Low fat diet versus low carbohydrate diet for management of non-alcohol fatty liver disease: A systematic review

Abstract

Although there is a consensus on beneficial effects of a low calorie diet in management of non-alcoholic fatty liver disease, the optimal composition of diet has not yet been elucidated. The aim of this review is to summarize the results of current randomized controlled trials evaluating the effects of low fat diet (LFD) vs. low carbohydrate diet (LCD) on NAFLD. This is a systematic review of all the available data reported in published clinical trials up to February 2022. The methodological quality of eligible studies was assessed, and data were presented aiming specific standard measurements. A total of 15 clinical trial studies were included in this systematic review. There is an overall lack of consensus on which dietary intervention is the most beneficial for NAFLD patients. There is also an overall lack of consensus on the definition of the different restrictive diets and the percentage of macronutrient restriction recommended. It seems that low calorie diets, regardless of their fat and carbohydrate composition, are efficient for liver enzyme reduction. Both LCD and LFD have similar effects on liver enzymes change; however, this improvement tends to be more marked in LFD. All calorie restrictive dietary interventions are beneficial for reducing weight, liver fat content and liver enzymes in individuals with NAFLD. Low fat diets seem to be markedly successful in reducing transaminase levels. Further research is needed to explore diet intensity, duration and long-term outcome.

Non-Pharmacological Approach to Diet and Exercise in Metabolic-Associated Fatty Liver Disease: Bridging the Gap between Research and Clinical Practice

“…However, no significant improvements in BMI, blood pressure, fasting blood glucose (FBG), or C-reactive protein (CRP) levels were observed. A recent metaanalysis pooling five studies failed to demonstrate differences in H-MRS measurements, weight loss, intrahepatic fat levels, or liver enzyme levels such as AST and ALT [85]. Nonetheless, individual studies showed significant effects of both diets on MASLD compared to a standard diet [86].…”

Management of metabolic-associated fatty liver disease: The diabetology perspective

“…Various nutritional interventions targeting a weight loss ≥ 5% has shown to be effective in the management of MAFLD[ 14 , 23 , 24 ]. Aim of all forms of nutritional interventions for MAFLD is to reduce the proportion of macronutrient content of the diet to achieve total energy deficit by restricting intake of simple carbohydrates, saturated fat, and added sugars, along with adoption of healthier eating options like a Mediterranean diet.…”

Effects of low fat diet on inflammatory parameters in individuals with obesity/overweight and non-alcoholic fatty liver disease: A cross-sectional study

“…[ 13 , 15 ] A systematic review assessing randomized controlled trials found that low-fat diet appears to be more successful in reducing in transaminase levels in NAFLD. [ 16 ] The recommended dietary intake of fatty acids for adults should be 20% to 35% of daily energy intake. [ 13 ] However, this ratio is approximately 40% of daily energy intake on Western-type diets.…”