{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T01:29:41Z","timestamp":1778030981977,"version":"3.51.4"},"reference-count":36,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:00:00Z","timestamp":1699056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health, Ricerca Corrente"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Extra virgin olive oil (EVOO) has healthy benefits for noncommunicable diseases (NCDs). However, limited evidence is available about the effects of liver disease and non-alcoholic fatty liver disease (NAFLD). We evaluate whether dose-increased consumption of EVOO is associated with a lower prevalence of NAFLD and if these effects vary based on body weight. The study included 2436 subjects with a 33% NAFLD prevalence. Daily EVOO was categorized into tertiles: low (0\u201324 g\/day), moderate (25\u201337 g\/day), and high consumption (&gt;37 g\/day). Subjects were also classified by body mass index (BMI) as normo-weight (18.5\u201324.9), overweight (25\u201329.9), and obese (\u226530). Logistic regression analysis was applied to calculate odds ratios (ORs) for NAFLD, considering a 20-gram increment in EVOO intake and accounting for EVOO categories combined with BMI classes. The ORs were 0.83 (0.74;0.93) C.I. p = 0.0018 for continuous EVOO, 0.89 (0.69;1.15) C.I. p = 0.37, and 0.73 (0.55;0.97) C.I. p = 0.03 for moderate and high consumption, respectively, when compared to low consumption. Overall, the percent relative risk reductions (RRR) for NAFLD from low to high EVOO consumption were 18% (16.4%;19.2%) C.I. and 26% (25%;27.4%) C.I. in overweight and obese subjects. High EVOO consumption is associated with a reduced risk of NAFLD. This effect is amplified in overweight subjects and even more in obese subjects.<\/jats:p>","DOI":"10.3390\/nu15214673","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T14:51:01Z","timestamp":1699109461000},"page":"4673","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["High Extra Virgin Olive Oil Consumption Is Linked to a Lower Prevalence of NAFLD with a Prominent Effect in Obese Subjects: Results from the MICOL Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Calogero Claudio.","family":"Tedesco","sequence":"first","affiliation":[{"name":"Data Science Unit, National Institute of Gastroenterology, IRCCS \u201cSaverio de Bellis\u201d Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8650-348X","authenticated-orcid":false,"given":"Caterina","family":"Bonfiglio","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology, IRCCS \u201cSaverio de Bellis\u201d Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2274-2198","authenticated-orcid":false,"given":"Maria","family":"Notarnicola","sequence":"additional","affiliation":[{"name":"Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, IRCCS \u201cSaverio de Bellis\u201d Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Rendina","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy, University Hospital, Policlinico of Bari, 70100 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Castellaneta","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, 70100 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2026-1200","authenticated-orcid":false,"given":"Alfredo","family":"Di Leo","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, 70100 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5140-8060","authenticated-orcid":false,"given":"Gianluigi","family":"Giannelli","sequence":"additional","affiliation":[{"name":"Scientific Direction, National Institute of Gastroenterology, IRCCS \u201cSaverio de Bellis\u201d Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Fontana","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia"},{"name":"Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW 2006, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/S0140-6736(20)32511-3","article-title":"Non-alcoholic fatty liver disease","volume":"397","author":"Powell","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/TP.0000000000002480","article-title":"Nonalcoholic Fatty Liver Disease: Basic Pathogenetic Mechanisms in the Progression From NAFLD to NASH","volume":"103","author":"Pierantonelli","year":"2019","journal-title":"Transplantation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jhep.2011.06.010","article-title":"Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: A systematic review","volume":"56","author":"Thoma","year":"2012","journal-title":"J. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"154455","DOI":"10.1016\/j.metabol.2020.154455","article-title":"The effect of the magnitude of weight loss on non-alcoholic fatty liver disease: A systematic review and meta-analysis","volume":"115","author":"Koutoukidis","year":"2020","journal-title":"Metabolism"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/hep.23276","article-title":"Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis","volume":"51","author":"Promrat","year":"2010","journal-title":"Hepatology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/j.jhep.2015.11.004","article-title":"EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease","volume":"64","author":"Marchesini","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1016\/j.clnu.2022.06.037","article-title":"The effectiveness and acceptability of Mediterranean diet and calorie restriction in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis","volume":"41","author":"Haigh","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1111\/liv.13435","article-title":"The Mediterranean dietary pattern as the diet of choice for non-alcoholic fatty liver disease: Evidence and plausible mechanisms","volume":"37","author":"Salomone","year":"2017","journal-title":"Liver Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.jhep.2018.01.019","article-title":"Fructose and sugar: A major mediator of non-alcoholic fatty liver disease","volume":"68","author":"Jensen","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1038\/s41575-021-00472-y","article-title":"Dietary carbohydrates and fats in nonalcoholic fatty liver disease","volume":"18","author":"Luukkonen","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/liv.14360","article-title":"The role of nutrition in non-alcoholic fatty liver disease: Pathophysiology and management","volume":"40","year":"2020","journal-title":"Liver Int."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Perdomo, C.M., Fr\u00fchbeck, G., and Escalada, J. (2019). Impact of Nutritional Changes on Nonalcoholic Fatty Liver Disease. Nutrients, 11.","DOI":"10.3390\/nu11030677"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1007\/s10654-020-00627-2","article-title":"Adherence to a plant-based, high-fibre dietary pattern is related to regression of non-alcoholic fatty liver disease in an elderly population","volume":"35","author":"Alferink","year":"2020","journal-title":"Eur. J. Epidemiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.3748\/wjg.15.1809","article-title":"Olive oil consumption and non-alcoholic fatty liver disease","volume":"15","author":"Assy","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2174\/1871530317666171114120552","article-title":"Liver Protective Effects of Extra Virgin Olive Oil: Interaction between Its Chemical Composition and the Cell-signaling Pathways Involved in Protection","volume":"18","author":"Valenzuela","year":"2017","journal-title":"Endocr. Metab. Immune Disord. -Drug Targets"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3748\/wjg.v13.i3.361","article-title":"Monounsaturated fat decreases hepatic lipid content in non-alcoholic fatty liver disease in rats","volume":"13","author":"Hussein","year":"2007","journal-title":"World J. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5637","DOI":"10.1074\/jbc.M807616200","article-title":"Hepatic lipid partitioning and liver damage in nonalcoholic fatty liver disease: Role of stearoyl-Coa desaturase","volume":"284","author":"Li","year":"2009","journal-title":"J. Biol. Chem."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1111\/j.1440-1746.2008.05733.x","article-title":"Differential effect of oleic and palmitic acid on lipid accumulation and apoptosis in cultured hepatocytes","volume":"24","author":"Ricchi","year":"2009","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/00042737-199410000-00017","article-title":"The epidemiology of cholelithiasis in southern Italy","volume":"6","author":"Misciagna","year":"1994","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1093\/ije\/29.5.922","article-title":"Hepatitis C virus (HCV) infection and liver-related mortality: A population-based cohort study in southern Italy","volume":"29","author":"Osella","year":"2000","journal-title":"Int. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1053\/gast.2002.35354","article-title":"The utility of radiological imaging in nonalcoholic fatty liver disease","volume":"123","author":"Saadeh","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1136\/bmj.311.7018.1457","article-title":"Diet and overall survival in elderly people","volume":"311","author":"Trichopoulou","year":"1995","journal-title":"Br. Med. J."},{"key":"ref_23","first-page":"5","article-title":"Predicting basal metabolic rate, new standards and review of previous work","volume":"39","author":"Schofield","year":"1985","journal-title":"Hum. Nutr. Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/j.jhep.2018.01.015","article-title":"High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance","volume":"68","author":"Isakov","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Semmler, G., Bachmayer, S., Wernly, S., Wernly, B., Niederseer, D., Huber-Sch\u00f6nauer, U., Stickel, F., Aigner, E., and Datz, C. (2020). Nut consumption and the prevalence and severity of non-alcoholic fatty liver disease. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0244514"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1136\/jech-2020-214568","article-title":"Fruit and vegetable consumption and non-alcoholic fatty liver disease among Korean adults: A prospective cohort study","volume":"74","author":"Kim","year":"2020","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1093\/jn\/nxz147","article-title":"A Mediterranean Diet Rich in Extra-Virgin Olive Oil Is Associated with a Reduced Prevalence of Nonalcoholic Fatty Liver Disease in Older Individuals at High Cardiovascular Risk","volume":"149","author":"Corbella","year":"2019","journal-title":"J. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1017\/S0007114519002769","article-title":"Whole-grain consumption and its effects on hepatic steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: A randomised controlled clinical trial","volume":"123","author":"Dorosti","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0007114520000914","article-title":"Food groups and the likelihood of non-alcoholic fatty liver disease: A systematic review and meta-analysis","volume":"124","author":"He","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.nut.2018.10.016","article-title":"No association between fruits or vegetables and non-alcoholic fatty liver disease in middle-aged men and women","volume":"61","author":"Tajima","year":"2019","journal-title":"Nutrition"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.nut.2018.02.021","article-title":"Olive oil lessened fatty liver severity independent of cardiometabolic correction in patients with non-alcoholic fatty liver disease: A randomized clinical trial","volume":"57","author":"Rezaei","year":"2019","journal-title":"Nutrition"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1700479","DOI":"10.1002\/mnfr.201700479","article-title":"Supplementation with Docosahexaenoic Acid and Extra Virgin Olive Oil Prevents Liver Steatosis Induced by a High-Fat Diet in Mice through PPAR-\u03b1 and Nrf2 Upregulation with Concomitant SREBP-1c and NF-kB Downregulation","volume":"61","author":"Valenzuela","year":"2017","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1136\/gutjnl-2017-315940","article-title":"Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: The Rotterdam Study","volume":"68","author":"Alferink","year":"2018","journal-title":"Gut"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.jhep.2010.08.019","article-title":"Oleuropein attenuates hepatic steatosis induced by high-fat diet in mice","volume":"54","author":"Park","year":"2010","journal-title":"J. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1017\/S0007114507701666","article-title":"Minor compounds of olive oil have postprandial anti-inflammatory effects","volume":"98","author":"Pacheco","year":"2007","journal-title":"Br. J. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"333","DOI":"10.7326\/0003-4819-145-5-200609050-00006","article-title":"The effect of polyphenols in olive oil on heart disease risk factors: A randomized trial","volume":"145","author":"Covas","year":"2006","journal-title":"Ann. Intern. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/21\/4673\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:17:36Z","timestamp":1760131056000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/21\/4673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,4]]},"references-count":36,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["nu15214673"],"URL":"https:\/\/doi.org\/10.3390\/nu15214673","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,4]]}}}