title: A low-glycemic-load versus low-fat diet in the treatment of fatty liver in obese children.
abstract: BACKGROUND
  Fatty liver is highly prevalent among obese children and represents a major risk factor for chronic liver diseases and severe metabolic complications.
  
  
  METHODS
  We randomly assigned 17 obese children 8-17 years of age with fatty liver to either an experimental low-glycemic-load or conventional low-fat diet for 6 months. Participants in both groups received nutrition education and behavioral counseling of equal intensity. The primary outcome was hepatic lipid content measured by proton magnetic resonance spectroscopy. Secondary outcomes included change in visceral fat, BMI, anthropometrics, alanine aminotransferase (ALT), and insulin resistance.
  
  
  RESULTS
  A total of 16 participants completed the study. Reported glycemic load decreased in the low-glycemic-load group and reported dietary fat decreased in the low-fat group. At baseline, liver fat was 23.8% [standard deviation (SD) 12.2] in the low-glycemic-load group and 29.3% (14.1) in the low-fat group. Liver fat decreased substantially in both groups at 6 months expressed as absolute percentage change, with no between-group differences [-8.8 (standard error (SE) 4.1) vs. -10.5 (3.7)%, respectively, p=0.76 for group×time interaction]. Secondary outcomes also improved on both diets, with no between-group differences. Baseline and change in ALT were strongly associated with hepatic fat content.
  
  
  CONCLUSIONS
  Weight-reducing diets focused either on glycemic load or dietary fat improved hepatic steatosis over 6 months. Additional research is needed to determine whether these diets differ in effectiveness over the long term.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00480922.
authors.affiliation: New Balance Foundation Obesity Prevention Center, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Marta
authors.initials: M
authors.lastname: Ramon-Krauel
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Salsberg
authors.forename: Cara B
authors.initials: CB
authors.lastname: Ebbeling
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Voss
authors.forename: Robert V
authors.initials: RV
authors.lastname: Mulkern
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Apura
authors.forename: Emily A
authors.initials: EA
authors.lastname: Cooke
authors.forename: Karen
authors.initials: K
authors.lastname: Sarao
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Jonas
authors.forename: David S
authors.initials: DS
authors.lastname: Ludwig
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000410:Alanine Transaminase; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D018752:Diet, Fat-Restricted; D004038:Diet, Reducing; D004040:Dietary Carbohydrates; D005234:Fatty Liver / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat; D008055:Lipids / Q000097:blood*; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D008055:Lipids; D000410:Alanine Transaminase