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Efficacy of Traditional Persian Medicine-Based Diet on Non-Alcoholic Fatty Liver Disease: A Randomized, Controlled, Clinical Trial

Gholam Reza Ghayour Razmgah, Seyed Mousal-Reza Hosseini, Mohsen Nematy, Habibollah Esmaily, Mahdi Yousefi, Mohammad Kamalinejad, Seyed Hamdollah Mosavat

Background: Regarding the preventive approaches of traditional Persian medicine (TPM) in the management of chronic diseases such as fatty liver, we evaluated the effect of a TPM-based nutritional style on liver enzymes levels and fatty liver grade in patients with non-alcoholic fatty liver. Materials and Methods: Patients were randomly assigned to receive either a three-month TPM-based diet as the intervention group or received the low-fat, low-calorie diet as the control group. The primary outcome measure was changes in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Secondary outcome measures were changes in fatty liver grade (fatty tissue infiltration in liver by using ultrasound imaging) and changes in patients’ body mass index (BMI). All outcome measures were evaluated at the baseline, at six weeks, and at three months after intervention. Results: Regarding within-group changes in outcome measures’ mean values, there was a significant reduction in ALT serum level, AST, BMI, and fatty liver grade after intervention, compared with baseline in both groups of study (P< 0.001). The results of between-group analyses showed significant decreases in both mean body mass index and mean fatty liver grade between the intervention group compared to the control group at the end of intervention (P<0.037 and P<0.003, respectively). Conclusion: This randomized open-label controlled clinical trial demonstrated that the traditional Persian medicine-based nutritional style, used as a non-pharmacological remedy, could reduce body weight and improve fatty liver grade in patients suffering from non-alcoholic fatty liver disease. [GMJ.2017;6(3):208-216] DOI:10.22086/gmj.v6i3.813

Non-Alcoholic Fatty Liver Disease; Diet; Traditional Medicine; Clinical Trial

Ludwig J, Viggiano TR, Mcgill DB, Oh B, editors. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc; 1980.

Caldwell SH, Crespo DM. The spectrum expanded: cryptogenic cirrhosis and the natural history of non-alcoholic fatty liver disease. J Hepatol. 2004;40(4):578-84.

Wong VW-S, Wong GL-H, Choi PC-L, Chan AW-H, Li MK-P, Chan H-Y, et al. Disease progression of non-alcoholic fatty liver disease: a prospective study with paired liver biopsies at 3 years. Gut. 2010;59(7):969-74.

Lankarani KB, Ghaffarpasand F, Mahmoodi M, Lotfi M, Zamiri N, Heydari ST, et al. Non alcoholic fatty liver disease in southern Iran: a population based study. Hepat Mon. 2013;13(5).

Sohrabpour AA, Rezvan H, Amini-Kafiabad S, Dayhim M, Merat S, Pourshams A. Prevalence of nonalcoholic steatohepatitis in Iran: a population based study. Middle East J Dig. 2010;2(1):14-9.

Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121-9.

Keating SE, Hackett DA, George J, Johnson NA. Exercise and non-alcoholic fatty liver disease: a systematic review and meta-analysis. J Hepatol. 2012;57(1):157-66.

Angulo P, Lindor KD. Treatment of nonalcoholic fatty liver: present and emerging therapies. Semin Liver Dis. 2001;21(1):81-8.

Hajiaghamohammadi AA, Ziaee A, Samimi R. The Efficacy of Licorice Root Extract in Decreasing Transaminase Activities in Non‐alcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial. Phytother Res. 2012;26(9):1381-4.

Hashempur MH, Heydari M, Mosavat SH, Heydari ST, Shams M. Complementary and alternative medicine use in Iranian patients with diabetes mellitus. J Integr Med. 2015;13(5):319-25.

Samani NB, Jokar A, Soveid M, Heydari M, Mosavat SH. Efficacy of the Hydroalcoholic Extract of Tribulus terrestris on the Serum Glucose and Lipid Profile of Women With Diabetes Mellitus: A Double-Blind Randomized Placebo-Controlled Clinical Trial. J Evid Based Complementary Altern Med. 2016;21(4):NP91-7

Hashempur MH, Ghasemi MS, Daneshfard B, Ghoreishi PS, Lari ZN, Homayouni K, et al. Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome: A randomized double-blind placebo-controlled clinical trial. Complement Ther Clin Pract. 2017;26:61-7

Mosavat SH, Marzban M, Bahrami M, Parvizi MM, Hajimonfarednejad M. Sexual headache from view point of Avicenna and traditional Persian medicine. Neurol Sci. 2016:1-4.

Rezaeizadeh H, Alizadeh M, Naseri M, Ardakani MS. The Traditional Iranian Medicine Point of View on Health and disease. Iranian J Publ Health. 2009;38(1):169-72.

Sharifi AR, Homayounfar A, Mosavat SH, Heydari M, Naseri M. Premature ejaculation and its remedies in medieval Persia. Urology. 2016 (90):225-8.

Heyadri M, Hashempur MH, Ayati MH, Quintern D, Nimrouzi M, Mosavat SH. The use of Chinese herbal drugs in Islamic medicine. J Integr Med. 2015;13(6):363-7.

Asadi-Samani M, Kafash-Farkhad N, Azimi N, Fasihi A, Alinia-Ahandani E, Rafieian-Kopaei M. Medicinal plants with hepatoprotective activity in Iranian folk medicine. Asian Pac J Trop Biomed. 2015;5(2):146-57.

Choopani R, Emtiazy M. The concept of lifestyle factors, based on the teaching of avicenna (ibn sina). Int J Prev Med. 2015;6.

Movahhed M, Mosaddegh M, Farsani GM, Abolhasani MH. History of fatty liver in Medieval Iranian Medicine. HealthMED. 2013;7:786-92.

Toosi MN, Ardekani MRS, Minaie MB, Nazim I, Esfahani MM, Khadem E. Fatty liver disease from the perspective of traditional Iranian medicine. Quran Med. 2012;1(4):117-8.

Zarshenas MM, Khademian S, Moein M. Diabetes and related remedies in medieval Persian medicine. Indian J Endocrinol Metab. 2014;18(2):142.

Nimrouzi M, Zare M. Principles of Nutrition in Islamic and Traditional Persian Medicine. J Evid Based Complementary Altern Med. 2014;19(4):267-70.

Hashempur MH, Khademi F, Rahmanifard M, Zarshenas MM. An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia. J Evid Based Complementary Altern Med. 2017:2156587216688597.

Mosavat SH, Ghahramani L, Haghighi ER, Chaijan MR, Hashempur MH, Heydari M. ANORECTAL DISEASES IN AVICENNA'S "CANON OF MEDICINE". Acta Med Hist Adriat. 2015;13 Suppl 2:103-14

Mosavat SH, Ghahramani L, Sobhani Z, Haghighi ER, Chaijan MR, Heydari M. The effect of leek (Allium iranicum (Wendelbo)) leaves extract cream on hemorrhoid patients: A double blind randomized controlled clinical trial. Eur J Integr Med. 2015;7(6):669-73.

Jahromi MM, Pasalar M, Afsharypuor S, Choopani R, Mosaddegh M, Kamalinejad M, et al. Preventive care for gastrointestinal disorders; role of herbal medicines in traditional persian medicine. Jundishapur J Nat Pharm Prod. 2015;10(4).

Gir AG, Namdar H, Emaratkar E, Nazem E, Minaii MB, Nasrabadi A. Avicenna's view on the prevention of thrombosis. Int J Cardiol. 2013;166(1):274-5.

Kordafshari G, Kenari HM, Esfahani MM, Ardakani MRS, Keshavarz M, Nazem E, et al. Nutritional aspects to prevent heart diseases in traditional Persian medicine. J Evid Based Complementary Altern Med. 2015;20(1):57-64.

Alorizi E, Morteza S, Fattahi MR, Saghebi SA, Salehi A, Rezaeizadeh H, et al. Assessment of the impacts of traditional Persian medical schemes and recommendations on functional chronic constipation compared to a classic medicine lactulose, a randomized clinical trial. J Complement Integr Med. 2015;12(4):325-31.

Yamamoto M, Iwasa M, Iwata K, Kaito M, Sugimoto R, Urawa N, et al. Restriction of dietary calories, fat and iron improves non‐alcoholic fatty liver disease. J Gastroenterol Hepatol. 2007;22(4):498-503.

Kazemi R, Aduli M, Sotoudeh M, Malekzadeh R, Seddighi N, Sepanlou SG, et al. Metformin in nonalcoholic steatohepatitis: a randomized controlled trial. Middle East J Dig Dis. 2012;4(1):16.

Farsani GM, Movahhed M, Motlagh AD, Hosseini S, Yunesian M, Farsani TM, et al. Is the Iranian Traditional Medicine warm and cold temperament related to Basal Metabolic Rate and activity of the sympathetic-parasympathetic system? Study protocol. J Diabetes Metab Disord. 2014;13(1):1.

Parvinroo S, Zahediasl S, Sabetkasaei M, Kamalinejad M, Naghibi F. The effects of selected hot and cold temperament herbs based on Iranian traditional medicine on some metabolic parameters in normal rats. Iran J Pharm Res. 2014;13(Suppl):177.

Shahabi S, Hassan ZM, Mahdavi M, Dezfouli M, Rahvar MT, Naseri M, et al. Hot and Cold natures and some parameters of neuroendocrine and immune systems in traditional Iranian medicine: a preliminary study. J Altern Complement Med. 2008;14(2):147-56.

Huang MA, Greenson JK, Chao C, Anderson L, Peterman D, Jacobson J, et al. One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. Am J Gastroenterol. 2005;100(5):1072-81.

Mattar SG, Velcu LM, Rabinovitz M, Demetris AJ, Krasinskas AM, Barinas-Mitchell E, et al. Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann. Surg. 2005;242(4):610-20.

Dixon JB, Bhathal PS, Hughes NR, O'Brien PE. Nonalcoholic fatty liver disease: improvement in liver histological analysis with weight loss. Hepatology. 2004;39(6):1647-54.

Ueno T, Sugawara H, Sujaku K, Hashimoto O, Tsuji R, Tamaki S, et al. Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. J Hepatol. 1997;27(1):103-7.

Hollingsworth K, Abubacker M, Joubert I, Allison M, Lomas D. Low-carbohydrate diet induced reduction of hepatic lipid content observed with a rapid non-invasive MRI technique. Br J Radiol. 2014.

Wong VW-S, Chan RS-M, Wong GL-H, Cheung BH-K, Chu WC-W, Yeung DK-W, et al. Community-based lifestyle modification programme for non-alcoholic fatty liver disease: a randomized controlled trial. J Hepatol. 2013;59(3):536-42.

Ryan MC, Itsiopoulos C, Thodis T, Ward G, Trost N, Hofferberth S, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol. 2013;59(1):138-43.

Sofi F, Casini A. Mediterranean diet and non-alcoholic fatty liver disease: new therapeutic option around the corner. World J Gastroenterol. 2014;20(23):7339-46.

Trovato FM, Catalano D, Martines GF, Pace P, Trovato GM. Mediterranean diet and non-alcoholic fatty liver disease: the need of extended and comprehensive interventions. Clin Nut. 2015;34(1):86-8.

Abenavoli L, Milic N, Peta V, Alfieri F, De Lorenzo A, Bellentani S. Alimentary regimen in non-alcoholic fatty liver disease: Mediterranean diet. World J Gastroenterol. 2014;20(45):16831-40.

Tyrovolas S, Panagiotakos DB. The role of Mediterranean type of diet on the development of cancer and cardiovascular disease, in the elderly: a systematic review. Maturitas. 2010;65(2):122-30.

Ardekani MRS, Rahimi R, Javadi B, Abdi L, Khanavi M. Relationship between temperaments of medicinal plants and their major chemical compounds. J Tradit Chin Med. 2011;31(1):27-31.

Panchal SK, Brown L. Cardioprotective and hepatoprotective effects of ellagitannins from European oak bark (Quercus petraea L.) extract in rats. Eur J Nutr. 2013;52(1):397-408.

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