title: How Much Weight Loss is Effective on Nonalcoholic Fatty Liver Disease?
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide with no specific treatment. Weight loss is the most effective therapeutic strategy in its management; however, there is no consensus on its specifics. Thus, this study was conducted to evaluate the effects of weight loss on liver enzymes, markers of inflammation, oxidative stress and CK18-M30 (cytokeratin 18) as a biomarker of hepatocellular apoptosis.
  
  
  OBJECTIVE
  To study the effect of weight reduction diet as an exclusive treatment for NAFLD.
  
  
  METHODS
  Forty four patients with NAFLD received a diet including a 500 to 1000 kcal per day intake reduction as30% fat, 15% protein, and 55% carbohydrate for six months. Anthropometric parameters, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), lipid profile, malondialdehyde (MDA), TNF-α, IL-6, CK18-M30 were measured at baseline and at the end of the study. At the end of follow up, patients were classified as adherent or nonadherent to treatment according to a weight loss of ≥ 5%, or < 5% of initial body weight, respectively.
  
  
  RESULTS
  Twenty five patients were classified as adherent group and nineteen as nonadherent group (9.7% vs. 1.9% total body weight loss after 6 months, respectively). After 6 months, changes in adherent and nonadherent groups were as follows: reduction in body weight from 93.7 ± 15.8 kg to 84.2 ± 13.4 kg vs. 94 ± 16.6 kg to 92.2 ± 16.2 kg (P < 0.05), BMI from 32.7 ± 3.9 to 29.5 ± 3.2 vs.31.8 ± 5.4 to 31.1 ± 5.3 (P < 0.001), and waist circumference from 105.1 ± 12.6 cm to 97.4 ± 9.8 cm vs.106.8 ± 14.2 cm to 103.7 ± 14 cm (P < 0.001), respectively. Diastolic blood pressure was significantly decreased in adherent group (from 80.2 ± 5.1 mmHg to 76.9 ± 5 mmHg; P < 0.001). Also, total cholesterol, LDL, triglyceride, ALT, AST, GGT and CK18-M30 levels were significantly decreased in the adherent group compared to nonadherent group (P < 0.05).
  
  
  CONCLUSIONS
  This intervention offers a practical approach for treatment of patients with NAFLD with diet therapy.
authors.affiliation: Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghaemi
authors.affiliation: Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Fourugh Azam
authors.initials: FA
authors.lastname: Taleban
authors.affiliation: Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Azita
authors.initials: A
authors.lastname: Hekmatdoost
authors.affiliation: Molecular and Cell Biology Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Rafiei
authors.affiliation: Inflammatory Diseases of Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Hosseini
authors.affiliation: Department of Basic Sciences, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Amiri
authors.affiliation: Department of Basic Sciences, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Homayounfar
authors.affiliation: Inflammatory Diseases of Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Hafez
authors.initials: H
authors.lastname: Fakheri
keywords: Diet; Nonalcoholic Fatty Liver Disease; Weight Loss