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Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 36322

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Special Issue Editors

Dr. Francesco Angelico

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Guest Editor

Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro, 00185 Rome, Italy
Interests: atherosclerosis; risk factors; metabolic diseases; fatty liver disease; dyslipidaemia
Special Issues, Collections and Topics in MDPI journals

Dr. Francesco Baratta

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Guest Editor

Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
Interests: metabolic syndrome; liver diseases; atherosclerosis; liver; internal medicine; cirrhosis; hepatocellular carcinoma; insulin resistance; liver cirrhosis; hypertension
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Dr. Maria Del Ben

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Department of Clinical, Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
Interests: obesity; clinical nutrition; metabolic syndrome; diabetes; liver diseases

Special Issue Information

Dear Colleagues,

Metabolic syndrome (MetS) is a leading public health and clinical challenge worldwide. MetS is a clustering of medical conditions including abdominal obesity, high blood pressure, atherogenic dyslipidaemia and glucose intolerance/diabetes. PCOS, OSAS and NAFLD are further clinical components of MetS. Recently, it has been proposed to rename NAFLD into MAFLD (metabolic associated fatty liver disease) to better characterize pathophysiology and its interpretation as a hepatic component of MetS. MetS is associated to lifestyle and obesity, and insulin resistance is the main underlining metabolic alteration together with low-grade inflammation and increased oxidative stress.

Healthy dietary and lifestyle choices can reverse MetS and many nutrients and different diets have been associated with favourable effects.

Diets low in calories, saturated fat, refined carbohydrates, and salt have been proposed. Monounsaturated and polyunsaturated fats, fiber, antioxidants, small amount of alcohol and well-planned vegetarian diets have also been suggested. Mediterranean diet, with or without energy restriction, seems to be the best dietary pattern for the prevention and management of MetS.

In this Special Issue we aim to summarize the main evidence on the different dietary approaches for MetS and its many clinical components and comorbidities. Particular attention will be paid to dietary approaches for the new clinical entity named MAFLD.

Dr. Francesco Angelico
Dr. Francesco Baratta
Prof. Dr. Maria Del Ben
Guest Editors

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Keywords

Metabolic syndrome
Metabolic associated fatty liver disease
Mediterranean diet
Insulin resistance
Oxidative stress
Risk factors for cardiovascular disease

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Published Papers (7 papers)

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Research

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16 pages, 671 KiB

Open AccessArticle

Identification of Lifestyle Risk Factors in Adolescence Influencing Cardiovascular Health in Young Adults: The BELINDA Study

by Jules Morcel, Laurent Béghin, Nathalie Michels, Jérémy Vanhelst, Julien Labreuche, Elodie Drumez, Angela Polito, Marika Ferrari, Laura Censi, Dominique Deplanque, María Luisa Miguel-Berges, Thaïs De Ruyter, Stefaan De Henauw, Luis A. Moreno and Frédéric Gottrand

Nutrients 2022, 14(10), 2089; https://doi.org/10.3390/nu14102089 - 17 May 2022

Cited by 3 | Viewed by 4241

Abstract

Cardiovascular diseases are the leading cause of mortality worldwide. These diseases originate in childhood, and a better understanding of their early determinants and risk factors would allow better prevention. The BELINDA (BEtter LIfe by Nutrition During Adulthood) study is a 10–14-year follow-up of the HEalthy Lifestyle in Europe by Nutrition in Adolescence study (the HELENA study, a European cross-sectional study in adolescents). The study aims to evaluate cardiovascular risk using the PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score during young adulthood (21–32 years), and to examine the impact of risk factors identified during adolescence (12.5–17.5 years). Our secondary objective is to compare the characteristics of the BELINDA study population with the HELENA population not participating in the follow-up study. The HELENA study recruited 3528 adolescents during 2006–2007 and reassessed 232 of them 10–14 years later as young adults. We assessed clinical status, anthropometry, nutrition, physical activity (including sedentary behavior), physical fitness, and mental health parameters, and collected biological samples (blood, stool, and hair). Dietary intake, and physical activity and fitness data were also collected. A multivariable linear regression model will be used for the analysis of the primary outcome. A Chi-square and T-test were conducted for the comparison of the descriptive data (gender, age, weight, height, body mass index (BMI), and maternal school level) between participating and non-participating BELINDA adolescents. When comparing the 1327 eligible subjects with the 232 included in the BELINDA study, no significant differences regarding gender (p = 0.72), age (p = 0.60), height (p = 0.11), and weight (p = 0.083) at adolescence were found. However, the participating population had a lower BMI (20.4 ± 3.1 kg/m² versus 21.2 ± 3.6 kg/m²; p < 0.001) and a higher maternal educational level (46.8% high school or university level versus 38.6%; p = 0.027) than the HELENA population who did not participate in the BELINDA study. The complete phenotyping obtained at adolescence through the HELENA study is a unique opportunity to identify adolescent risk factors for cardiovascular diseases. This paper will serve as a methodological basis for future analysis of this study. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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11 pages, 658 KiB

Open AccessArticle

Do MAFLD Patients with Harmful Alcohol Consumption Have a Different Dietary Intake?

by Sara Policarpo, Sofia Carvalhana, Ana Craciun, Ricardo Rios Crespo and Helena Cortez-Pinto

Nutrients 2022, 14(7), 1335; https://doi.org/10.3390/nu14071335 - 23 Mar 2022

Cited by 7 | Viewed by 2535

Abstract

The term metabolic-associated fatty liver disease (MAFLD) has been proposed to define positively fatty liver disease in the form associated with metabolic risk factors. The aim of this study was to assess the dietary intake of MAFLD and explore a possible relationship between its inflammatory characteristics (assessed by Dietary Inflammatory Index—DII^®), the degree of liver fibrosis (assessed by transient elastography), and the amount of alcohol intake. MAFLD patients were included (n = 161) and were classified, according to the amount of alcoholic intake, as MAFLD without alcohol intake (n = 77) and MAFLD with alcohol intake (n = 84), with 19 presenting harmful alcoholic consumption. Dietary intake was 1868 ± 415 kcal/day and did not present differences in energy or nutrient intake based on the presence of metabolic comorbidities. Patients with MAFLD and alcohol intake consumed significantly more energy and presented a tendency for higher intake of carbohydrates and sugar. Patients with harmful alcohol intake presented a higher intake of total fat and cholesterol compared with moderate alcohol intake. There were no differences in DII^® based on fibrosis severity or the amount of alcohol consumption. This work contributes to the characterization of baseline dietary intake in MAFLD patients, paving the way to design more suited dietary interventional trials. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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12 pages, 658 KiB

Open AccessArticle

High Compliance to Mediterranean Diet Associates with Lower Platelet Activation and Liver Collagen Deposition in Patients with Nonalcoholic Fatty Liver Disease

by Francesco Baratta, Vittoria Cammisotto, Giulia Tozzi, Mattia Coronati, Simona Bartimoccia, Valentina Castellani, Cristina Nocella, Alessandra D’Amico, Francesco Angelico, Roberto Carnevale, Pasquale Pignatelli and Maria Del Ben

Nutrients 2022, 14(6), 1209; https://doi.org/10.3390/nu14061209 - 12 Mar 2022

Cited by 5 | Viewed by 2804

Abstract

The Mediterranean diet (Med-Diet) is considered the most effective dietary patterns to obtain weight loss in NAFLD patients. Previous evidence suggested that Med-Diet adherence could reduce cardiovascular risk and have a beneficial effect on NAFLD severity. Aim of the study was to investigate the relationship between Med-Diet adherence, platelet activation (PA), and liver collagen deposition. The study was performed in 655 consecutive NAFLD outpatients from the PLINIO study, a prospective observational cohort study aimed to identify non-conventional predictors of liver fibrosis progression in NAFLD. PA was measured by the serum thromboxane B₂ (TxB₂), and liver collagen deposition by N-terminal propeptide of type III collagen (Pro-C3). Adherence to the Med-diet was investigated by a short nine-item validated dietary questionnaire. Patients with high Med-Diet adherence were older and had less metabolic syndrome and lower serum triglycerides, GGT, TxB₂, and Pro-C3. At multivariate regression analyses, in the linear model, the Med-Diet score negatively correlated with both TxB₂ (Beta = −0.106; p = 0.009) and Pro-C3 (Beta = −0.121; p = 0.002) and in the logistic model high adherence inversely correlated with higher TxB₂ tertiles (II tertile: OR = 0.576, p = 0.044; III tertile: OR = 0.556, p = 0.026) and Pro-C3 tertile (III tertile: OR = 0.488, p = 0.013). Low consumption of red meat inversely correlated with higher TxB₂ tertile (II tertile: OR = 0.448, p < 0.001, III tertile: OR = 0.567, p = 0.004). In conclusion, NAFLD patients with high adherence to the Med-Diet show lower PA and liver collagen deposition, suggesting a protective role of the Med-Diet against NAFLD progression and cardiovascular risk. In addition, the correlation between TxB₂ and Pro-C3 suggests a link between NAFLD severity and cardiovascular risk. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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12 pages, 2431 KiB

Open AccessArticle

Baicalin Attenuates Oxidative Stress in a Tissue-Engineered Liver Model of NAFLD by Scavenging Reactive Oxygen Species

by Wen Gao, Bin Xu, Yizhi Zhang, Shuang Liu, Zhongping Duan, Yu Chen and Xiaohui Zhang

Nutrients 2022, 14(3), 541; https://doi.org/10.3390/nu14030541 - 26 Jan 2022

Cited by 23 | Viewed by 3195

Abstract

Oxidative stress plays an important role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Baicalin has been shown to exert protective effects in various liver diseases. The mechanism of baicalin’s antioxidative effect in NAFLD is currently unclear. The aim of this study was to investigate the effects and mechanisms of baicalin on oxidative stress in a new tissue-engineered liver model of NAFLD. The 3D model of NAFLD was induced by a fat-supplemented medium (fatty acids, FFA group) for 8 days and baicalin was administered on the 5th day. CCK-8 assay showed that baicalin at concentrations below 100 μM had no obvious cytotoxicity. Baicalin inhibited apoptosis and lactate dehydrogenase release in the FFA group. Baicalin reduced the levels of reactive oxygen species and malondialdehyde induced by FFA, and increased superoxide dismutase and glutathione amounts. However, it did not upregulate nuclear erythroid 2-related factor 2 compared with the FFA group. Mitochondrial morphology was partially restored after baicalin treatment, and ATP5A expression and mitochondrial membrane potential were increased. The superoxide anion scavenging ability of baicalin was enhanced in a dose-dependent manner. In summary, baicalin reduces oxidative stress and protects the mitochondria to inhibit apoptosis in the 3D NAFLD model via its own antioxidant activity. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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14 pages, 523 KiB

Open AccessArticle

Consumption of Monounsaturated Fatty Acids Is Associated with Improved Cardiometabolic Outcomes in Four African-Origin Populations Spanning the Epidemiologic Transition

by Supal Mehta, Lara Ruth Dugas, Candice Choo-Kang, Pascal Bovet, Terrence Forrester, Kweku Bedu-Addo, Estelle Vicki Lambert, Jacob Plange-Rhule, Walter Riesen, Wolfgang Korte and Amy Luke

Nutrients 2021, 13(7), 2442; https://doi.org/10.3390/nu13072442 - 16 Jul 2021

Cited by 5 | Viewed by 2835

Abstract

Long-chain omega-3 PUFAs, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are of increasing interest because of their favorable effect on cardiometabolic risk. This study explores the association between omega 6 and 3 fatty acids intake and cardiometabolic risk in four African-origin populations spanning the epidemiological transition. Data are obtained from a cohort of 2500 adults aged 25–45 enrolled in the Modeling the Epidemiologic Transition Study (METS), from the US, Ghana, Jamaica, and the Seychelles. Dietary intake was measured using two 24 h recalls from the Nutrient Data System for Research (NDSR). The prevalence of cardiometabolic risk was analyzed by comparing the lowest and highest quartile of omega-3 (EPA+ DHA) consumption and by comparing participants who consumed a ratio of arachidonic acid (AA)/EPA + DHA

\leq 4 : 1

and >4:1. Data were analyzed using multiple variable logistic regression adjusted for age, gender, activity, calorie intake, alcohol intake, and smoking status. The lowest quartile of EPA + DHA intake is associated with cardiometabolic risk 2.16 (1.45, 3.2), inflammation 1.59 (1.17, 2.16), and obesity 2.06 (1.50, 2.82). Additionally, consuming an AA/EPA + DHA ratio of >4:1 is also associated with cardiometabolic risk 1.80 (1.24, 2.60), inflammation 1.47 (1.06, 2.03), and obesity 1.72 (1.25, 2.39). Our findings corroborate previous research supporting a beneficial role for monounsaturated fatty acids in reducing cardiometabolic risk. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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Review

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10 pages, 407 KiB

Open AccessReview

Meal Timing, Meal Frequency and Metabolic Syndrome

by Fatema Alkhulaifi and Charles Darkoh

Nutrients 2022, 14(9), 1719; https://doi.org/10.3390/nu14091719 - 21 Apr 2022

Cited by 31 | Viewed by 12807

Abstract

Individuals with metabolic syndrome have increased risk for developing health conditions, including cardiovascular diseases and stroke. Modifiable risk factors, such as exercise and diet, are key components in the prevention and control of metabolic syndrome. Specifically, dietary patterns and habits are extremely successful in controlling more than one of the metabolic syndrome risk factors. Meal timing and frequency have been associated with type 2 diabetes, cardiovascular diseases, and other chronic conditions. However, there is limited evidence linking metabolic syndrome to meal timing and meal frequency. This review summarizes and discusses how meal timing and frequency impact metabolic outcomes in adults. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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10 pages, 698 KiB

Open AccessEditor’s ChoiceReview

Added Fructose in Non-Alcoholic Fatty Liver Disease and in Metabolic Syndrome: A Narrative Review

by Mattia Coronati, Francesco Baratta, Daniele Pastori, Domenico Ferro, Francesco Angelico and Maria Del Ben

Nutrients 2022, 14(6), 1127; https://doi.org/10.3390/nu14061127 - 8 Mar 2022

Cited by 33 | Viewed by 6701

Abstract

Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease and it is considered the hepatic manifestation of metabolic syndrome (MetS). Diet represents the key element in NAFLD and MetS treatment, but some nutrients could play a role in their pathophysiology. Among these, fructose added to foods via high fructose corn syrup (HFCS) and sucrose might participate in NAFLD and MetS onset and progression. Fructose induces de novo lipogenesis (DNL), endoplasmic reticulum stress and liver inflammation, promoting insulin resistance and dyslipidemia. Fructose also reduces fatty acids oxidation through the overproduction of malonyl CoA, favoring steatosis. Furthermore, recent studies suggest changes in intestinal permeability associated with fructose consumption that contribute to the risk of NAFLD and MetS. Finally, alterations in the hunger–satiety mechanism and in the synthesis of uric acid link the fructose intake to weight gain and hypertension, respectively. However, further studies are needed to better evaluate the causal relationship between fructose and metabolic diseases and to develop new therapeutic and preventive strategies against NAFLD and MetS. Full article

(This article belongs to the Special Issue Diet Habits and Lifestyle in Prevention and Treatment of Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease)

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