Beneficial effects of raisin consumption in patients with non-alcoholic fatty liver disease (NAFLD)

INTRODUCTION: NAFLD is the most prevalent cause of hepatic injury without standard and effective therapy. OBJECTIVES: The aim of the study was to assess the potential beneficial effects of incorporating raisins, a dried fruit with known antioxidant properties and median glycemic index, into the diet of patients with NAFLD. METHOD / DESIGN: This was a randomized parallel arm clinical study involving 56 patients with NAFLD, who were randomly assigned to two isocaloric dietary treatments for 24 weeks: (a) a low-calorie diet (control group, N=28) (b) the same diet with the addition of raisins (36 g/day), substituting snacks of isocaloric content (intervention group, N=28). Anthropometric measurements, MedDietScore, NAFLD Fibrosis Score, liver imaging (ultrasound, elastography), measurement of fasting metabolic parameters (glucose, insulin, HbA1c, HOMA-IR, lipids, liver enzymes, leptin, adiponectin, CRP) were performed pre- and post-intervention. RESULTS: A total of 51 patients completed the trial. Six patients were excluded from analysis due to non compliance. No significant differences in any parameter were found at baseline between two groups. Weight loss was observed in both groups (-3.9±0.7 kg, p <0.0001 in control and -2.8 ±0.5 kg, p <0.0001 in intervention group, p=NS between groups). When patients who didn't lose any weight were excluded, 18 patients remained in each group. In these, liver stiffness, CRP, and serum leptin were decreased significantly in intervention group (-0.5±0.2 kPa, p=0.013, -1.5±0.4 mg/L, p=0.002, and -19.9±8.7 ng/ml, p=0.036, respectively). Fasting glucose was significantly decreased in intervention group (-8.2 ± 1.8 mg/dl, p<0.0001), and was significantly different between the two groups at the end of the study (p=0.005). MedDietScore increased significantly in both groups (+2.8 ±1, p=0.015 in control and 5.1.±1, p<0.0001 in intervention group, p=NS between groups post-intervention). CONCLUSIONS: The addition of raisins to the diet of patients with NAFLD, results in beneficial effects on glycemia, liver stiffness, and indices of inflammation.