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Adults newly diagnosed with NAFLD will be included in the study. At the beginning of the research, the socio-demographic characteristics and nutritional habits of the individuals will be questioned with a face-to-face questionnaire. In addition, at the beginning of the study, blood samples, 3-day food consumption record, physical activity record, anthropometric measurements (height, body weight, waist, hip and neck circumference and body composition analysis) and stool samples will be taken from the patients. Oxidative stress (TAS, TOS, SOD, Malondialdehyde, Catalase, Glutathione peroxidase, Glutathione, AGE and DNA oxidative damage) and inflammation (CRP, TNF-alpha, IL-17, IL-23, IL-10, IL-13, TGF-beta) parameters in blood samples will be analyzed. Patients will then be randomized into four groups to follow a Mediterranean diet supplemented with aronia, a Mediterranean diet, a low-fat diet supplemented with aronia, or a low-fat diet. Necessary training will be given to the participants so that they can apply the individually planned diet. Dietary adherence and anthropometric measurements will be evaluated every 2 weeks. At the end of the twelve-week follow-up, all parameters evaluated at the beginning of the study will be repeated and compared with previous values.
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease in which more than 5% fat accumulation in the liver (steatosis). It has become the most common liver disease in adults with the effect of obesity. In fact, NAFLD is seen in approximately 25% of adults. If left untreated, it can progress to cirrhosis, hepatocellular carcinoma, and end-stage liver failure. It is obvious that it is necessary to identify preventive factors for NAFLD and to develop new approaches for its treatment. There is an increase in inflammation and oxidative stress levels in NAFLD, which is important for the development of possible treatment methods. In this study, the Mediterranean diet supplemented with aronia is expected to contribute positively to progression of the disease by improving inflammation and oxidative stress parameters. Adding aronia to the Mediterranean diet will increase the polyphenol content of this diet. This study was planned with the thought that a Mediterranean diet supplemented with aronia will have positive effects on hepatic steatosis, oxidative stress, inflammation, and microbiota in NAFLD, where lifestyle changes, including healthy nutrition, are included in the primary treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mediterranean diet group | Experimental | An individually planned nutrition program suitable for the energy-restricted Mediterranean diet will be created for individuals in this group. |
|
| Mediterranean diet supplemented with aronia group | Experimental | An individually planned nutrition program suitable for the energy-restricted Mediterranean diet will be created for individuals in this group. Also 100 mL/day of 100% aronia juice will be given. |
|
| Low-fat diet group | Experimental | An individually planned nutrition program suitable for the energy-restricted low-fat diet will be created for individuals in this group. |
|
| Low-fat diet supplemented with aronia group | Experimental | An individually planned nutrition program suitable for the energy-restricted low-fat diet will be created for individuals in this group. Also 100 mL/day of 100% aronia juice will be given. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aronia juice | Other | 100% aronia juice, 100 mL/day, twelve-week follow-up |
|
| Measure | Description | Time Frame |
|---|---|---|
| Oxidative stress | TAS, TOS, SOD, Malondialdehyde (MDA), Catalase, Glutathione peroxidase, Glutathione, AGE and DNA oxidative damage will be evaluated. | Baseline and end of the 12th week |
| Inflammation | CRP, TNF-alfa, IL-10, IL-13, IL-17, IL-23, TGF-β, LPS will be evaluated. | Baseline and end of the 12th week |
| Degree of hepatic steatosis | Evaluation of hepatic steatosis by liver ultrasonography | Baseline and end of the 12th week |
| Microbiota analysis | 16s rRNA Gene Sequencing and Compositional Analyzes | Baseline and end of the 12th week |
| Body composition analysis | Body weight, height and body composition, waist, hip and neck circumference measurements | Baseline, every 15 days and end of the 12th week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Gamze Akbulut | Contact | +90 0212 610 10 10 | gamze.akbulut@kent.edu.tr | |
| Feride Ayyıldız | Contact | +90 312 216 2674 | feridecelebi@gazi.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Gamze Akbulut | Kent University | Study Director |
| Tarkan Karakan | Gazi University | Principal Investigator |
| Ali Karataş |
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| ID | Term |
|---|---|
| D065626 | Non-alcoholic Fatty Liver Disease |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D005234 | Fatty Liver |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D010335 | Pathologic Processes |
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| ID | Term |
|---|---|
| D038441 | Diet, Mediterranean |
| D018752 | Diet, Fat-Restricted |
| ID | Term |
|---|---|
| D000095500 | Diet, Plant-Based |
| D004035 | Diet Therapy |
| D044623 | Nutrition Therapy |
| D013812 | Therapeutics |
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| Mediterranean diet | Other | An individually planned nutrition program suitable for the energy-restricted Mediterranean diet |
|
| Low-fat diet | Other | An individually planned nutrition program suitable for the energy-restricted low-fat diet |
|
| Gazi University |
| Principal Investigator |
| Emine Yassıbaş | Gazi University | Principal Investigator |
| Feride Ayyıldız | Gazi University | Principal Investigator |
| Büşra Atabilen | Karamanoğlu Mehmetbey University | Principal Investigator |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D004032 |
| Diet |
| D009747 | Nutritional Physiological Phenomena |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |