Can Diet Help Non-Obese Individuals with Non-Alcoholic Fatty Liver Disease (NAFLD)?

Abstract

Subjects diagnosed with non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis are usually obese or overweight. NAFLD has also been reported in many non-obese healthy subjects as an incidental finding during imaging. Subjects with early-stage NAFLD who are otherwise healthy are often left unmanaged in current clinical practice; it is not clear if an early intervention in those individuals would be of any benefit in preventing NAFLD progression to more serious conditions. Since many of these subjects are non-alcoholic and have a normal body mass index (BMI), an intensive lifestyle change program is not usually recommended. This report presents an otherwise healthy non-alcoholic subject with incidental NAFLD having a normal BMI and a waist circumference below 90 cm who successfully reversed his condition by undertaking a lifestyle intervention. The case report is expected to encourage large cohort studies to substantiate the benefits of dietary interventions in alleviating hepatic steatosis among non-obese individuals.

Effect of weight reduction on histological activity and fibrosis of lean nonalcoholic steatohepatitis patient

“…described that like obese NAFLD patients, lean NAFLD patients can get benefits in dietary modification as well as weight reduction strategy. [16] This data is also supported by another study that concluded that change in the body weight is a potent independent issue for both the development and regression of NAFLD in non-obese individuals, regardless of baseline BMI. [17] As none of the study focused on the benefits of weight reduction on histological activity in patients with lean NASH, the study was focused to explore the effect of weight reduction strategy in lean NASH individuals.…”

“…Therefore, diet and lifestyle modification, with weight reduction remains the mainstay of treatment in these patients. [16,22] Previous studies testing the effectiveness of lifestyle modification in NAFLD have found that 7 to 10% weight loss is accompanied by a remarkable normalization of liver enzymes and a systematic reduction of liver fat. [29] But, no previous study tested the effect of weight reduction on non-obese lean NASH patients.…”

“…have shown that weight reduction of more than 7% sustained over 48 weeks is associated with a significant reduction in the histological severity of obese NASH patients. [16] Vilar-Gomez et al . found that a 10% reduction in weight over 52 weeks was associated with the highest reduction in NAS reduction, NASH resolution and fibrosis regression in non-lean NASH.…”

Effect of a moderately carbohydrate-restricted diet on liver enzymes, steatosis and fibrosis in normal-weight individuals with non-alcoholic fatty liver disease: study protocol for a parallel randomised controlled clinical trial

“…In addition, other studies have found that high fructose intake is linked to fatty liver disease via gut microbiota changes in NAFLD patients of normal weight 37. Given the importance of dietary carbohydrates in the aetiology of NAFLD, we hypothesised that restricting carbohydrate intake without reducing calorie intake might be an appropriate strategy in patients with normal weight 10–12. Although several studies have examined the effects of macronutrient manipulation among patients with NAFLD,38 39 we are aware of no study that evaluated the effects of a moderate carbohydrate-restricted diet, without weight loss, in normal-weight individuals with NAFLD.…”

“…The main effective strategy for management of NAFLD is weight loss 9. Given the key role of dietary carbohydrates in the development of NAFLD, it seems that a moderate restriction of carbohydrates, even without inducing any significant weight loss, might improve the fat content of the liver in normal-weight individuals with NAFLD 10–12. Earlier evidence has shown the efficacy of this dietary pattern in controlling inflammation and other metabolic abnormalities.…”