BioChem - DOS

Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease: the TANGO randomized controlled trial

The American journal of clinical nutrition

Chooi, Yu Chung; Zhang, Qinze Arthur; Magkos, Faidon; Ng, Maisie; Michael, Navin; Wu, Xiaorong; Volchanskaya, Vera Sergeyevna Brok; Lai, Xianning; Wanjaya, Elvy Riani; Elejalde, Untzizu; Goh, Chew Chan; Yap, Clara Poh Lian; Wong, Long Hui; Lim, Kevin Junliang; Velan, S. Sendhil; Yaligar, Jadegoud; Muthiah, Mark Dhinesh; Chong, Yap Seng; Loo, Evelyn Xiu Ling; Eriksson, Johan G.; Lim, Kezlyn Li Ming; Kouk, Mabel Shu Fung; Mei Chong, Evelyn Wai; Gani, Munirah Abd; Li, Lisha; Tay, Vicky Hwee Kee; Kway, Yeshe Manuel; Kumar, Mukkesh; Sadananthan, Suresh Anand; Khoo, Kaijie; Koh, Danyu; Lim, Rebecca; Kang, Chin Wei; Sin, Kwang Li; Lim, Jun Wei

BACKGROUND: Weight loss is the most effective treatment for nonalcoholic fatty liver disease (NAFLD). There is evidence that the Mediterranean diets rich in unsaturated fatty acids and fiber have beneficial effects on weight homeostasis and metabolic risk factors in individuals with NAFLD. Studies have also shown that higher circulating concentrations of pentadecanoic acid (C15:0) are associated with a lower risk for NAFLD. OBJECTIVES: To examine the effects of a Mediterranean-like, culturally contextualized Asian diet rich in fiber and unsaturated fatty acids, with or without C15:0 supplementation, in Chinese females with NAFLD. METHODS: In a double-blinded, parallel-design, randomized controlled trial, 88 Chinese females with NAFLD were randomly assigned to 1 of the 3 groups for 12 wk: diet with C15:0 supplementation (n = 31), diet without C15:0 supplementation (n = 28), or control (habitual diet and no C15:0 supplementation, n = 29). At baseline and after the intervention, body fat percentage, intrahepatic lipid content, muscle and abdominal fat, liver enzymes, cardiometabolic risk factors, and gut microbiome were assessed. RESULTS: In the intention-to-treat analysis, weight reductions of 4.0 ± 0.5 kg (5.3%), 3.4 ± 0.5 kg (4.5%), and 1.5 ± 0.5 kg (2.1%) were achieved in the diet-with-C15:0, diet without-C15:0, and the control groups, respectively. The proton density fat fraction (PDFF) of the liver decreased by 33%, 30%, and 10%, respectively. Both diet groups achieved significantly greater reductions in body weight, liver PDFF, total cholesterol, gamma-glutamyl transferase, and triglyceride concentrations compared with the control group. C15:0 supplementation reduced LDL-cholesterol further, and increased the abundance of Bifidobacterium adolescentis. Fat mass, visceral adipose tissue, subcutaneous abdominal adipose tissue (deep and superficial), insulin, glycated hemoglobin, and blood pressure decreased significantly in all groups, in parallel with weight loss. CONCLUSION: Mild weight loss induced by a Mediterranean-like diet adapted for Asians has multiple beneficial health effects in females with NAFLD. C15:0 supplementation lowers LDL-cholesterol and may cause beneficial shifts in the gut microbiome. TRIAL REGISTRATION NUMBER: This trial was registered at the clinicaltrials.gov as NCT05259475.

2024

Elsevier

0002-9165

1938-3207

119

3

pp.788-799

10.1016/j.ajcnut.2023.11.013

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