Addressing Western dietary pattern in obesity and NAFLD

Background: Western diet and sedentary life are imputed for non-alcoholic fatty liver disease (NAFLD). Relationship of obesity and bright liver, i.e., the ultrasound hallmarks of fatty liver, evaluated as Bright Liver Score (BLS), with Western diet pattern score (WDS) and with the level of physical exercise, assessed by the Baecke questionnaire, were investigated. Methods: One hundred fifty (72 females, 78 males) NAFLD non-diabetic patients, 47.89 ± 13.85 years old, were referred to a diagnostic-therapeutic unit with the lone evidence of fatty liver as detected by an ultrasound. WDS, Adherence to Mediterranean Diet Score (AMDS), physical exercise, insulin resistance (HOMA-IR), and BMI were assessed also after 6 months of comprehensive lifestyle intervention. Results: BLS, BMI, HOMA, and WDS were significantly greater, while AMDS and physical exercise were lower at the greater severity of ultrasound (US)-detected NAFLD. Positive linear correlation of WDS, BMI, and HOMA vs. BLS was present at patients’ referral. After intervention, decrease of liver dimension and of Bright Liver Score concurrent with a reduction of BMI, HOMA-IR, WDS, LDL cholesterol, and triglycerides was observed. A reciprocal increase of AMDS, physical exercise, and HDL cholesterol was also reported. Conclusions: The assessment of some features of the Western diet is possible; its effect, along with overweight, is associated with a greater severity of fatty liver as evaluated by ultrasound in NAFLD. Trial registration: NCT02670590. Registered on February 2, 2016.