TY - JOUR

T1 - Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease

T2 - the TANGO randomized controlled trial

AU - Chooi, Yu Chung

AU - Zhang, Qinze Arthur

AU - Magkos, Faidon

AU - Ng, Maisie

AU - Michael, Navin

AU - Wu, Xiaorong

AU - Volchanskaya, Vera Sergeyevna Brok

AU - Lai, Xianning

AU - Wanjaya, Elvy Riani

AU - Elejalde, Untzizu

AU - Goh, Chew Chan

AU - Yap, Clara Poh Lian

AU - Wong, Long Hui

AU - Lim, Kevin Junliang

AU - Velan, S. Sendhil

AU - Yaligar, Jadegoud

AU - Muthiah, Mark Dhinesh

AU - Chong, Yap Seng

AU - Loo, Evelyn Xiu Ling

AU - Eriksson, Johan G.

AU - Lim, Kezlyn Li Ming

AU - Kouk, Mabel Shu Fung

AU - Mei Chong, Evelyn Wai

AU - Gani, Munirah Abd

AU - Li, Lisha

AU - Tay, Vicky Hwee Kee

AU - Kway, Yeshe Manuel

AU - Kumar, Mukkesh

AU - Sadananthan, Suresh Anand

AU - Khoo, Kaijie

AU - Koh, Danyu

AU - Lim, Rebecca

AU - Kang, Chin Wei

AU - Sin, Kwang Li

AU - Lim, Jun Wei

AU - TANGO Study Group

N1 - Publisher Copyright: © 2023 The Authors

PY - 2024

Y1 - 2024

N2 - Background: Weight loss is the most effective treatment for nonalcoholic fatty liver disease (NAFLD). There is evidence that the Mediterranean diets rich in unsaturated fatty acids and fiber have beneficial effects on weight homeostasis and metabolic risk factors in individuals with NAFLD. Studies have also shown that higher circulating concentrations of pentadecanoic acid (C15:0) are associated with a lower risk for NAFLD. Objectives: To examine the effects of a Mediterranean-like, culturally contextualized Asian diet rich in fiber and unsaturated fatty acids, with or without C15:0 supplementation, in Chinese females with NAFLD. Methods: In a double-blinded, parallel-design, randomized controlled trial, 88 Chinese females with NAFLD were randomly assigned to 1 of the 3 groups for 12 wk: diet with C15:0 supplementation (n = 31), diet without C15:0 supplementation (n = 28), or control (habitual diet and no C15:0 supplementation, n = 29). At baseline and after the intervention, body fat percentage, intrahepatic lipid content, muscle and abdominal fat, liver enzymes, cardiometabolic risk factors, and gut microbiome were assessed. Results: In the intention-to-treat analysis, weight reductions of 4.0 ± 0.5 kg (5.3%), 3.4 ± 0.5 kg (4.5%), and 1.5 ± 0.5 kg (2.1%) were achieved in the diet-with-C15:0, diet without-C15:0, and the control groups, respectively. The proton density fat fraction (PDFF) of the liver decreased by 33%, 30%, and 10%, respectively. Both diet groups achieved significantly greater reductions in body weight, liver PDFF, total cholesterol, gamma-glutamyl transferase, and triglyceride concentrations compared with the control group. C15:0 supplementation reduced LDL-cholesterol further, and increased the abundance of Bifidobacterium adolescentis. Fat mass, visceral adipose tissue, subcutaneous abdominal adipose tissue (deep and superficial), insulin, glycated hemoglobin, and blood pressure decreased significantly in all groups, in parallel with weight loss. Conclusion: Mild weight loss induced by a Mediterranean-like diet adapted for Asians has multiple beneficial health effects in females with NAFLD. C15:0 supplementation lowers LDL-cholesterol and may cause beneficial shifts in the gut microbiome. Trial registration number: This trial was registered at the clinicaltrials.gov as NCT05259475.

AB - Background: Weight loss is the most effective treatment for nonalcoholic fatty liver disease (NAFLD). There is evidence that the Mediterranean diets rich in unsaturated fatty acids and fiber have beneficial effects on weight homeostasis and metabolic risk factors in individuals with NAFLD. Studies have also shown that higher circulating concentrations of pentadecanoic acid (C15:0) are associated with a lower risk for NAFLD. Objectives: To examine the effects of a Mediterranean-like, culturally contextualized Asian diet rich in fiber and unsaturated fatty acids, with or without C15:0 supplementation, in Chinese females with NAFLD. Methods: In a double-blinded, parallel-design, randomized controlled trial, 88 Chinese females with NAFLD were randomly assigned to 1 of the 3 groups for 12 wk: diet with C15:0 supplementation (n = 31), diet without C15:0 supplementation (n = 28), or control (habitual diet and no C15:0 supplementation, n = 29). At baseline and after the intervention, body fat percentage, intrahepatic lipid content, muscle and abdominal fat, liver enzymes, cardiometabolic risk factors, and gut microbiome were assessed. Results: In the intention-to-treat analysis, weight reductions of 4.0 ± 0.5 kg (5.3%), 3.4 ± 0.5 kg (4.5%), and 1.5 ± 0.5 kg (2.1%) were achieved in the diet-with-C15:0, diet without-C15:0, and the control groups, respectively. The proton density fat fraction (PDFF) of the liver decreased by 33%, 30%, and 10%, respectively. Both diet groups achieved significantly greater reductions in body weight, liver PDFF, total cholesterol, gamma-glutamyl transferase, and triglyceride concentrations compared with the control group. C15:0 supplementation reduced LDL-cholesterol further, and increased the abundance of Bifidobacterium adolescentis. Fat mass, visceral adipose tissue, subcutaneous abdominal adipose tissue (deep and superficial), insulin, glycated hemoglobin, and blood pressure decreased significantly in all groups, in parallel with weight loss. Conclusion: Mild weight loss induced by a Mediterranean-like diet adapted for Asians has multiple beneficial health effects in females with NAFLD. C15:0 supplementation lowers LDL-cholesterol and may cause beneficial shifts in the gut microbiome. Trial registration number: This trial was registered at the clinicaltrials.gov as NCT05259475.

KW - Asian-adapted Mediterranean diet

KW - C15:0

KW - Chinese female

KW - NAFLD

KW - Pentadecanoic acid

KW - Weight loss

U2 - 10.1016/j.ajcnut.2023.11.013

DO - 10.1016/j.ajcnut.2023.11.013

M3 - Journal article

C2 - 38035997

AN - SCOPUS:85183990922

VL - 119

SP - 788

EP - 799

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 3

ER -