Efficacy of the Mediterranean diet in treating metabolic dysfunction-associated steatotic liver disease (MASLD) in children and adolescents: a systematic review and meta-analysis.
Study Goal
To evaluate the effectiveness of the Mediterranean diet in improving liver function in children and adolescents with metabolic dysfunction-associated steatotic liver disease (MASLD).
Results Summary
The Mediterranean diet was associated with moderate improvements in liver function, as shown by reductions in liver enzymes (ALT, AST, and GGT), but changes in body weight, lipid profile, and insulin resistance were small and insignificant.
Population
Children and adolescents with MASLD.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mediterranean diet | increase | liver function | children and adolescents with MASLD | - | was associated with moderate improvements | #1 |
Mediterranean diet | decrease | Alanine Transaminase (ALT) | children and adolescents with MASLD | WMD -10.85 U/L, 95% CI -20.03 to -1.68 | reductions in | #2 |
Mediterranean diet | decrease | Aspartate Transaminase (AST) | children and adolescents with MASLD | WMD -9.26 U/L, 95% CI -17.14 to -1.38 | reductions in | #3 |
Mediterranean diet | decrease | Gamma-glutamyl transferase (GGT) | children and adolescents with MASLD | WMD -1.99, 95% CI -5.09 to 1.11 | reductions in | #4 |
Mediterranean diet | no change | body weight | children and adolescents with MASLD | small and insignificant | changes in | #5 |
Mediterranean diet | no change | lipid profile | children and adolescents with MASLD | small and insignificant | changes in | #6 |
Mediterranean diet | no change | insulin resistance | children and adolescents with MASLD | small and insignificant | changes in | #7 |
BACKGROUND: There are limited treatment options for metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic Fatty Liver Disease (MASLD) in children and adolescents. AIM: To evaluate the effectiveness of the Mediterranean diet in improving liver function in children and adolescents with MASLD. METHODS: In this systematic review and meta-analysis, we searched PubMed, Scopus, Embase, CINAHL, and Cochrane CENTRAL for interventional studies investigating the effect of Mediterranean diet on MASLD in children and adolescents. The primary outcome was a change in liver function measured using these liver enzymes; Alanine Transaminase (ALT), Aspartate Transaminase (AST) and Gamma-glutamyl transferase (GGT). The secondary outcomes were lipid profile, body weight, and insulin resistance. The risk of bias was assessed using the MASTER scale. Bias-adjusted inverse variance heterogeneity models were used to synthesize overall weighted mean differences for the treatment effect (WMD) and their 95% confidence intervals. Heterogeneity and publication bias were evaluated using the I2 statistics, Tau-squared and Doi plots, respectively. RESULT: Out of 5915 study records identified from database searches, five studies with 308 participants, two randomized controlled trials, and three quasi-experimental studies, met the inclusion criteria. In overall synthesis, the Mediterranean diet was associated with moderate improvements in liver function as shown by reductions in the liver enzymes [ALT - WMD - 10.85 U/L, 95% CI -20.03 to -1.68, I2 = 42, T2 = 38.8, AST - WMD - 9.26 U/L, 95% CI -17.14 to -1.38, I2 = 70.7, T2 = 42.7, and GGT - WMD - 1.99 95% CI -5.09 to 1.11)], but changes in body weight, lipid profile and insulin resistance were small and insignificant. CONCLUSION: The Mediterranean diet may improve liver function in children with MASLD. More randomized controlled trials are needed to develop high-certainty evidence on these findings. REGISTRATION: This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) CRD42023426939. 31/05/2023.