The effect of a Mediterranean and low fat diet on liver fat in patients with non alcoholic fatty liver disease: Preliminary findings from the MEDINA trial

Dr Elena George1,2, Ms Anjana Reddy2, Prof Stuart Roberts3, Dr Audrey Tierney2,4

1Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia, 2School of Allied Health, La Trobe University, Bundoora, Australia, 3Department of Gastroenterology, Alfred Health, Prahran, Australia, 4School of Allied Health, University of Limerick, Limerick, Ireland


The aim of this study was to explore the effect of a Mediterranean Diet (MD) compared to a Low Fat Diet (LFD) on liver fat.

Patients with proven NAFLD were randomised to a MD or LFD for a three month intervention.  Liver fat was quantified using Magnetic Resonance Spectroscopy, liver stiffness measurement with Transient Elastography and insulin resistance using homeostatic model assessment. Anthropometry, dietary and biochemistry were also measured.

Interim results included 25 patients, mean age 49.6±15.9 years, BMI of 32.7±7.1 kg/m2, 44% male and 48% with diabetes were randomised to a MD (n=12) or a LFD (n=13).The MD group demonstrated a clinically meaningful reduction in liver fat (-12%, NS) with no change in the LFD group (0.2%, NS). The LFD group reduced energy consumption (-800kJ) resulting in significant weight loss (-6.6kg, p=0.045), there was no weight change in the MD group (0.8kg, p=0.213). There was a small significant improvement in liver stiffness (-0.9kPa, p=0.022) in the LFD group but not in the MD group (0.1kPa, p=0.65). Insulin resistance improved equally across both groups (-0.6 mmol/L, NS).

Significance of the findings to allied health:
Diet is an effective management strategy for patients with NAFLD. The MD may possibly reduce liver fat ad libitum while LFD may be better at facilitating weight loss, larger studies are required to confirm these findings.


Dr Elena George is an Accredited Practising Dietitian and Lecturer in Nutrition and Dietetics at Deakin University. Elena is interested in translational research, in particular enhancing evidence based practice in dietetics through research. Her interests are in metabolic factors that contribute to chronic disease and dietary interventions for the prevention and management of including non-alcoholic fatty liver disease, metabolic syndrome, diabetes and cardiovascular disease.