The use of very low‐calorie diets in subjects with obesity complicated with nonalcoholic fatty liver disease: A scoping review

Abstract

This scoping review synthesizes the existing research on the use of very low‐calorie diets (VLCDs) in subjects with nonalcoholic fatty liver disease (NAFLD) and end‐stage liver disease (ESLD). 19 studies were included, of which 5 were clinical trials, 11 were cohort studies, 1 was a case‐control study, and 2 were case series totaling 968 subjects. About 17 studies were focused on patients with NAFLD while the two case series described in patients with ESLD on the transplant list or post‐liver transplant. Six studies included subjects managed with VLCDs prior bariatric surgery. Most studies were short term and demonstrated acute improvement of diverse liver biomarkers including liver function tests, indices of hepatosteatosis and reduction in liver size. Adherence rates in these studies were between 69% and 93%. Eight studies did not report any adverse events and four subjects were reported to have discontinued VLCD due to adverse effects in two different studies. Aggregated adverse events were mild. Treatments based on VLCD in subjects with NAFLD seem to be safe and tolerable but can result in mild adverse effects. The findings of this scoping review suggest that the use of VLCD in patients with obesity complicated with NAFLD and potentially in ESLD appear to be effective to induce weight loss and to acutely reduce hepatosteatosis.

Impact of pre-operative weight loss on non-alcoholic fatty liver disease histopathology and insulin resistance in individuals undergoing bariatric surgery: a propensity matched cross-sectional comparison

“…There is extensive evidence detailing the relationship between WL and improvement of NAFLD and IR. [16][17][18][19][20] In the current study, significantly lower blood glucose levels were observed in the WL group, indicating a tendency toward better glycemic metabolism in this group. In addition, lower frequencies of macro-and microvesicular steatosis and portal inflammation were observed in the pre-operative WL group.…”

SICOB-endorsed national Delphi consensus on obesity treatment optimization: focus on diagnosis, pre-operative management, and weight regain/insufficient weight loss approach

“…A systematic review confirmed that VLCD led to a significant weight loss of 2.8 to − 14.8 kg together with liver size reduction (− 5–20% of the initial volume) [ 29 ]. A more recent study comparing the effect of VLCD, and LCD showed that VLCD was more effective in reducing total body weight [ 30 ]. VLCKD demonstrated similar VLCD weight loss results, but with a significant liver volume reduction (5.8 vs. 4.2%) [ 30 ].…”

“…A more recent study comparing the effect of VLCD, and LCD showed that VLCD was more effective in reducing total body weight [ 30 ]. VLCKD demonstrated similar VLCD weight loss results, but with a significant liver volume reduction (5.8 vs. 4.2%) [ 30 ]. The efficacy of liraglutide on weight loss has been demonstrated by the Safety and Clinical Adiposity–Liraglutide Evidence (SCALE) trials.…”

Very low‐calorie ketogenic diet rapidly augments testosterone levels in non‐diabetic obese subjects

“…VLCKD is known to ameliorate liver function, [44][45][46] reducing intrahepatic fat content, 47 and increasing the insulin sensitivity index. 48 In obese patients with T2DM, the reduction in carbohydrate intake has been associated with an early and significant decrease in hepatic triacylglycerol content.…”