Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease: the TANGO randomized controlled trial

Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease: the TANGO randomized controlled trial

The American Journal of Clinical Nutrition

10.1016/j.ajcnut.2023.11.013

http://dx.doi.org/10.1016/j.ajcnut.2023.11.013

Yu Chung Chooi, Qinze Arthur Zhang, Faidon Magkos, Maisie Ng, Navin Michael, Xiaorong Wu, Vera Sergeyevna Brok Volchanskaya, Xianning Lai, Elvy Riani Wanjaya, Untzizu Elejalde, Chew Chan Goh, Clara Poh Lian Yap, Long Hui Wong, Kevin Junliang Lim, S. Sendhil Velan, Jadegoud Yaligar, Mark Dhinesh Muthiah, Yap Seng Chong, Evelyn Xiu Ling Loo, Johan G. Eriksson, Kezlyn Li Ming Lim, Mabel Shu Fung Kouk, Evelyn Wai Mei Chong, Munirah Abd Gani, Lisha Li, Vicky Hwee Kee Tay, Yeshe Manuel Kway, Mukkesh Kumar, Suresh Anand Sadananthan, Kaijie Khoo, Danyu Koh, Rebecca Lim, Chin Wei Kang, Kwang Li Sin, Jun Wei Lim

Nutrition and Dietetics, Medicine (miscellaneous)

29 November 2023

Chooi, Y. C., Zhang, Q. A., Magkos, F., Ng, M., Michael, N., Wu, X., Volchanskaya, V. S. B., Lai, X., Wanjaya, E. R., Elejalde, U., Goh, C. C., Yap, C. P. L., Wong, L. H., Lim, K. J., Velan, S. S., Yaligar, J., Muthiah, M. D., Chong, Y. S., Loo, E. X. L., … Lim, J. W. (2024). Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease: the TANGO randomized controlled trial. The American Journal of Clinical Nutrition, 119(3), 788–799. https://doi.org/10.1016/j.ajcnut.2023.11.013

Background: Weight loss is the most effective treatment for non-alcoholic fatty liver disease (NAFLD). There is evidence that 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 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 Asian women with NAFLD. Methods: In a double-blinded, parallel-design, randomized controlled trial, 88 Asian women with NAFLD were randomized to one of three groups for 12-weeks: 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 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 to the control group. C15:0 supplementation reduced LDL-cholesterol further, and increased 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 women with NAFLD. C15:0 supplementation lowers LDL-cholesterol and may cause beneficial shifts in gut microbiome.

Attribution 4.0 International (CC BY 4.0)

This research / project is supported by the Agency for Science, Technology and Research (A*STAR) - IAF-ICP funding
Grant Reference no. : I1701E0011

https://oar.a-star.edu.sg/communities-collections/articles/19645

0002-9165

Singapore Institute for Clinical Sciences