Effect of 6-month nutritional intervention on non-alcoholic fatty liver disease

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2010-11, Vol.26 (11), p.1094-1099
• Main Authors: Elias, Maria Cristina, M.S, Parise, Edison Roberto, M.D., Ph.D, Carvalho, Luciana de, Ph.D, Szejnfeld, Denis, M.D, Netto, João Prola, M.D
• Format: Article
• Language: English
• Subjects: Adiposity; Adult; alanine transaminase; anthropometric measurements; aspartate transaminase; Biological and medical sciences; biopsy; Body Mass Index; Body weight; Carbohydrates; Cholesterol; Cholesterol, HDL - blood; Computed tomography; Diet; diet therapy; Diet, Reducing; Disease; Fatty acids; fatty liver; Fatty Liver - blood; Fatty Liver - diagnostic imaging; Fatty Liver - diet therapy; Fatty Liver - physiopathology; Feeding. Feeding behavior; Female; food intake; food records; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; histopathology; Humans; Insulin Resistance; Liver; Liver - physiopathology; Male; Metabolic disorders; metabolic syndrome; Metabolic Syndrome - physiopathology; Middle Aged; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Nutrition therapy; nutritional intervention; Obesity; Obesity, Abdominal - blood; Obesity, Abdominal - diet therapy; Obesity, Abdominal - physiopathology; Patient Compliance; patients; Tomography, X-Ray Computed; Vertebrates: anatomy and physiology, studies on body, several organs or systems; visceral fat; Waist Circumference; Weight control; Weight Loss
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2009.09.001

Abstract Objective We evaluated the effect of diet therapy as exclusive treatment on insulin resistance, biochemical parameters of metabolic syndrome, and degree of hepatic steatosis in patients with non-alcoholic fatty liver disease. Methods Thirty-one patients with non-alcoholic fatty liver disease received a diet with a reduction of 500 to 1000 cal/d, containing 15% protein, 55% carbohydrates, and 30% fat, for 6 mo. At entry and 6 mo after dietary instructions, degrees of hepatic steatosis and visceral obesity were assessed by computed tomography; serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured by automated methods. Body mass index, waist circumference, waist-to-hip ratio, and food intake (7-d diary) were also evaluated. At the end of follow-up, the patients were classified as adherent or non-adherent to treatment according to a weight loss of more or less than 5% of initial body weight, respectively. Results Seventeen patients were classified as adherent (group 1) and 14 as non-adherent (group 2). Group 2 only presented a significant reduction in body mass index and waist circumference. In contrast, in group 1, in addition to significant improvement of all anthropometric parameters, a significant reduction was observed in alanine aminotransferase and γ-glutamyl transferase levels, homeostasis model assessment for insulin resistance, visceral fat and tomographic liver density, together with an increase in serum high-density lipoprotein cholesterol levels. These patients presented a significant decrease in total energy intake and in total and saturated fats. Conclusion Nutritional intervention as exclusive treatment, with a loss of at least 5% of initial weight, is effective in the treatment of non-alcoholic fatty liver disease.