BACKGROUND AND AIMS: Different dietary components other than energy load may be implicated in non-alcoholic fatty liver disease (NAFLD). The aim of this randomized controlled trial (NCT03380416) is to evaluate the efficacy of a dietary intervention targeting multiple dietary components (PORTFOLIO diet) on liver fat in T2D vs. a diet rich in monounsaturated fatty acids (MUFA diet), known to reduce liver fat.

METHODS: According to a parallel group design, so far, thirty-eight overweight-obese individuals with T2D and NAFLD, aged 35-75 years, after a 3-week run-in, have been randomized to a PORTFOLIO or MUFA diet, similar for energy and macronutrients but not for fibre, low glycemic index foods, polyphenols, n-3 and n-6 polyunsaturated fatty acids — higher in the PORTFOLIO. Before and after the 8-week intervention, liver fat content was evaluated by 1H-MRS and fasting blood samples were collected for measuring metabolic parameters.

RESULTS: During the intervention, dietary adherence was optimal with no significant changes in body weight. Glycated hemoglobin and liver enzymes remained unchanged. Liver fat decreased significantly after the PORTFOLIO diet (8.8±8.0% vs. 5.0±4.7%; p=0.006) and less after the MUFA diet (9.5±9.3% vs. 8.1±8.0%; p=0.018), with a significant difference between the two regimens (p=0.043). The percentage variation of liver fat was -44% after the PORTFOLIO diet and -15% after the MUFA diet, with a significant difference between the treatments (p=0.031).

CONCLUSIONS: The PORTFOLIO diet reduced liver fat content in T2D individuals with NAFLD more than a MUFA diet, suggesting that the former could be the regimen of choice for NAFLD treatment in T2D individuals.

05 - TREATING NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH TYPE 2 DIABETES BY TARGETING MULTIPLE DIETARY COMPONENTS: THE PORTFOLIO DIET