title: Effect of 6-month nutritional intervention on non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  We evaluated the effect of diet therapy as exclusive treatment on insulin resistance, biochemical parameters of metabolic syndrome, and degree of hepatic steatosis in patients with non-alcoholic fatty liver disease.
  
  
  METHODS
  Thirty-one patients with non-alcoholic fatty liver disease received a diet with a reduction of 500 to 1000 cal/d, containing 15% protein, 55% carbohydrates, and 30% fat, for 6 mo. At entry and 6 mo after dietary instructions, degrees of hepatic steatosis and visceral obesity were assessed by computed tomography; serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured by automated methods. Body mass index, waist circumference, waist-to-hip ratio, and food intake (7-d diary) were also evaluated. At the end of follow-up, the patients were classified as adherent or non-adherent to treatment according to a weight loss of more or less than 5% of initial body weight, respectively.
  
  
  RESULTS
  Seventeen patients were classified as adherent (group 1) and 14 as non-adherent (group 2). Group 2 only presented a significant reduction in body mass index and waist circumference. In contrast, in group 1, in addition to significant improvement of all anthropometric parameters, a significant reduction was observed in alanine aminotransferase and γ-glutamyl transferase levels, homeostasis model assessment for insulin resistance, visceral fat and tomographic liver density, together with an increase in serum high-density lipoprotein cholesterol levels. These patients presented a significant decrease in total energy intake and in total and saturated fats.
  
  
  CONCLUSIONS
  Nutritional intervention as exclusive treatment, with a loss of at least 5% of initial weight, is effective in the treatment of non-alcoholic fatty liver disease.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, Federal University of São Paulo, São Paulo, Brazil. crisepm@yahoo.com.br
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Elias
authors.forename: Edison Roberto
authors.initials: ER
authors.lastname: Parise
authors.forename: Luciana
authors.initials: L
authors.lastname: de Carvalho
authors.forename: Denis
authors.initials: D
authors.lastname: Szejnfeld
authors.forename: João Prola
authors.initials: JP
authors.lastname: Netto
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D004038:Diet, Reducing; D005234:Fatty Liver / Q000097:blood / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D010349:Patient Compliance; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL