Author Identifier

Catherine Properzi

https://orcid.org/0000-0002-5868-3575

Date of Award

2024

Document Type

Thesis - ECU Access Only

Publisher

Edith Cowan University

Degree Name

Doctor Of Philosophy

School

School of Medical and Health Sciences

First Supervisor

Professor Therese O'Sullivan

Second Supervisor

Dr Johnny Lo

Third Supervisor

Professor Leon Adams

Fourth Supervisor

Professor Jill Sherriff

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common liver condition in the world, and both incidence and prevalence continue to grow. While progression to severe liver pathology occurs in a smaller percentage of these patients, the growing prevalence has led to NAFLD-related disease becoming a leading indicator for liver transplant. However, the leading cause of morbidity and mortality in this patient group is cardiovascular disease (CVD) and NAFLD is an independent risk factor for the development of CVD. Weight loss has been shown to improve liver histopathology in NAFLD, however there is limited high-quality evidence for dietary approaches which do not involve weight loss. The high monounsaturated fat Mediterranean diet (MD) has been shown to improve CVD risk and incident CVD in general populations. Despite this, approaches to NAFLD have traditionally tended to be low in fat and high in carbohydrate, consistent with national dietary guidelines. We compared effects on liver and cardiovascular outcomes for 50 NAFLD patients randomised to either a low-fat diet (based on standard care) or a MD over a 12-week period and also compared their diets with an age and sex matched general Australian population. Findings suggest that: 1. The diets of people with NAFLD differ significantly from those of the general population in terms of total energy intake, protein, fat and fat-subtypes. Contributions of individual macronutrients towards total energy intake also differ significantly in diets of those with NAFLD, where fat and protein contributed a significantly greater percentage of total energy intake and carbohydrate significantly less, than in the general population. 2. Healthy dietary approaches, including both a low-fat diet and a MD, can significantly reduce hepatic steatosis in a three-month period. 3. Hepatic steatosis can be significantly improved without subjects needing to achieve clinically significant levels of body weight loss (ie. ≥5%). Overall, this project has demonstrated that using either a MD or a low-fat diet can effectively reduce hepatic fat and lipid risk factors in NAFLD even in the absence of body weight change.

DOI

10.25958/cc4x-sg08

Access Note

ECU Access Only

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