Hypocaloric high-protein diet improves clinical and biochemical markers in patients with nonalcoholic fatty liver disease (NAFLD).
OBJECTIVE
To investigate the role of hypocaloric highprotein diet, a prospective clinical study was conducted in NAFLD patients.


METHODS
Pre-versus post-interventional data were analyzed in 48 stable NAFLD patients (submitted to a hypocaloric high-protein diet during 75 days. Variables included anthropometrics (body mass index/ BMI and waist circumference/WC), whole-body and segmental bioimpedance analysis and biochemical tests. Diet compliance was assessed by interviews every two weeks.


RESULTS
BMI, WC and body fat mass remained relatively stable (-1.3%, -1.8% and -2.5% respectively, no significance). HDL- cholesterol increased (P < 0.05) whereas total, LDL and VLDL cholesterol, triglycerides, aspartate aminotransferase/ AST, gamma glutamyltransferase/GGT, alkaline phosphatase/ AP, fasting blood glucose and glycated hemoglobin/ HbA1c decreased (P < 0.05). When patients were stratified according to increase (22/48, 45.8%) and decrease (21/48, 43.8%) of BMI, association between weight decrease and liver benefit could be elicited in such circumstances for ALT, AP and AST/ALT ratio. No change could be demonstrated in patients who gained weight. Multivariate assessment confirmed that waist circumference, ferritin, triacylglycerol, and markers of glucose homeostasis were the most relevant associated with liver enzymes.


CONCLUSIONS
Ours results are consistent with the literature of calorie restriction in the management of NAFLD. Changes in lifestyle and weight loss are recommended for NAFLD patients. European guidelines also support this recommendation.


CONCLUSIONS
This is the first study that demonstrated that a high protein, hypocaloric diet were associated with improvement of lipid profile, glucose homeostasis and liver enzymes in NAFLD independent on BMI decrease or body fat mass reduction.
University of São Paulo School of Medicine. Department of Gastroenterology. Clinical Division. Hepatology Branch (LIM-07).. cpm@usp.br.
Sebastião Mauro
SM
Bezerra Duarte
Joel
J
Faintuch
José Tadeu
JT
Stefano
Maria Beatriz
MB
Sobral de Oliveira
Daniel Ferraz
DF
de Campos Mazo
Fabiola
F
Rabelo
Denise
D
Vanni
Monize Aydar
MA
Nogueira
Flair José
FJ
Carrilho
Claudia Pinto
CP
Marques Souza de Oliveira
D050154:Adiposity; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D031204:Caloric Restriction; D004038:Diet, Reducing; D004044:Dietary Proteins / Q000008:administration & dosage*; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000178:diet therapy* / Q000378:metabolism*; D011446:Prospective Studies; D016896:Treatment Outcome
D004044:Dietary Proteins