Holmer M, et al. Abstract: OS-1627. Presented at: The International Liver Congress; June 23-26 (virtual meeting).
Low-carb high-fat, intermittent fasting diets reduce more hepatic steatosis in NAFLD
Researchers saw higher reduction in steatosis and body weight with the low-carb high-fat and 5:2 diets compared with the standard of care in patients with nonalcoholic fatty liver disease, according to a presentation at the International Liver Congress.
“5:2 and [low-carb high-fat (LCHF)] diets were equally effective for short-term reduction of liver steatosis, body weight and measured insulin resistance in NAFLD,” Magnus Holmer, MD, from the department of medicine at the Karolinska Institute in Stockholm, Sweden, said during his presentation. “From the strong correlation between reduction of liver steatosis and body weight, we conclude that weight reduction itself and not the composition of macronutrients that is crucial for successful diet treatment in NAFLD.”
Holmer and colleagues performed an open-label trial of 74 patients with NAFLD and randomly assigned patients to a 12-week treatment program with either low-carb high-fat diet, 5:2 diet with energy intake restricted to less than 500/600 kcal on two non-consecutive days per week alternated with days with an intake of 2,000/2,400 kcal, or standard of care. Reduction of hepatic steatosis measured with MR spectroscopy served as the main outcome.
“The standard of care group received oral and written instruction on how to choose a healthy diet based on the Nordic nutrition recommendations,” he said. “They received general advice on how to control energy intake, but they were not instructed to follow a specific caloric restriction.”
Results showed that compared with standard of care, the low-carb high-fat diet and 5:2 diet were superior in reducing steatosis. Investigators noted the low-carb high-fat and 5:2 diets were more effective in reducing body weight (low-carb high-fat diet –7.3 kg vs. 5:2 –7.4 kg vs. standard of care –2.5 kg).
Holmer and colleagues said no different was observed between the 5:2 and low-carb high-fat diets regarding steatosis (P = .41) or body weight (P = .78). Liver stiffness improved with the 5:2 diet (–1.8 kPa; P < .001) and standard of care (–1.5 kPa, P = .005); however, not with the low-carb high-fat diet (–0.3 kPa, P = .52).
According to researchers, LDL levels decreased in the 5:2 diet group (–0.4 mmol/L, P < .001). They observed higher LDL in the low-carb high-fat diet group (+0.2 mmol/L, P = .075).