Short-Term Hypocaloric High-Fiber and High-Protein Diet Improves Hepatic Steatosis Assessed by Controlled Attenuation Parameter

Abstract

OBJECTIVES:Non-alcoholic fatty liver disease is one of the most prevalent liver diseases and increases the risk of fibrosis and cirrhosis. Current standard treatment focuses on lifestyle interventions. The primary aim of this study was to assess the effects of a short-term low-calorie diet on hepatic steatosis, using the controlled attenuation parameter (CAP) as quantitative tool.METHODS:In this prospective observational study, 60 patients with hepatic steatosis were monitored during a hypocaloric high-fiber, high-protein diet containing 1,000 kcal/day. At baseline and after 14 days, we measured hepatic fat contents using CAP during transient elastography, body composition with bioelectrical impedance analysis, and serum liver function tests and lipid profiles using standard clinical–chemical assays.RESULTS:The median age was 56 years (25–78 years); 51.7% were women and median body mass index was 31.9 kg/m2 (22.4–44.8 kg/m2). After 14 days, a significant CAP reduction (14.0% P<0.001) was observed from 295 dB/m (216–400 dB/m) to 266 dB/m (100–353 dB/m). In parallel, body weight decreased by 4.6% (P<0.001), of which 61.9% was body fat. In addition, liver stiffness (P=0.002), γ-GT activities, and serum lipid concentrations decreased (all P<0.001).CONCLUSIONS:This study shows for the first time that non-invasive elastography can be used to monitor rapid effects of dietary treatment for hepatic steatosis. CAP improvements occur after only 14 days on short-term low-calorie diet, together with reductions of body composition parameters, serum lipids, and liver enzymes, pointing to the dynamics of hepatic lipid turnover.

Hepatic steatosis in patients with acromegaly

“…Interestingly, we and others have shown that lifestyle interventions appear to be more effective in carriers of the PNPLA3 risk allele when compared to noncarriers, as evidenced in several studies. 34,35 We did not find differences in CAP values based on the TM6SF2 and MBOAT7 genotypes; however, a trend for higher CAP was observed based on the presence of risk alleles. This finding is in line with recent research supporting a stronger role of PNPLA3 as compared to TM6SF2 and MBOAT7 genotypes in terms of severity of hepatic-related injury.…”

“…32 Moreover, the PNPLA3 gene has been associated with increased risk of cardiovascular disease in the setting of type II diabetes. 34, 35 We did not find differences in CAP values based on the TM6SF2 and MBOAT7 genotypes; however, a trend for higher CAP was observed based on the presence of risk alleles. Interestingly, we and others have shown that lifestyle interventions appear to be more effective in carriers of the PNPLA3 risk allele when compared to noncarriers, as evidenced in several studies.…”

Dietary fibre alleviates hepatic fat deposition via inhibiting lipogenic gene expression in meat ducks

“…Furthermore, a supplement of 5% guar gum in rat diets significantly reduced liver weight and lipid concentrations (Brockman, Chen, & Gallaher, ). It was this role of DF that has been shown to be beneficial for liver health (Arslanow et al., ; Reimer et al., ). This standpoint was also supported by our results, in which serum AST and ALT concentrations, indicators of liver health, were reduced by DF, thereby suggesting an improved liver health with increasing DF.…”

Nutritional Approaches to Achieve Weight Loss in Nonalcoholic Fatty Liver Disease

“…The FGF21 receptor then decreases serum FFAs by inhibiting visceral adipose from undergoing further lipolysis, inhibiting further hepatic TG synthesis, and promoting FFA oxidation and ketogenesis (90). Another smaller prospective study of 60 patients showed that a hypocaloric (1000 kcal/d) high-protein diet (41% protein, 29% carbohydrate, 24% fat, and 6% fiber) decreased liver stiffness, alkaline phosphatase, g-glutamyl transferase, lipid concentrations, and controlled attenuation parameters, or measurements of hepatic steatosis through transient elastography, by 14.0% (P < 0.001) (91). Thus, these studies are promising, but participants were only given a high-protein diet for short duration of time.…”