{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:43:23Z","timestamp":1784033003526,"version":"3.55.0"},"reference-count":73,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Regional Development Fund","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}]},{"name":"European Regional Development Fund","award":["OBN18PI03"],"award-info":[{"award-number":["OBN18PI03"]}]},{"name":"Spanish Agency of Research (MCINN)","award":["CB12\/03\/30038"],"award-info":[{"award-number":["CB12\/03\/30038"]}]},{"name":"Spanish Agency of Research (MCINN)","award":["OBN18PI03"],"award-info":[{"award-number":["OBN18PI03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: COVID-19 lockdowns had a significant impact on people\u2019s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40\u201360-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight gain and increases in glycemia, ALT and intrahepatic fat content post lockdown. Participants with worsened liver status had low consumption of fibre, cheese, nuts and coffee, and high consumption of sweets and pastries. Participants who improved liver status ameliorated ALT values, waist circumference, and intrahepatic fat content, assessed by magnetic resonance imaging post-lockdown. Conclusions: The maintenance of healthy lifestyle habits is vital, especially for populations with NAFLD and MetS, to reduce unhealthy lifestyle patterns displayed during lockdown.<\/jats:p>","DOI":"10.3390\/nu14173462","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T23:48:58Z","timestamp":1661384938000},"page":"3462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7833-2118","authenticated-orcid":false,"given":"Sof\u00eda","family":"Montemayor","sequence":"first","affiliation":[{"name":"Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina M.","family":"Mascar\u00f3","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Ugarriza","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"Camp Red\u00f3 Primary Health Care Center, 07010 Palma de Mallorca, 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9776-4730","authenticated-orcid":false,"given":"Cristina","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"Clinical Analysis Service, Universitary Hospital Son Espases, 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Alfredo","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Center for Nutrition Research, Department of Nutrition, Food Sciences, and Physiology, University of Navarra, 31008 Pamplona, Spain"},{"name":"Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, 28049 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6940-0761","authenticated-orcid":false,"given":"Josep A.","family":"Tur","sequence":"additional","affiliation":[{"name":"Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition CB12\/03\/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, 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 and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain"},{"name":"Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain"},{"name":"CIBEROBN (Physiopathology of Obesity and Nutrition CB12\/03\/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"ref_1","first-page":"715","article-title":"Non-alcoholic fatty liver disease: An expanded review","volume":"9","author":"Benedict","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.21037\/tgh.2019.09.08","article-title":"Epidemiology of non-alcoholic and alcoholic fatty liver diseases","volume":"5","author":"Mitra","year":"2020","journal-title":"Transl. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1002\/hep.29546","article-title":"Nonalcoholic Fatty Liver Disease Incidence and Impact on Metabolic Burden and Death: A 20 Year-Community Study","volume":"67","author":"Allen","year":"2018","journal-title":"Hepatology"},{"key":"ref_4","unstructured":"Le, M.H., Yeo, Y.H., Li, X., Li, J., Zou, B., Wu, Y., Ye, Q., Huang, D.Q., Zhao, C., and Zhang, J. (Clin. Gastroenterol. Hepatol., 2021). 2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis, Clin. Gastroenterol. Hepatol., in press."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.cld.2015.10.001","article-title":"Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in the United States and the Rest of the World","volume":"20","author":"Sayiner","year":"2016","journal-title":"Clin. Liver Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.cld.2015.10.002","article-title":"The Metabolic Syndrome and Its Influence on Nonalcoholic Steatohepatitis","volume":"20","author":"Kanwar","year":"2016","journal-title":"Clin. Liver Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.dld.2010.01.016","article-title":"From the metabolic syndrome to NAFLD or vice versa?","volume":"42","author":"Vanni","year":"2010","journal-title":"Dig. Liver Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1053\/j.gastro.2013.11.001","article-title":"Metabolic phenotyping and systems biology approaches to understanding metabolic syndrome and fatty liver disease","volume":"146","author":"Dumas","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_10","first-page":"2726","article-title":"NAFLD and COVID-19: A Pooled Analysis","volume":"2","author":"Sachdeva","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/S0140-6736(20)30309-3","article-title":"2019-nCoV epidemic: Address mental health care to empower society","volume":"395","author":"Bao","year":"2020","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100254","DOI":"10.1016\/j.obmed.2020.100254","article-title":"Dietary habits in adults during quarantine in the context of COVID-19 pandemic","volume":"19","author":"Abbas","year":"2020","journal-title":"Obes. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pellegrini, M., Ponzo, V., Rosato, R., Scumaci, E., Goitre, I., Benso, A., Belcastro, S., Crespi, C., De Michieli, F., and Ghigo, E. (2020). Changes in weight and nutritional habits in adults with obesity during the \u201clockdown\u201d period caused by the COVID-19 virus emergency. Nutrients, 12.","DOI":"10.3390\/nu12072016"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Galanakis, C.M. (2020). The food systems in the era of the coronavirus (COVID-19) pandemic crisis. Foods, 9.","DOI":"10.3390\/foods9040523"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Rodrigo, C., Gianzo-Citores, M., Herv\u00e1s-B\u00e1rbara, G., Ruis-Litago, F., Cas\u00eds-S\u00e1enz, L., Arija, V., L\u00f3pez-Sobaler, A.M., Mart\u00ednez de Victoria, E., Ortega, R.M., and Partearroyo, T. (2021). Patterns of Change in Dietary Habits and Physical Activity during Lockdown in Spain Due to the COVID-19 Pandemic. Nutrients, 13.","DOI":"10.3390\/nu13020300"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-S\u00e1nchez, E., Ramirez-Vargas, G., Avellaneda-L\u00f3pez, Y., Orellana-Pecino, J.I., Garc\u00eda-Mar\u00edn, E., and D\u00edaz-Jim\u00e9nez, J. (2020). Eating Habits and Physical Activity of the Spanish Population during the COVID-19 Pandemic Period. Nutrients, 12.","DOI":"10.3390\/nu12092826"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.numecd.2020.05.020","article-title":"Quarantine during COVID-19 outbreak changes in diet and physical activity increase the risk of cardiovascular disease","volume":"30","author":"Mattioli","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2417","DOI":"10.1007\/s00394-022-02814-1","article-title":"Changes in Spanish lifestyle and dietary habits during the COVID-19 lockdown","volume":"61","author":"Casas","year":"2022","journal-title":"Eur. J. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Mascherini, G., Catelan, D., Pellegrini-Giampietro, D.E., Petri, C., Scaletti, C., and Gulisano, M. (2021). Changes in physical activity levels, eating habits and psychological well-being during the Italian COVID-19 pandemic lockdown: Impact of socio-demographic factors on the Florentine academic population. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252395"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Lombardo, M., Guseva, E., Perrone, M.A., M\u00fcller, A., Rizzo, G., and Storz, M.A. (2021). Changes in Eating Habits and Physical Activity after COVID-19 Pandemic Lockdowns in Italy. Nutrients, 13.","DOI":"10.3390\/nu13124522"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/j.numecd.2020.05.027","article-title":"Changes in food choice following restrictive measures due to COVID-19","volume":"30","author":"Bracale","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Scarmozzino, F., and Visioli, F. (2020). COVID-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods, 9.","DOI":"10.3390\/foods9050675"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Di Renzo, L., Gualtieri, P., Cinelli, G., Bigioni, G., Soldati, L., Attin\u00e0, A., Bianco, F.F., Caparello, G., Camodeca, V., and Carrano, E. (2020). Psychological aspects and eating habits during COVID-19 home confinement: Results of EHLC-COVID-19 Italian online survey. Nutrients, 12.","DOI":"10.3390\/nu12072152"},{"key":"ref_24","unstructured":"(2022, May 05). Prevention and Reversion of NAFLD in Obese Patients with Metabolic Syndrome by Mediterranean Diet and Physical Activity (FLIPAN), Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04442620."},{"key":"ref_25","unstructured":"Consensus International Diabetic Federation (IDF) (2022, August 23). Consensus Statement\u2014The IDF Consensus Worldwide Definition of the Metabolic Syndrome. Available online: https:\/\/www.idf.org\/e-library\/consensus-statements\/60-idfconsensus-worldwidedefinitionof-the-metabolic-syndrome.html."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1093\/oxfordjournals.aje.a114086","article-title":"Reproducibility and validity of a semiquantitative food frequency questionnaire","volume":"122","author":"Willett","year":"1985","journal-title":"Am. J. Epidemiol."},{"key":"ref_27","unstructured":"Moreiras, O., Carbajal, A., Cabrera, L., and Cuadrado, C. (2018). Food Composition Tables (Spanish), Pir\u00e1mide. [19th ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., and Tiribelli, C. (2006). The Fatty Liver Index: A simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol., 6.","DOI":"10.1186\/1471-230X-6-33"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.dld.2009.08.002","article-title":"Hepatic steatosis index: A simple screening tool reflecting nonalcoholic fatty liver disease","volume":"42","author":"Lee","year":"2010","journal-title":"Dig. Liver Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1148\/radiol.12120896","article-title":"Nonalcoholic fatty liver disease: MR imaging of liver proton density fat fraction to assess hepatic steatosis","volume":"267","author":"Tang","year":"2013","journal-title":"Radiology"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Cinque, F., Cespiati, A., Lombardi, R., Costantino, A., Maffi, G., Alletto, F., Colavolpe, L., Francione, P., Oberti, G., and Fatta, E. (2022). Interaction between Lifestyle Changes and PNPLA3 Genotype in NAFLD Patients during the COVID-19 Lockdown. Nutrients, 14.","DOI":"10.3390\/nu14030556"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e13597","DOI":"10.1111\/eci.13597","article-title":"Multiplying effects of COVID-19 lockdown on metabolic risk and fatty liver","volume":"51","author":"Shanmugam","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1017\/S0007114521000921","article-title":"Systematic review of the effects of pandemic confinements on body weight and their determinants","volume":"127","author":"Khan","year":"2022","journal-title":"Br. J. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"626432","DOI":"10.3389\/fnut.2021.626432","article-title":"The Impact of Lockdown During the COVID-19 Outbreak on Dietary Habits in Various Population Groups: A Scoping Review","volume":"8","author":"Bennett","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO) (2016). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Diabetologia, 59, 1121\u20131140.","DOI":"10.1007\/s00125-016-3902-y"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","article-title":"Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis","volume":"149","author":"Friedman","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jhep.2020.03.044","article-title":"Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study","volume":"73","author":"Ji","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4133","DOI":"10.12998\/wjcc.v9.i17.4133","article-title":"Nonalcoholic fatty liver disease and COVID-19: An epidemic that begets pandemic","volume":"9","author":"Ahmed","year":"2021","journal-title":"World. J. Clin. Cases."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"30","DOI":"10.3390\/livers2010003","article-title":"Oxidative Stress in Non-Alcoholic Fatty Liver Disease","volume":"2","author":"Smirne","year":"2022","journal-title":"Livers"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Galli, F., Marcantonini, G., Giustarini, D., Albertini, M.C., Migni, A., Zatini, L., Gioiello, A., Rossi, R., and Bartolini, D. (2022). How Aging and Oxidative Stress Influence the Cytopathic and Inflammatory Effects of SARS-CoV-2 Infection: The Role of Cellular Glutathione and Cysteine Metabolism. Antioxidants, 11.","DOI":"10.3390\/antiox11071366"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Buonaurio, F., Borra, F., Pigini, D., Paci, E., Spagnoli, M., Astolfi, M.L., Giampaoli, O., Sciubba, F., Miccheli, A., and Canepari, S. (2022). Biomonitoring of Exposure to Urban Pollutants and Oxidative Stress during the COVID-19 Lockdown in Rome Residents. Toxics, 10.","DOI":"10.3390\/toxics10050267"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"635859","DOI":"10.3389\/fnut.2021.635859","article-title":"Changes in Food Consumption During the COVID-19 Pandemic: Analysis of Consumer Survey Data from the First Lockdown Period in Denmark, Germany, and Slovenia","volume":"8","author":"Janssen","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/13543784.2020.1716333","article-title":"Effectiveness of lifestyle interventions in NAFLD (nonalcoholic fatty liver disease)-how are clinical trials affected?","volume":"29","author":"Michel","year":"2020","journal-title":"Expert. Opin. Investig. Drugs."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4","DOI":"10.23736\/S1121-421X.20.02666-5","article-title":"Non-alcoholic fatty liver disease and primary care physicians","volume":"66","author":"Abenavoli","year":"2020","journal-title":"Minerva. Gastroenterol. Dietol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Krawczyk, M., Maciejewska, D., Ryterska, K., Czerwi\u0144ka-Rogowska, M., Jamio\u0142-Milc, D., Skonieczna-\u017bydecka, K., Milkiewicz, P., Raszeja-Wyszomirska, J., and Stachowska, E. (2018). Gut Permeability Might be Improved by Dietary Fiber in Individuals with Nonalcoholic Fatty Liver Disease (NAFLD) Undergoing Weight Reduction. Nutrients, 10.","DOI":"10.3390\/nu10111793"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1111\/j.1478-3231.2011.02730.x","article-title":"The potential role of prebiotic fibre for treatment and management of non-alcoholic fatty liver disease and associated obesity and insulin resistance","volume":"32","author":"Parnell","year":"2011","journal-title":"Liver Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1038\/ejcn.2017.148","article-title":"Associations between dietary factors and markers of NAFLD in a general Dutch adult population","volume":"72","author":"Rietman","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12986-019-0420-1","article-title":"Insoluble dietary fibre intake is associated with lower prevalence of newly-diagnosed non-alcoholic fatty liver disease in Chinese men: A large population-based cross-sectional study","volume":"17","author":"Xia","year":"2020","journal-title":"Nutr. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"98","DOI":"10.4103\/2008-7802.188083","article-title":"Intake of nutrients, fiber, and sugar in patients with nonalcoholic fatty liver disease in comparison to healthy individuals","volume":"7","author":"Zolfaghari","year":"2016","journal-title":"Int. J. Prev. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.jhep.2007.06.020","article-title":"Long term nutritional intake and the risk for non-alcoholic fatty liver disease (NAFLD): A population based study","volume":"47","author":"Goldsmith","year":"2007","journal-title":"J. Hepatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e17613","DOI":"10.1097\/MD.0000000000017613","article-title":"Association between dietary iron intake and the prevalence of nonalcoholic fatty liver disease: A cross-sectional study","volume":"98","author":"Yang","year":"2019","journal-title":"Medicine"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s00394-008-0710-2","article-title":"Bioactive peptides and proteins from foods: Indication for health effects","volume":"47","author":"Moller","year":"2008","journal-title":"Eur. J. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e017995","DOI":"10.1136\/bmjopen-2017-017995","article-title":"Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: A systematic review and meta-analysis of randomised controlled trials","volume":"9","author":"Koutnikova","year":"2019","journal-title":"BMJ Open."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s13594-016-0288-z","article-title":"Cheese consumption prevents fat accumulation in the liver and improves serum lipid parameters in rats fed a high-fat diet","volume":"96","author":"Higurashi","year":"2016","journal-title":"Dairy Sci. Technol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1093\/ajcn\/71.3.674","article-title":"Consumption of fermented and nonfermented dairy products: Effects on cholesterol concentrations and metabolism","volume":"71","author":"Farnworth","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"5252","DOI":"10.1016\/j.clnu.2021.08.012","article-title":"Dairy protein intake is inversely related to development of non-alcoholic fatty liver disease","volume":"40","author":"Lee","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"S68","DOI":"10.1017\/S0007114514003729","article-title":"Review of nut phytochemicals, fat-soluble bioactives, antioxidant components and health effects","volume":"1132","author":"Alasalvar","year":"2015","journal-title":"Br. J. Nutr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"126192","DOI":"10.1016\/j.foodchem.2020.126192","article-title":"Bioactives and health benefits of nuts and dried fruits","volume":"314","author":"Alasalvar","year":"2020","journal-title":"Food Chem."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e028961","DOI":"10.1136\/bmjopen-2019-028961","article-title":"Association between nut intake and non-alcoholic fatty liver disease risk: A retrospective case-control study in a sample of Chinese Han adults","volume":"9","author":"Chen","year":"2019","journal-title":"BMJ Open."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"195","DOI":"10.7762\/cnr.2020.9.3.195","article-title":"The Association between Nuts Intake and Non-Alcoholic Fatty Liver Disease (NAFLD) Risk: A Case-Control Study","volume":"9","author":"Asbaghi","year":"2020","journal-title":"Clin. Nutr. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"783","DOI":"10.3945\/ajcn.114.099515","article-title":"Nut consumption on all-cause, cardiovascular, and cancer mortality risk: A systematic review and meta-analysis of epidemiologic studies","volume":"101","author":"Grosso","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1093\/ajcn\/nqy236","article-title":"The effect of nuts on markers of glycemic control: A systematic review and meta-analysis of randomized controlled trials","volume":"109","author":"Tindall","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.3945\/ajcn.115.110965","article-title":"Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: Systematic review, meta-analysis, and dose-response of 61 controlled intervention trials","volume":"102","author":"Falk","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1002\/hep.24731","article-title":"Association of coffee and caffeine consumption with fatty liver disease, nonalcoholic steatohepatitis, and degree of hepatic fibrosis","volume":"55","author":"Molloy","year":"2012","journal-title":"Hepatology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1365-2036.2011.04916.x","article-title":"Caffeine is protective in patients with non-alcoholic fatty liver disease","volume":"35","author":"Birerdinc","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3200","DOI":"10.1007\/s10620-010-1143-3","article-title":"Protective role of coffee in non-alcoholic fatty liver disease (NAFLD)","volume":"55","author":"Catalano","year":"2010","journal-title":"Dig. Dis. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/S1665-2681(19)30931-7","article-title":"High coffee intake is associated with lower grade nonalcoholic fatty liver disease: The role of peripheral antioxidant activity","volume":"11","author":"Uribe","year":"2012","journal-title":"Ann. Hepatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/1756283X15593700","article-title":"Association between caffeine consumption and nonalcoholic fatty liver disease: A systemic review and meta-analysis","volume":"9","author":"Shen","year":"2016","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.vph.2015.05.011","article-title":"The cardiovascular benefits of dark chocolate","volume":"71","author":"Kerimi","year":"2015","journal-title":"Vascul. Pharmacol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/j.1753-4887.2008.00114.x","article-title":"Clinical benefit and preservation of flavonols in dark chocolate manufacturing","volume":"66","author":"McShea","year":"2008","journal-title":"Nutr. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Leyva-Soto, A., Chavez-Santoscoy, R.A., Lara-Jacobo, L.R., Chavez-Santoscoy, A.V., and Gonzalez-Cobian, L.N. (2018). Daily Consumption of Chocolate Rich in Flavonoids Decreases Cellular Genotoxicity and Improves Biochemical Parameters of Lipid and Glucose Metabolism. Molecules, 23.","DOI":"10.20944\/preprints201807.0399.v1"},{"key":"ref_72","first-page":"2257","article-title":"Effects of dark chocolate in a population of Normal Weight Obese women: A pilot study","volume":"17","author":"Rizzo","year":"2013","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"217","DOI":"10.14218\/JCTH.2018.00021","article-title":"Non-invasive quantitative detection methods of liver fat content in non-alcoholic fatty liver disease","volume":"6","author":"Lv","year":"2018","journal-title":"J. Clin. Transl. Hepatol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/17\/3462\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:14:21Z","timestamp":1760141661000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/17\/3462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,24]]},"references-count":73,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["nu14173462"],"URL":"https:\/\/doi.org\/10.3390\/nu14173462","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,24]]}}}