{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T10:42:06Z","timestamp":1786272126215,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundaci\u00f3 La Marat\u00f3 TV3 (Spain)","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}]},{"name":"Fundaci\u00f3 La Marat\u00f3 TV3 (Spain)","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}]},{"name":"Instituto de Salud Carlos III","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}]},{"name":"Instituto de Salud Carlos III","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}]},{"name":"European Regional Development Fund","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}]},{"name":"European Regional Development Fund","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}]},{"name":"JUNIOR-IDISBA pre-doctoral grant","award":["201630.10"],"award-info":[{"award-number":["201630.10"]}]},{"name":"JUNIOR-IDISBA pre-doctoral grant","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Background: The Mediterranean Diet (MedDiet) is recognized as a healthy dietary pattern. Non-alcoholic fatty liver disease (NAFLD) is characterized by the excessive accumulation of fat in the liver. Objectives: To assess the antioxidant status in erythrocytes, plasma, and peripheral blood mononuclear cells (PBMCs) of NAFLD patients following a 24-month lifestyle intervention based on the MedDiet. Adult patients (n = 40; aged 40\u201360 years) diagnosed with NAFLD by magnetic resonance imaging were divided into two groups based on their adherence to the MedDiet. Consumption was assessed using a validated 143-item semiquantitative Food Frequency Questionnaire. Anthropometrics, biochemistry parameters, intrahepatic fat contents (IFC), antioxidants, and inflammatory biomarkers were measured in plasma and erythrocytes before and after the intervention. Results: After the intervention, body mass index (BMI) and plasma levels of total cholesterol, low-density lipoprotein cholesterol (LDL-chol), triglycerides, malondialdehyde (MDA), and cytokeratin-18 (CK18) decreased, and high-density lipoprotein cholesterol (HDL-chol) increased. Participants with high adherence to MedDiet showed lower IFC, hepatic enzyme (AST, ALT, and GGT), glycemia, oxidase LDL (oxLDL) plasma levels, and erythrocyte MDA levels. Higher antioxidant activity (erythrocyte catalase-CAT, superoxide dismutase-SOD, glutathione peroxidase-GPx, glutathione reductase-GRd, and total glutathione-GSH as well as PBMCs-CAT gene expression) was observed in these patients, along with a reduction of PBMCs reactive oxygen species production and Toll-like receptor 4 (TLR4) expression. Inverse associations were observed between adherence to the MedDiet and BMI, glycemia, AST, IFC, and CK18 plasma levels and oxLDL, CAT, SOD, and GRd activities in erythrocytes. A significant linear regression was observed between adherence to the MedDiet and antioxidant score. Conclusions: Adherence to the MedDiet is associated with improved plasma and PBMC antioxidant and inflammatory biomarker profiles and high antioxidant defences in erythrocytes.<\/jats:p>","DOI":"10.3390\/antiox13040480","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T07:55:54Z","timestamp":1713426954000},"page":"480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Impact of Adherence to the Mediterranean Diet on Antioxidant Status and Metabolic Parameters in NAFLD Patients: A 24-Month Lifestyle Intervention Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4155-7780","authenticated-orcid":false,"given":"Maria Magdalena","family":"Quetglas-Llabr\u00e9s","sequence":"first","affiliation":[{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8856-135X","authenticated-orcid":false,"given":"Margalida","family":"Monserrat-Mesquida","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-8461","authenticated-orcid":false,"given":"Cristina","family":"Bouzas","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3534-1588","authenticated-orcid":false,"given":"Silvia","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Argelich","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Casares","sequence":"additional","affiliation":[{"name":"Radiodiagnosis Service, Red Asistencial Juaneda, 07011 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Ugarriza","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Health Research Institute of Balearic Islands (IdISBa), 07120 Palma, Spain"},{"name":"C.S. 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