Probe • Vol LXII • No. 3 • May–Aug 2023 • 35 Hepatology Abstracts From Literature Effect of Green Mediterranean Diet on Intrahepatic Fat This study examined the effect of a green Mediterranean (MED) diet, restricted in red/processed meat and enriched with green plants and polyphenols, on nonalcoholic fatty liver disease (NAFLD), reflected by intrahepatic fat (IHF) loss. A total of 294 participants with abdominal obesity/ dyslipidemia were assigned into healthy dietary guideline (HDG), MED, and green MED weight loss diet groups, all accompanied by physical activity. Both the isocaloric MED groups consumed 28 g of walnuts per day (+ 440 mg/d polyphenols provided). The green MED group consumed green tea (3–4 cups/d) and Mankai (a Wolffia globosa aquatic plant strain; 100 g/day frozen cubes) green shake (+ 1240 mg/d total polyphenols provided). Participants had 89.8% 18-month retention rate, and 78% had eligible follow-up magnetic resonance spectroscopy. Overall, NAFLD prevalence declined to 54.8% (HDG), 47.9% (MED), and 31.5% (green MED) between the groups. Despite similar moderate weight loss in both MED groups, the green MED group achieved almost double IHF% loss compared with MED and HDG. After 18 months, both MED groups had significantly higher total plasma polyphenol levels versus HDG, with detection of higher Naringenin and 2-5-dihydroxybenzoic acid in the green MED group. Greater IHF% loss was independently associated with increased Mankai and walnuts intake, decreased red/processed meat consumption, improved serum folate and adipokine/ lipid biomarkers, and changes in microbiome composition (β-diversity) and specific bacteria. This new strategy of green MED diet can double IHF loss than other healthy nutritional strategies and reduce NAFLD by half. Source: Meir AY, et al. Gut. 2021;70(11):2085–2095. Association of Ultra-Processed Food IntakeWith Risk of Inflammatory Bowel Disease This study evaluated the relationship between intake of ultra-processed food and the risk of inflammatory bowel disease (IBD). A total of 116,087 adults aged 35 to 70 years with at least 1 cycle of follow-up and complete baseline food frequency questionnaire data were enrolled, and baseline dietary intake was documented. Participants were followed up prospectively at least every 3 years. The main outcome was development of IBD, including Crohn’s disease or ulcerative colitis. Associations between ultra-processed food intake and the risk of IBD were assessed using Cox proportional hazard multivariable models. The results were presented as hazard ratios with 95% confidence intervals. During the median follow-up of 9.7 years, 467 participants developed incident IBD (90 with Crohn’s disease and 377 with ulcerative colitis). After adjustment for potential confounding factors, higher intake of ultra-processed food was associated with a higher risk of incident IBD. Different subgroups of ultra-processed food, including soft drinks, refined sweetened foods, salty snacks, and processed meat, were associated with higher hazard ratios for IBD. The results were consistent for Crohn’s disease and ulcerative colitis with low heterogeneity. Intake of white meat, red meat, dairy, and starch and fruits, vegetables, and legumes were not associated with incident IBD. Thus, higher intake of ultra-processed food was positively associated with a risk of IBD. Further studies are needed to identify the contributory factors within ultra-processed foods. Source: Narula N, et al. BMJ. 2021;374:n1554.
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