1 Cattedra di Gastroenterologia, Dipartimento di Medicina Interna, Università degli Studi di Genova, 16132 Genova, Italy.
2 Programma Dipartimentale Diagnosi e Terapia delle Malattie Emergenti dell'Apparato Digerente, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
3 Divisione di Medicine Interna ed Epatologia, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Italy.
4 Dipartimento di Scienze Biomediche, Humanitas University, 20090 Pieve Emanuele, Italy.
5 Area Medicina Interna, Gastroenterologia e Medicina Interna, Fondazione Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, 20123 Roma, Italy.
6 Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, no.6, 16132 Genoa, Italy.
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is expected to become the leading cause of end-stage liver disease worldwide over the next few decades. In fact, NAFLD encompasses different clinical scenarios, from the simple accumulation of fat (steatosis) to steatohepatitis (NASH), NASH-cirrhosis, and cirrhosis complications. In this context, it is fundamental to pursue strategies aimed at both preventing the disease and reducing the progression of liver fibrosis once liver damage is already initiated. As of today, no pharmacological treatment has been approved for NAFLD/NASH, and the only recommended treatment of proven efficacy are life-style modifications, including diet and physical exercise pointing at weight loss of 5%-7%. Different dietetic approaches have been proposed in this setting, and in this review, we will discuss the evidence regarding the efficacy of the Mediterranean Diet as a treatment for NAFLD. In particular, we will report the effects on liver-related outcomes.