This study aims to evaluate the effects of Intermittent Fasting (IF) 14/10 compared with the Low Glycemic Index Mediterranean Diet on NAFLD.
Interventional, randomized, controlled 2-arm clinical trial The two study arms are: * Low-Glycemic Index Mediterranean Diet (Control Arm). * IF 14/10 (Experimental Arm) with 14 hours of overnight fasting and 10 hours of feeding with Low Glycemic Index Mediterranean Diet. The study involves the enrollment of 60 subjects (30 in each arm) with NAFLD, medium/severe grade diagnosed by Fibroscan, randomly assigned using randomization tables to one of the two study arms. The duration of the nutritional intervention is 4 months. During the study duration period, patients will undergo 3 visits. At T0 (Screening Visit) patients, who are potentially enrollable, after signing the informed consent, will undergo: * Medical history (family, physiological, remote and upcoming pathological and pharmacological); * Fibroscan, to assess the degree of hepatic steatosis; * Survey of anthropometric characteristics (BMI, abdominal circumference, neck circumference); * Bioimpedance examination; * NuWell (Nutrition Wellness Survey) questionnaire completion. * IPAQ (Daily Physical Activity Questionnaire) questionnaire. In case the inclusion criteria are met, the enrolled patients will be randomized, using randomization tables, into one of the two arms under the study. The enrolled patients, will be invited to return after 7 days to complete T0 and receive the personalized food plan, depending on the arm they belong to and anthropometric characteristics. Fasting for at least 12 hours, they will undergo blood sampling by venipuncture and body composition assessment by DEXA. Enrolled subjects will be asked to bring a stool sample and a urine sample for fecal and urinary mycriobiota and metabolome analysis. Patients will be given the Food Diary, which must be reported completed at each visit. After 2 months from the start of treatment (T0 + 60gg) patients will be called for T1. At this visit, patients who have been fasting for at least 12 hours will undergo: * Samples by venous puncture; * Bioimpedance examination; * Anthropometric measurements. Patients will be asked to bring a stool sample and a urine sample, and the Food Diary will be checked. After another 2 months (T1 + 60gg: End of treatment) patients will be called for T2. At this visit, patients, fasting for at least 12 hours, will undergo: * Samples by venous puncture; * Fibroscan * Bioimpedance examination; * DEXA * Anthropometric measurements. Patients will be asked to bring a stool sample and a urine sample, and a Food Diary will be collected. The blood sample taken will be used to assay routine hematochemical parameters and nutritional, metabolic and cardiovascular risk. Specifically, the following will be assayed: blood glucose, glycated hemoglobin, insulin, azotemia, creatinine, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, urate, AST, ALT, gamma GT, total protein, protein electrophoresis, high-sensitivity PCR, TSH, FT3, FT4, blood count, ferritin, vitamin D, prolactin, cortisol, urine tests, IL 1, 4, 6, 8, 10, CK18 and TNFα. Patients will be given the reports of Routine blood tests only, Fibroscan, Bioimpedance Examination and DEXA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
In this group, a diet based on intermittent fasting will be administered - with 14 hours of nocturnal fasting and 10 hours of feeding with a low glycemic index Mediterranean diet.
The effect of intervention on CAP value
To evaluate the change in hepatic steatosis score after 4 months of a low glycemic index Mediterranean diet and 14/10 intermittent fasting with a low glycemic index Mediterranean diet. The cut off to indicate the presence of steatosis is CAP\>268. A decrease in the CAP value indicates an improvement in the pathology
Time frame: at Baseline and after 4 months
The effect of the intervention on the Body Composition detected with DEXA
Evaluate the change in body composition detected with DEXA after 4 months of a low glycemic index Mediterranean diet and 14/10 intermittent fasting with a low glycemic index Mediterranean diet
Time frame: at Baseline and after 4 months
The effect of the intervention on the Body Composition detected with bioimpedance analysis
Evaluate the change in body composition detected with bioimpedance analysis after 4 months of a low glycemic index Mediterranean diet and 14/10 intermittent fasting with a low glycemic index Mediterranean diet
Time frame: at Baseline and after 4 months
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