title: Impact of Hypocaloric Hyperproteic Diet on Gut Microbiota in Overweight or Obese Patients with Nonalcoholic Fatty Liver Disease: A Pilot Study.
abstract: NAFLD is likely to become the most common cause of chronic liver disease. The first-line treatment includes weight loss.
  
  
  
  To analyze the impact of a hypocaloric hyperproteic diet (HHD) on gut microbiota in NAFLD patients.
  
  
  
  Fifteen overweight/obese patients with NAFLD were included. At baseline and after a 3-week HHD (Eurodiets(®), ~1000 kcal/day, ~125 g protein/day), we measured gut microbiota composition and function by shotgun metagenomics; body weight; body composition by bioelectrical impedance analysis; liver and visceral fat by magnetic resonance imaging; plasma C-reactive protein (CRP); and liver tests. Results between both time points, expressed as median (first and third quartile), were compared by Wilcoxon signed-rank tests.
  
  
  
  At baseline, age was 50 (47-55) years and body mass index 34.6 (32.4, 36.7) kg/m(2). HDD decreased body weight by 3.6 % (p < 0.001), percent liver fat by 65 % (p < 0.001), and CRP by 19 % (p = 0.014). HDD was associated with a decrease in Lachnospira (p = 0.019), an increase in Blautia (p = 0.026), Butyricicoccus (p = 0.024), and changes in several operational taxonomic units (OTUs) of Bacteroidales and Clostridiales. The reduced liver fat was negatively correlated with bacteria belonging to the Firmicutes and Bacteroidetes phyla (a Ruminococcaceae OTU, r = -0.83; Bacteroides, r = -0.73). The associated metabolic changes concerned mostly enzymes involved in amino acid and carbohydrate metabolism.
  
  
  
  In this pilot study, HHD changes gut microbiota composition and function in overweight/obese NAFLD patients, in parallel with decreased body weight, liver fat, and systemic inflammation. Future studies should aim to confirm these bacterial changes and understand their mode of action.
  
  
  
  Under clinicaltrials.gov: NCT01477307.
authors.affiliation: Service of Therapeutic Education for Chronic Diseases, WHO Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. zoltan.pataky@hcuge.ch.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Pataky
authors.affiliation: Clinical Nutrition, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Laurence
authors.initials: L
authors.lastname: Genton
authors.affiliation: Gastroenterology and Hepatology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Spahr
authors.affiliation: Genomic Research Lab, Infectious Diseases, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Lazarevic
authors.affiliation: Radiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Terraz
authors.affiliation: Genomic Research Lab, Infectious Diseases, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Nadia
authors.initials: N
authors.lastname: Gaïa
authors.affiliation: Clinical Pathology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Rubbia-Brandt
authors.affiliation: Service of Therapeutic Education for Chronic Diseases, WHO Collaborating Centre, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: Alain
authors.initials: A
authors.lastname: Golay
authors.affiliation: Genomic Research Lab, Infectious Diseases, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Schrenzel
authors.affiliation: Clinical Nutrition, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001439:Bacteroides / Q000235:genetics; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D002097:C-Reactive Protein / Q000378:metabolism; D031204:Caloric Restriction; D002784:Cholesterol / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D002965:Classification; D000068016:Eubacteriales / Q000235:genetics; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000032:analysis; D004044:Dietary Proteins / Q000627:therapeutic use*; D017097:Electric Impedance; D005260:Female; D000069196:Gastrointestinal Microbiome / Q000235:genetics*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D056186:Metagenomics; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000178:diet therapy* / Q000378:metabolism / Q000382:microbiology; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism / Q000382:microbiology; D050177:Overweight / Q000178:diet therapy / Q000378:metabolism / Q000382:microbiology; D010865:Pilot Projects; D011446:Prospective Studies; D017422:Sequence Analysis, DNA; D014280:Triglycerides / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004269:DNA, Bacterial; D004044:Dietary Proteins; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Fatty liver disease; Gut; Hypocaloric hyperproteic diet; Microbiota; Obesity