Non-alcoholic Fatty Liver Disease and Carbohydrate Restricted Diets: A Case Report and Literature Review

Abstract

Non-alcoholic fatty liver disease is the accumulation of excessive fat in the liver. Various treatment options are available to manage the condition, among which carbohydrate restriction has been shown to reduce liver fat accumulation, liver inflammation, serum liver enzyme levels, and hepatic de-novo lipogenesis in people with non-alcoholic fatty liver disease. Here, we present a case report of a 25-year-old South Asian patient presenting with right upper quadrant pain, fatigue, and headaches. After confirmation of non-Alcoholic fatty liver disease (NAFLD) diagnosis by biopsy, the patient initiated a low-carbohydrate diet. Four months after which significant improvement was noticed in clinical and laboratory parameters. Peer-reviewed publications were then sourced from online databases to explore the efficacy of low-carbohydrate diets for NAFLD. Our results were compared with the existing data. However, limited literature existed for such an intervention in the South Asian population therefore, the case report is novel. Combined with findings from the literature, our results from the case report supported our hypothesis that carbohydrate restriction might promote a reduction in hepatic fat accumulation and inflammation in patients with NAFLD and diabetes in various ethnicities including South Asians.

A Review on the Role of Low Glycemic Index Foods for Glycemic Control in Chronic Liver Disease

“…Carbohydrates are the basic diet in people with cirrhosis, covering up to 50% -60% of their non-protein daily needs, hence foods rich in complex carbohydrates must be considered [42]. Abstain, to reduce risk for comorbidity and to improve liver biochemistry and histology beans, legumes and whole grains along with fiber intake of at least 25 gm improves insulin resistance and hepatic steatosis [43]. Carbohydrate restriction in patients with NAFLD reduces liver inflammation, hepatic fat accumulation, liver enzyme levels and hepatic de novo lipogenesis [43].…”

“…Abstain, to reduce risk for comorbidity and to improve liver biochemistry and histology beans, legumes and whole grains along with fiber intake of at least 25 gm improves insulin resistance and hepatic steatosis [43]. Carbohydrate restriction in patients with NAFLD reduces liver inflammation, hepatic fat accumulation, liver enzyme levels and hepatic de novo lipogenesis [43]. Another major macronutrient is protein that provides 10% -15% of total calories along with the 20 naturally occurring amino acids, including 9 essential amino acids [44].…”