needed to identify the underlying mechanisms of the effects of fruits on NAFLD.

CLINICAL TRIAL REGISTRATION

This trial was registered at Iranian randomized clinical trial website with IRCT registration no. IRCT20201010048982N1on October 15, 2020.

The synergic effects of alpha-lipoic acid supplementation and electrical isotonic contraction on anthropometric measurements and the serum levels of VEGF, NO, sirtuin-1, and PGC1-α in obese people undergoing a weight loss diet

Background: The anti-obesity effects of Alpha-lipoic acid (α-LA) and isotonic contraction has been reported. However, the underlying mechanism is not fully understood. This study aimed to investigate the effect of 1200 mg/day α-LA supplementation and 3 sessions per week of Faradic (an electrical stimulating system) on anthropometric parameters, body composition, VEGF, Sirtuin-1, nitric oxide (NO), and PGC1-α in obese people undergoing a weight loss regime.Methods: This randomised clinical trial was carried out on 100 obese adults. The subjects were randomly assigned to four groups of 25 subjects including Faradic, α-LA, α-LA + Faradic, and control. A Bio Impedance Analyser (BIA) was used to estimate anthropometric measurements including weight, body mass index (BMI), fat mass, and fat free mass. The serum levels of Sirtuin-1, PGC1-α, VEGF, and NO levels were measured. All measurements were done at baseline and after 8 weeks of the intervention.Results: A significant weight reduction was observed in all four groups compared to baseline (p<.01). The placebo group had significantly higher weight, BMI, weight circumstance (WC), and body fat (BF) compared with the other groups. The α-LA + Faradic group had significantly lower weight, BMI, BF, WC than control, faradic, and α-LA groups and higher, Sirtuin and PGC than the control group (all p < .05).Conclusions: The findings indicated that the α-LA and Faradic interventions may have a synergistic effect on weight, BMI, BF, WC, and SLM, possibly through changes in serum level of VEGF, NO, and PGC. Further studies are warranted to clarify the mutual effects of -α-LA and Faradic on obesity and its molecular mechanisms. Name of the registry: Iranian Registry of Clinical TrialsTrial registration number: IRCT20131117015424N2Date of registration: 04/04/2018URL of trial registry record: https://www.irct.ir/search/result?query=IRCT20131117015424N2.

The effectiveness and acceptability of Mediterranean diet and calorie restriction in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis

BACKGROUND & AIMS

Lifestyle interventions that focus on reduced energy intake and improved dietary pattern are the mainstay of non-alcoholic fatty liver disease (NAFLD) management. However, it remains unclear which dietary approaches are most beneficial and promote greatest adherence. We aimed to synthesise data from randomised and clinical controlled trials, describing the effects of Mediterranean Diet and Calorie Restriction interventions on NAFLD surrogate markers, in adults.

METHODS

We searched MEDLINE, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials (October 2021). Study quality was assessed using the Cochrane Collaboration's tools: risk of bias for randomised controlled trials, and risk of bias in non-randomised studies of interventions. Meta-analyses were performed using a random effects model, and the I2 statistic was used to assess heterogeneity.

RESULTS

Of 4041 records identified, 26 articles with 3037 participants met the inclusion criteria, including studies on calorie-restricted interventions (CRI) (n 9), Mediterranean diet (MD) interventions (n 13) and MD component interventions (n 4). Studies were heterogeneous regarding intervention components, assessment of liver status and diet outcomes. 3 studies reported zero attrition and mean attrition rate for the remaining 23 studies was 14%. Post-intervention meta-analyses revealed that dietary interventions reduced alanine aminotransferase (ALT) (P < 0.001), aspartate aminotransferase (AST) (P = 0.004), Fatty Liver Index (FLI) (P < 0.001), hepatic steatosis (HS) (P = 0.02), and liver stiffness (P = 0.01). CRI had favourable effects on ALT (P < 0.001), HS (P < 0.001) and liver stiffness (P = 0.009). MD reduced ALT (P = 0.02), FLI (P < 0.001) and liver stiffness (P = 0.05). There was a dose-response relationship between degree of calorie restriction and beneficial effects on liver function and weight loss, suggesting that this approach should remain the cornerstone of NAFLD management. In addition, diet composition changes have potential for improving NAFLD and the limited data suggest that MD may be an effective diet therapy.

CONCLUSION

These results support the current guidelines in NAFLD. However, further studies, which robustly evaluate the effects of interventions on dietary intake, acceptability and sustainability of the interventions, and quality of life and other patient-related outcomes are needed to support effective care delivery.

The effects of Mediterranean diet on hepatic steatosis, oxidative stress, and inflammation in adolescents with non-alcoholic fatty liver disease: A randomized controlled trial

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in children and adolescents. The optimal dietary strategy to improve hepatic stetatosis and reduce oxidative stress and inflammation in adolescents is unknown.

OBJECTIVE

This study was conducted to evaluate the effect of Mediterranean diet (MD) versus low-fat diet (LFD) on hepatic steatosis, inflammation, and oxidative stress in adolescents with obesity and NAFLD.

METHODS

Adolescents diagnosed with NAFLD between the ages of 11-18 years were randomized to either a MD or conventional LFD (control diet) for 12 weeks. Dietary status, anthropometry, body composition, and biochemical parameters were evaluated. Hepatic steatosis was determined by ultrasonography.

RESULTS

A total of 44 participants completed the study. At the end of the study, severity of hepatic steatosis, serum transaminase levels, and insulin resistance decreased significantly in both groups with no significant differences between groups except for aspartate aminotransferase (AST). The amount of decrease in AST levels in the MD group was greater than the LFD group (p < 0.05). In the MD group, serum total antioxidant capacity, paraoxanase-1, and glutathione peroxidase levels increased (p < 0.05); it did not change in the LFD group compared to baseline (p > 0.05). C-Reactive Protein (CRP) levels decreased only in the MD group (p = 0.008), interleukine-6 decreased only in the LFD group (p = 0.031).

CONCLUSION

Consumption of MD and LFD for 12 weeks in adolescents with obesity and NAFLD reduced BMI, fat mass, hepatic steatosis, and insulin resistance, improved high transaminase levels, and had positive effects on inflammation and oxidative stress. Registered under ClinicalTrials.gov Identifier no. NCT04845373.

The effects of saffron petals and damask rose petals on biochemical and inflammatory measurements

OBJECTIVES

Diabetes is a chronic disease caused by high blood sugar greatly affected by diet. The chemical medicines applied to treat diabetes usually have side effects. This study aimed to investigate the effect of saffron petals, damask rose petals, and saffron-damask rose petal herbal teas on weight loss, fasting blood sugar, lipid profile, and the inflammatory factors of diabetic rats.

METHODS

In this study, 40 male Sprague Dawley rats with an average age of four weeks received a high-calorie, high-fat, high-sugar diet for nine weeks. The rats were then randomly assigned to five groups, including normal, control, saffron petal, damask rose petal, and saffron plus damask rose petal groups. For nine weeks, 3 mL of the herbal tea was administered to the intervention groups daily through oral gavage. The levels of FBS, lipid profile, Insulin-like growth factor 1 (IGF-1), the high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1C), and glucose tolerance test (GTT) were measured following the intervention.

RESULTS

Saffron petals reduced weight gain, Triglyceride (TG), and HbA1c and increased hs-CRP and IGF-1 (all p < 0.05). The damask rose petal reduced weight gain, FBS, hs-CRP, and HbA1c and increased the IGF-1 (all p < 0.05). Saffron plus damask-rose petals reduced the weight gain, TG, hs-CRP and HbA1c, and increase IGF-1 factor (all p < 0.05) compared to the control group. No significant effect was found on visceral fat, LDL-C, and HDL-C. Compared with the normal group, saffron petals and damask rose petals increased the FBS, HDL, and LDL levels. Damask rose and the combination of saffron petals and damask rose decreased IGF-1 compared with the normal group (all p < 0.05).

CONCLUSIONS

Saffron and damask rose petals could have beneficial effects on improving the status of biochemical markers. The simultaneous use of saffron and damask rose may counteract the adverse effects of saffron on inflammatory indices.

The effect of genistein on insulin resistance, inflammatory factors, lipid profile, and histopathologic indices in rats with polycystic ovary syndrome

OBJECTIVE

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, irregular menstruation, ovulatory dysfunction, and insulin resistance. Recent studies have reported the possible role of phytoestrogens in PCOS. This animal study aimed to evaluate the effects of genistein on insulin resistance, inflammatory factors, lipid profile, and histopathologic indices on PCOS.

METHODS

PCOS was induced by 1 mg/kg of letrozole in adult Sprague-Dawley rats. The rats then received normal saline (PCOS group), 150 mg/kg of metformin, or 20 mg/kg of genistein dissolved in 1% methylcellulose solution for 42 days. Body weight, the glycemic and lipid profile, and inflammatory, antioxidative, and histopathological parameters were assessed at the end of the intervention.

RESULTS

Treatment with genistein significantly alleviated the increased level of fasting blood insulin (p=0.16) and the homeostatic model assessment of insulin resistance (p=0.012). In addition, the genistein group had significantly lower levels of serum malondialdehyde (p=0.039) and tumor necrosis factor-alpha (p=0.003), and higher superoxide dismutase enzyme activity (p<0.001). Furthermore, the histopathological analysis indicated that genistein administration led to an increase in luteinization and the development of fewer cysts (p<0.05).

CONCLUSION

Biochemical and histopathological analyses indicated that genistein administration to rats with PCOS induced significant remission in oxidative, inflammatory, and glycemic and histopathologic parameters.

Targeting miRNA by Natural Products: A Novel Therapeutic Approach for Nonalcoholic Fatty Liver

The increasing prevalence of nonalcoholic fatty liver disease (NAFLD) as multifactorial chronic liver disease and the lack of a specific treatment have begun a new era in its treatment using gene expression changes and microRNAs. This study aimed to investigate the potential therapeutic effects of natural compounds in NAFLD by regulating miRNA expression. MicroRNAs play essential roles in regulating the cell's biological processes, such as apoptosis, migration, lipid metabolism, insulin resistance, and adipocyte differentiation, by controlling the posttranscriptional gene expression level. The impact of current NAFLD pharmacological management, including drug and biological therapies, is uncertain. In this context, various dietary fruits or medicinal herbal sources have received worldwide attention versus NAFLD development. Natural ingredients such as berberine, lychee pulp, grape seed, and rosemary possess protective and therapeutic effects against NAFLD by modifying the gene's expression and noncoding RNAs, especially miRNAs.

Dietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Background: With no approved pharmacotherapy to date, the present therapeutic cornerstone for non-alcoholic fatty liver diseases (NAFLD) is a lifestyle intervention. Guidelines endorse weight loss through dietary modifications, physical exercise, or both. However, no consensus exists on the optimal dietary treatment. Objectives: The aim of our systematic review and meta-analysis was to summarize and assess the evidence for applied types of dietary interventions on the liver and metabolic outcomes in patients with NAFLD, aside from any effects of exercise intervention. Methods: This systematic review was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement guidelines. The search was conducted in PubMed, Scopus, and Cochrane databases in February 2020. Included were only dietary interventions without exercise. This study was registered at PROSPERO: CRD42020203573. Results: Eight randomized controlled trials, seven with endpoint reduction of hepatic steatosis, one with an assessment of endpoint fibrosis, were included in this systematic review, five of which were included in the meta-analysis. Mediterranean dietary interventions without energy restriction (n = 3) showed significant reduction of intrahepatic lipid content (IHL) (SDM: -0.57, 95% CI: -1.04, -0.10), but there was no significant change in alanine transaminase (ALT) (SDM: 0.59, 95% CI: -0.5, -1.68). Hypocaloric dietary interventions with foods high in unsaturated fatty acids (n = 2) led to a significant decrease in ALT (SDM: -1.09, 95% CI: -1.49, -0.69) and aspartate aminotransferase (AST) (SDM: -0.75, 95% CI: -1.27, 0.23); yet effects on steatosis could not be aggregated due to different assessment techniques. Mediterranean diet did not lead to significant changes in concentrations of gamma-glutamyl transpeptidase (γGT), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), fasting glucose or insulin, or homeostatic assessment for insulin resistance. Conclusions: In patients with NAFLD, Mediterranean and hypocaloric dietary interventions favoring unsaturated fatty acids result in improvements in IHL and transaminases. Since many dietary intervention studies are combined with exercise interventions and there is a paucity of ample-sized studies examining dietary interventions on the more advanced and clinically relevant stages of NAFLD, that is active and fibrotic NASH, with multiparametric imaging and liver histology as outcome measures, the optimal dietary invention in NAFLD remains to be defined.

Synergistic effects of high-intensity interval training (HIIT) and intake of nettle on serum levels of chemerin and beta cells function in type 2 diabetic rats

OBJECTIVES

This animal study aimed to demonstrate the synergistic effect of high-intensity interval training (HIIT) and alcoholic extract of nettle on serum chemerin and beta cells function in type 2 diabetic male rats.

METHODS

Thirty-two STZ-induced diabetic male Wistar rats were randomly divided into four groups including the control group, the supplemented group with 200 mg/day of nettle, the training group with five sessions per week of HIIT, and the group with combined nettle and HITT intervention. Body weight, lipid profile, beta cells function, and chemerin level were assessed after eight weeks of the intervention.

RESULTS

The values of chemerin significantly decreased in combined HIIT and nettle intervention group compared to the control group (p=0.001). The levels of glucose and insulin decreased significantly in nettle group, exercise group, and combined HIIT and nettle group (p=0.001).

CONCLUSIONS

The present study found that intense interval exercise with the consumption of alcoholic extract of nettle can affect the performance of beta cells, glucose, and insulin. Future human studies are warranted.

Lifestyle modifications for nonalcohol-related fatty liver disease: a network meta-analysis

BACKGROUND

The prevalence of nonalcohol-related fatty liver disease (NAFLD) varies between 19% and 33% in different populations. NAFLD decreases life expectancy and increases the risks of liver cirrhosis, hepatocellular carcinoma, and requirement for liver transplantation. There is uncertainty surrounding the relative benefits and harms of various lifestyle interventions for people with NAFLD.

OBJECTIVES

To assess the comparative benefits and harms of different lifestyle interventions in the treatment of NAFLD through a network meta-analysis, and to generate rankings of the different lifestyle interventions according to their safety and efficacy.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, Science Citation Index Expanded, Conference Proceedings Citation Index - Science, World Health Organization International Clinical Trials Registry Platform, and trials registers until February 2021 to identify randomised clinical trials in people with NAFLD.

SELECTION CRITERIA

We included only randomised clinical trials (irrespective of language, blinding, or status) in people with NAFLD, whatever the method of diagnosis, age, and diabetic status of participants, or presence of non-alcoholic steatohepatitis (NASH). We excluded randomised clinical trials in which participants had previously undergone liver transplantation.

DATA COLLECTION AND ANALYSIS

We planned to perform a network meta-analysis with OpenBUGS using Bayesian methods and to calculate the differences in treatments using hazard ratios (HRs), odds ratios (ORs), and rate ratios (RaRs) with 95% credible intervals (CrIs) based on an available-participant analysis, according to National Institute of Health and Care Excellence Decision Support Unit guidance. However, the data were too sparse for the clinical outcomes. We therefore performed only direct comparisons (head-to-head comparisons) with OpenBUGS using Bayesian methods.

MAIN RESULTS

We included a total of 59 randomised clinical trials (3631 participants) in the review. All but two trials were at high risk of bias. A total of 33 different interventions, ranging from advice to supervised exercise and special diets, or a combination of these and no additional intervention were compared in these trials. The reference treatment was no active intervention. Twenty-eight trials (1942 participants) were included in one or more comparisons. The follow-up ranged from 1 month to 24 months. The remaining trials did not report any of the outcomes of interest for this review. The follow-up period in the trials that reported clinical outcomes was 2 months to 24 months. During this short follow-up period, clinical events related to NAFLD such as mortality, liver cirrhosis, liver decompensation, liver transplantation, hepatocellular carcinoma, and liver-related mortality were sparse. This is probably because of the very short follow-up periods. It takes a follow-up of 8 years to 28 years to detect differences in mortality between people with NAFLD and the general population. It is therefore unlikely that differences by clinical outcomes will be noted in trials with less than 5 years to 10 years of follow-up. In one trial, one participant developed an adverse event. There were no adverse events in any of the remaining participants in this trial, or in any of the remaining trials, which seemed to be directly related to the intervention.

AUTHORS' CONCLUSIONS

The evidence indicates considerable uncertainty about the effects of the lifestyle interventions compared with no additional intervention (to general public health advice) on any of the clinical outcomes after a short follow-up period of 2 months to 24 months in people with nonalcohol-related fatty liver disease. Accordingly, high-quality randomised clinical trials with adequate follow-up are needed. We propose registry-based randomised clinical trials or cohort multiple randomised clinical trials (a study design in which multiple interventions are trialed within large longitudinal cohorts of participants to gain efficiencies and align trials more closely to standard clinical practice), comparing aerobic exercise and dietary advice versus standard of care (exercise and dietary advice received as part of national health promotion). The reason for the choice of aerobic exercise and dietary advice is the impact of these interventions on indirect outcomes which may translate to clinical benefit. The outcomes in such trials should be mortality, health-related quality of life, decompensated liver cirrhosis, liver transplantation, and resource use measures including costs of intervention and decreased healthcare use after a minimum follow-up of eight years, to find meaningful differences in the clinically important outcomes.

Effects of Insoluble Cereal Fibre on Body Fat Distribution in the Optimal Fibre Trial

SCOPE

The Optimal Fibre Trial (OptiFiT) investigates metabolic effects of insoluble cereal fibre in subjects with impaired glucose tolerance (IGT), showing moderate glycemic and anti-inflammatory benefits, especially in subjects with an obesity-related phenotype. An OptiFiT sub-group is analysed for effects on body fat distribution.

METHODS AND RESULTS

180 participants with IGT receive a blinded, randomized supplementation with insoluble cereal fibre or placebo for 2 years. Once a year, all subjects undergo fasting blood sampling, oral glucose tolerance test, and anthropometric measurements. A subgroup (n=47) also received magnetic resonance imaging and spectroscopy for quantification of adipose tissue distribution and liver fat content. We compared MR, metabolic and inflammatory outcomes between fibre and placebo group metabolism and inflammation. Visceral and non-visceral fat, fasting glucose, HbA1c, fasting insulin, insulin resistance, and uric acid decrease only in the fibre group, mirroring effects of the entire cohort. However, after adjustment for weight loss, there are no significant between-group differences. There is a statistical trend for fibre-driven liver fat reduction in subjects with confirmed non-alcoholic fatty liver disease (NAFLD; n = 19).

CONCLUSIONS

Data and evidence on beneficial effects of insoluble cereal fibre on visceral and hepatic fatstorage is limited, but warrants further research. Targeted trials are required.

The effect of black seed raisin on some cardiovascular risk factors, serum malondialdehyde, and total antioxidant capacity in hyperlipidemic patients: a randomized controlled trials

BACKGROUND

The lipid-lowering properties and antioxidants of the raisins may reduce the risk factors of cardiovascular diseases. This study aimed to investigate the effect of black seeded raisin consumption on blood pressure (BP), lipid profile, high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), and serum total antioxidant capacity (TAC) in hyperlipidemic patients.

METHODS

Thirty-eight hyperlipidemic patients aged 41.05 ± 10.4 years were recruited to this two-armed, randomized, controlled intervention trial. Participants were instructed to consume 90 g per day black seed raisin in the intervention group, and control group received no intervention. BP, lipid profile, and plasma levels of TAC, MDA, hs-CRP, and FBS were determined at baseline and week 5.

RESULTS

After 5 weeks, the diastolic BP reduced significantly in raisin group compared with baseline (81.80 ± 10.22 vs 77.05 ± 11.03, P = 0.001) and TAC was significantly increased in raisin group compared with the control group (394 ± 116.93 vs 479 ± 122.31, P = 0.001). The serum level of MDA in the raisin group was significantly lower compared with the control group (1.35 ± 0.88 vs 1.39 ± 0.67, P = 0.039). No significant changes were found in lipid profile, SBP, hs-CRP, and FBS.

CONCLUSION

These results suggest that consumption of black raisin which is rich in polyphenolic compounds has beneficial effects on some cardiovascular risk factors especially blood pressure and serum antioxidant capacity in patients with hyperlipidemia.

TRIAL REGISTRATION

Trial registration number: IRCT2015091624049N1. This study was registered in the Iranian Registry of Clinical Trials (IRCT). URL of trial registry record: https://www.irct.ir/trial/20395.

The effect of L-arginine supplementation on maximal oxygen uptake: A systematic review and meta-analysis

Background

The efficacy and safety of L‐arginine supplements and their effect on maximal oxygen uptake (VO2 max) remained unclear. This systematic review aimed to investigate the effect of L‐arginine supplementation (LAS) on VO2 max in healthy people.

Methods

We searched PubMed, Scopus, Web of Science, Cochrane, Embase, ProQuest, and Ovid to identify all relevant literature investigating the effect of LAS on VO2 max. This meta‐analysis was conducted via a random‐effects model for the best estimation of desired outcomes and studies that meet the inclusion criteria were considered for the final analysis.

Results

The results of 11 randomized clinical trials indicated that LAS increased VO2 max compared to the control group. There was no significant heterogeneity in this meta‐analysis. Subgroup analysis detected that arginine in the form of LAS significantly increased VO2 max compared to the other forms (weighted mean difference = 0.11 L min⁻¹, I² = 0.0%, p for heterogeneity = 0.485).

Conclusions

This meta‐analysis indicated that supplementation with L‐arginine could increase VO2 max in healthy people. Further studies are warranted to confirm this finding and to identify the underlying mechanisms.

This meta‐analysis indicated that the supplementation of L‐arginine could increase VO2 max in healthy people

Nutritional Approach Targeting Gut Microbiota in NAFLD-To Date

Non-alcoholic fatty liver disease (NAFLD) is a significant clinical and epidemiological problem that affects around 25% of the adult global population. A large body of clinical evidence highlights that NAFLD is associated with increased liver-related morbidity and mortality and an increased risk of cardiovascular disease, extrahepatic cancers, type 2 diabetes, and chronic kidney disease. Recently, a series of studies revealed the pivotal role of gut microbiota (GM) dysbiosis in NAFLD's pathogenesis. The GM plays an essential role in different metabolic pathways, including the fermentation of diet polysaccharides, energy harvest, choline regulation, and bile acid metabolism. One of the most critical factors in GM stabilization is the diet; therefore, nutritional therapyappearsto be a promising tool in NAFLD therapy. This paper aims to review the current knowledge regardingthe nutritional approach and its implications with GM and NAFLD treatment. We discuss the positive impact of probiotics, prebiotics, and symbiotics in a reverse dysbiosis state in NAFLD and show the potential beneficial effects of bioactive substances from the diet. The full description of the mechanism of action and comprehensive examination of the impact of nutritional interventions on GM modulation may, in the future, be a simple but essential tool supporting NAFLD therapy.

Effect of dietary carbohydrate and lipid modification on clinical and anthropometric parameters in nonalcoholic fatty liver disease: a systematic review and meta-analysis

CONTEXT

Nonalcoholic fatty liver disease (NAFLD) is estimated to affect approximately 25% of the adult population, making it one of the most common chronic liver diseases worldwide and a major public health problem. Still, there is no consensus on the most appropriate nutritional intervention for disease treatment.

OBJECTIVE

To systematize and synthesize the results of randomized controlled trials that have evaluated the effect of dietary interventions with different, quantitative, macronutrient compositions on hepatic steatosis attenuation, serum levels of alanine aminotransferase, aspartate aminotransferase, lipid profile, glucose metabolism markers, and anthropometric parameters of adults and the elderly (age ≥ 60 years) with NAFLD.

DATA SOURCES

MEDLINE databases via PubMed, Embase, Science Direct, LILACS, Web of Science, ClinicalTrials.gov, and Cochrane Library were searched. Randomized controlled trials that compared interventions as diets with values ≤ 45% or 20% of the total daily energy intake from carbohydrates or lipids, respectively, compared with dietary reference intakes, were included.

DATA EXTRACTION

Risk of bias was assessed through the Cochrane Collaboration tool. The meta-analysis was only performed to evaluate the effect of carbohydrate-modified diets on the outcome variables. The number of participants and mean values and respective standard deviations of the outcome variables were extracted and used to calculate weighted mean differences and their respective 95%CIs.

RESULTS

The search strategy resulted in 21 146 studies, of which 10 were retained for qualitative analysis and 6 were included in the meta-analysis. From the analysis of 10 studies were identified 8 articles in which low-calorie diets were evaluated and 3 interventions that used an isocaloric diet. Only 3 studies were classified as having low risk of bias.

CONCLUSION

The observed effects on hepatic steatosis, serum alanine aminotransferase and aspartate aminotransferase levels, parameters of lipid and glucose metabolism, and anthropometric variables were mostly related to a hypocaloric diet. The use of reduced macronutrient interventions had no efficacy.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42018088824.

Lactobacillus plantarum KSFY06 Prevents Inflammatory Response and Oxidative Stress in Acute Liver Injury Induced by D-Gal/LPS in Mice

AIM

The purpose of this study is to investigate the preventive effect of Lactobacillus plantarum KSFY06 (LP-KSFY06) on D-galactose/lipopolysaccharide (D-Gal/LPS)-induced acute liver injury (ALI) in mice.

METHODS

We evaluated the antioxidant capacity of LP-KSFY06 in vitro, detailed the effects of LP-KSFY06 on the organ index, liver function index, biochemical index, cytokines, and related genes, and noted the accompanying pathological changes.

RESULTS

The results clearly showed that LP-KSFY06 can remove 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzthiazoline -6-sulphonic acid) diammonium salt (ABTS) free radicals in vitro. The analysis of the organ index and pathology demonstrated that LP-KSFY06 significantly prevented ALI. Biochemical and molecular biological analysis showed that LP-KSFY06 prevented a decrease in the antioxidant-related levels of superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GSH-Px), catalase (CAT), and total antioxidant capacity (T-AOC), and also prevented an increase in aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), malondialdehyde (MDA), myeloperoxidase (MPO), and nitric oxide (NO) levels. LP-KSFY06 upregulated the anti-inflammatory factor interleukin (IL)-10 and downregulated the pro-inflammatory factors IL-6, IL-1β, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). These oxidative and inflammatory indicators were consistent with the results of gene detections. Furthermore, we determined that LP-KSFY06 downregulated Keap1, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), caspase-1, nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB), IL-18, and mitogen-activated protein kinase 14 (MAPK14 or p38), upregulated Nrf2, heme oxygenase-1 (HO-1), NAD(P)H dehydrogenase [quinone] 1 (NQO1), B-cell inhibitor-α (IκB-α), and thioredoxin (Trx) mRNA expression. These may be related to the regulation of the Kelch-like ECH-associated protein-1 (Keap1)-nuclear factor-erythroid-2-related factor (Nrf2)/antioxidant response element (ARE) and NLRP3/NF-κB pathways.

CONCLUSION

LP-KSFY06 is an effective multifunctional Lactobacillus with strong anti-oxidant and anti-inflammatory ability that can prevent D-gal/LPS-induced ALI in mice and assist in maintaining health.

Olive oil antioxidants and non-alcoholic fatty liver disease

Introduction: Non-alcoholic fatty liver disease (NAFLD) is estimated to affect 25% of adult people worldwide. Nowadays, there is no definite treatment for NAFLD. International guidelines define an approach based on lifestyle changes, included a health alimentary regimen. The Mediterranean diet (MD) represents the gold standard in preventive medicine, probably due to the harmonic combination of many elements with antioxidant and anti-inflammatory properties. Its prescription is also recommended in patients with NAFLD. Olive oil, as part of MD, is associated with benefits on human health especially regarding the cardiovascular system, obesity, diabetes and related metabolic disorders. Areas covered: An overview of the beneficial effects of olive oil in the prevention and treatment of NAFLD is given. Expert opinion: A large body of evidence emphasizes that olive oil, used as primary source of fat in MD, may play a crucial role in the health benefits of NAFLD patients. However, there are still scarce clinical data that evaluate the direct effect of olive oil in human with NAFLD.