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Dear Colleagues and Friends,
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Non-alcoholic fatty liver disease
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A new analysis from the the PREDIMED (PREvención con DIeta MEDiterránea) study assessed whether an intervention with a MedDiet enriched with extra-virgin olive oil or nuts, compared to a low-fat control diet, modulated platelet count, the risk of developing thrombocytosis and thrombocytopenia, and the association between these alterations and all-cause mortality. The findings suggested that the MedDiet contributed to maintaining platelet counts within normal range in an older population at high cardiovascular risk. In particular, participants following a MedDiet supplemented with EVOO experienced a lower risk of thrombocytopenia, but not thrombocytosis, in comparison to the control group. Furthermore, individuals who developed thrombocytopenia in either intervention group did not experience an increased risk of mortality relative to those without this condition. Although levels of platelets and related consequences are traditionally addressed by pharmacological treatments, this is the first intervention study that sheds light on the protective effect of a healthy diet on the development of low platelet count and associated mortality.
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On another note, it is well established that healthy lifestyle interventions (including high adherence to MedDiet) have a positive preventative influence on euglycemia in patients with prediabetes; a factor which prevents the eventual onset of type 2 diabetes. However, little is known on the specific role that lifestyle factors play on the reversion to normal glycemia according to the type of prediabetes. Findings from a new study in a prospective cohort of individuals with prediabetes followed up by primary care physicians in Spain show that reversion to euglycemia after three years of follow-up was almost four times higher in subjects with isolated impaired glycated hemoglobin A1c (HbA1c) and five times higher in subjects with isolated impaired fasting plasma glucose (FPG) levels. Although the authors conclude that lifestyle factors in general did not determine a reversion to normoglycemia, those with a high MedDiet adherence were 78% more likely to achieve this goal. This suggests that FPG and HbA1c levels may be key determinants for the regression to normal glycaemia more so than lifestyle factors in subjects with prediabetes. Further studies evaluating the role of optimal lifestyles in prognostic results, among subjects with different classifications of prediabetes, will be very useful to harmonize definitions on prediabetes subtypes and initiate treatment earlier to improve patient outcomes.
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