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. 2016 Jun 16;7(6):e176.
doi: 10.1038/ctg.2016.28.

Short-Term Hypocaloric High-Fiber and High-Protein Diet Improves Hepatic Steatosis Assessed by Controlled Attenuation Parameter

Anita Arslanow  1 , Melanie Teutsch  2 , Hardy Walle  2 , Frank Grünhage  1 , Frank Lammert  1 , Caroline S Stokes  1
Affiliations

Short-Term Hypocaloric High-Fiber and High-Protein Diet Improves Hepatic Steatosis Assessed by Controlled Attenuation Parameter

Anita Arslanow et al. Clin Transl Gastroenterol. .

Abstract

Objectives: Non-alcoholic fatty liver disease is one of the most prevalent liver diseases and increases the risk of fibrosis and cirrhosis. Current standard treatment focuses on lifestyle interventions. The primary aim of this study was to assess the effects of a short-term low-calorie diet on hepatic steatosis, using the controlled attenuation parameter (CAP) as quantitative tool.

Methods: In this prospective observational study, 60 patients with hepatic steatosis were monitored during a hypocaloric high-fiber, high-protein diet containing 1,000 kcal/day. At baseline and after 14 days, we measured hepatic fat contents using CAP during transient elastography, body composition with bioelectrical impedance analysis, and serum liver function tests and lipid profiles using standard clinical-chemical assays.

Results: The median age was 56 years (25-78 years); 51.7% were women and median body mass index was 31.9 kg/m(2) (22.4-44.8 kg/m(2)). After 14 days, a significant CAP reduction (14.0%; P<0.001) was observed from 295 dB/m (216-400 dB/m) to 266 dB/m (100-353 dB/m). In parallel, body weight decreased by 4.6% (P<0.001), of which 61.9% was body fat. In addition, liver stiffness (P=0.002), γ-GT activities, and serum lipid concentrations decreased (all P<0.001).

Conclusions: This study shows for the first time that non-invasive elastography can be used to monitor rapid effects of dietary treatment for hepatic steatosis. CAP improvements occur after only 14 days on short-term low-calorie diet, together with reductions of body composition parameters, serum lipids, and liver enzymes, pointing to the dynamics of hepatic lipid turnover.

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Figures

Figure 1
Figure 1
Flow chart of study recruitment and participation.
Figure 2
Figure 2
Changes of CAP in all 60 patients. (a) Median and individual CAP at baseline and follow-up at the end of the dietary intervention. The median CAP reduction was 47 dB/m in the entire cohort, corresponding to a relative median reduction of 14.0% (P<0.001). (b) Absolute CAP in the individual patients during the dietary intervention.
Figure 3
Figure 3
Summary of significant reductions of key parameters assessed during the dietary intervention. The values are displayed as medians, interquartile range, and ordered based on the extent of reduction. BFM, body fat mass; BMI, body mass index; CAP, controlled attenuation parameter; DBP, diastolic blood pressure; FLI, fatty liver index; γ-GT, gamma-glutamyl transferase; LDL-C, low-density lipoprotein cholesterol; LSM, liver stiffness measurement; SBP, systolic blood pressure; TC, total cholesterol; TG, triglycerides; VFI, visceral fat index; WC, waist circumference.
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