The effectiveness of the Mediterranean diet (MD) in non-alcoholic fatty liver disease (NAFLD) subjects has been evaluated in several randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to evaluate the overall effects of MD intervention in a cohort of NAFLD patients targeting specific markers such as central obesity, lipid profile, liver enzymes and fibrosis, and intrahepatic fat (IHF). Google Scholar, PubMed, and Scopus were explored to collect relevant studies from the last 10 years. RCTs with NAFLD subjects were included in this systematic review with a mean intervention duration from 6 weeks to 1 year, and different intervention strategies, mainly including energy restriction MD (normal or low glycaemic index), low-fat MD with increased monounsaturated and polyunsaturated fatty acids, and increased exercise expenditure. The outcomes measured in this meta-analysis were gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), total cholesterol (TC), waist circumference (WC), and liver fibrosis. Ten randomized controlled trials, which involved a total of 737 adults with NAFLD, were included. According to the results, the MD seems to decrease the liver stiffness (kPa) by –0.42 (CI95% –0.92, 0.09) (p = 0.10) and significantly reduce the TC by –0.46 mg/dl (CI95% –0.55, −0.38) (p = 0.001), while no significant findings were documented for liver enzymes and WC among patients with NAFLD. In conclusion, the MD might reduce indirect and direct outcomes linked with NAFLD severity, such as TC, liver fibrosis, and WC, although it is important to consider the variations across trials. Further RCTs are necessary to corroborate the findings obtained and provide further evidence on the role of the MD in the modulation of other disorders related to NAFLD.

This systematic review and meta-analysis aimed to evaluate the overall effect of caper fruit on the modulation of glycemic, lipid profile, liver enzymes, and body mass. Google Scholar, PubMed, and Scopus were explored to collect relevant studies in the last 10 years. RCTs with caper fruit supplementation or consumption in different cohorts of subjects with non-alcoholic fatty liver disease (NAFLD), Type-2-Diabetes (T2D), metabolic syndrome, and hyperlipidemia were included in this systematic review with a mean intervention duration from 2 to 12 weeks. The outcomes measured in this meta-analysis were liver enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT), the lipid profile represented by triglycerides, total cholesterol (TC) with LDL and HDL and also, weight, and fasting blood glucose. Five randomized controlled trials, which involved a total of 178 adults, were included. According to the results, caper fruit seems to decrease liver enzymes ALT -12.29 U/L [-24.47, -0.11], AST -2.20 U/L [-4.70, 0.31]. Furthermore, the lipid profile seems to improve with a decrease in triglycerides. -11.89 mg/dL [-33.73, 9.95], LDL -4.80 mg/dL [-16.34, 6.74], HDL 0.72 mg/dL [0.10, 1.34], total cholesterol -7.83 mg/dL [-20.04, 4.38], FPG -17.93 [-42.66, 6.79], weight -1.00 kg [-1.44, -0.56]. Significant modulations were found only for ALT, HDL, and weight. In conclusion, this systematic review and meta-analysis showed the paucity of data available on the topic while showing the potential role of caper fruit as a promising food for improving the liver-lipid profile axis in patients with metabolic syndrome and diabetes. Further studies are required to confirm these results.

Middle Eastern males face unique eating disorder (ED) risks due to cultural transitions from traditional masculine ideals that emphasized functional strength to Western aesthetic standards. Male EDs in Middle Eastern populations constitute an emerging public health concern that has received limited systematic research attention, despite increasing clinical recognition. This systematic review synthesized available epidemiological data on ED prevalence among Middle Eastern males to examine regional patterns and associated risk factors. We conducted a systematic review following PRISMA guidelines by searching PubMed, Scopus, and Google Scholar databases for studies published between 2000 and 2023 that examined EDs in males aged 15 years and above across Middle Eastern countries. Thirteen studies encompassing 5236 male participants from 11 countries met the inclusion criteria. ED prevalence demonstrated substantial variation from 2.2% to 81.4% depending on population and assessment methodology, with Gulf Cooperation Council countries showing consistently higher rates. Age-stratified analysis revealed the highest rates among adolescents aged 15–18 years (mean: 35.0%) compared to adults over 25 years (mean: 2.1%), with university students showing intermediate levels (mean: 29.0%). Muscle dysmorphia emerged as particularly prevalent among bodybuilders (5.7–81.4%), while university students showed rates of 9.7–49.1%. Depression, body dissatisfaction, and cultural transition stress were consistently identified as correlates across multiple populations. These findings underscore late adolescence as a critical risk period and highlight the urgent need for culturally adapted diagnostic tools, healthcare provider training, and region-specific prevention strategies.