Author (year); country | Intervention | Age range; sample size (% male) | Study duration | Outcome measures | Changes to outcome measures postintervention |
---|---|---|---|---|---|
Yamamoto (2007);21 Japan | Low calorie (126 kJ/kg/d), low fat (20%), low iron (≤6 mg/d) and 1.1–1.2 g/kg/d protein | 37–74; 27 (52%) | 6 months | Primary: AST, ALT Other: WT, BMI, TG, TC, GLC, Iron, FER, TS | Primary: ↓ AST* ↓ ALT* ↓ WT* (4.8%) and ↓ BMI* |
Lin (2009);20 Taiwan | VLCD of 450 kcal/day or 800 kcal/day | 18–65; 132 (34%) | 12 weeks | Primary: NAFLD (ultrasound) resolution and improvement Other: WT, BMI, WC, FM, GLC, BP, TG | 95 completed trial; NAFLD resolved in 5 cases (450 kcal group) and 10 cases (800 kcal group) NAFLD improved in 17 cases (450 kcal group) and 21 cases (800 kcal group) ↓ WT* 9.14% (450 kcal/day), ↓ 8.98% (800 kcal/day), and ↓ BMI* |
De Luis (2010);22 Spain | Low fat, low calorie (1500 kcal/day, 27% fat/53% CHO) or low CHO, low calorie diet (1507 kcal/day, 38% CHO/36% fat) | 29–64; 162 (29%) | 3 months | Primary: AST, ALT Other: WT, BMI, BP, TC, HDL, LDL, TG, FM, WC, WHR, GLC, INS, HOMA | Low fat (NAFLD):
|
Browning (2011);23 USA | Low CHO (<20 g/d) or low calorie (1200–1500 kcal/d) | 33–57; 18 (27%) | 2 weeks | Primary: IHTG (MRS), AST, ALT Other: WT, BMI, TC, TG, GLC | ↓ IHTG* 28% (low cal), 55% (low CHO); ↓ AST*; ↑ ALT§ ; ↓ BMI* ↓ WT* (4.2% low cal and 4.7% low CHO) and ↓ BMI* |
Kani (2014);24 Iran | Calorie restriction (200–500 kcal/day; 55% CHO, 15% protein, 30% fat) Calorie restriction, low CHO (45% CHO, 20% protein, 35% fat) Calorie restriction, low CHO + 30 g soy protein | 43–52; 45 (46%) | 8 weeks | Primary: AST, ALT Other: WT, BMI, INS, TG, TC, HDL, LDL, ALP, FIB, MDA | ↓ AST* and ALT* in all groups; greatest reduction seen in the soy group. All diets saw ↓ WT*: 3.9%, 4.2%, 4.7%, respectively and ↓ BMI* |
Razavi Zade (2016);25 Iran | Calorie restriction (350–700 kcal) or Calorie restriction and DASH diet (rich in fruit, veg, whole grains and low fat dairy; low in saturated fats, cholesterol and sugar) | 25–75; 60 (50%) | 8 weeks | Primary: Steatosis grade (ultrasound), AST, ALT Other: WT, VLDL, LDL, HDL | Steatosis grade improved on both diets; more cases improved on DASH (80% vs 43%)* ↓ AST* ↓ ALT* with DASH not low cal ↓ WT* ( 3.0% low cal and 4.6% DASH) |
*Statistically significant; §No statistical difference.
ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index (kg/m2); BP, blood pressure; CHO, carbohydrate; DASH, dietary approaches to stop hypertension; FER, ferritin; FIB, serum fibrinogen; FM, fat mass; GLC, glucose; HDL, high-density lipoprotein; HOMA, Homeostasis Model Assessment; IHTG, intrahepatic triglyceride; INS, insulin; LDL, low-density lipoprotein; MDA, malondialdehyde; MRS, magnetic resonance spectroscopy; NAFLD, non-alcoholic fatty liver disease; NMR, nuclear magnetic resonance; TC, total cholesterol; TG, triglyceride; TS, transferrin saturation; VLCD, very low calorie diet; VLDL, very low density lipoprotein; WC, waist circumference; WHR = waist:hip ratio; WT, weight.