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Randomized Controlled Trial
. 2019 Aug 2;9(1):11232.
doi: 10.1038/s41598-019-47763-8.

A Randomised Controlled Trial on the Effectiveness and Adherence of Modified Alternate-day Calorie Restriction in Improving Activity of Non-Alcoholic Fatty Liver Disease

Muhammad Izzad Johari  1 , Khairiah Yusoff  1 , Juhara Haron  1 , Chandran Nadarajan  1 , Khairun Nisah Ibrahim  2   3 , Mung Seong Wong  1 , Muhammad Ilham Abdul Hafidz  1 , Bee Eng Chua  2 , Nurhazwani Hamid  1 , Wan Nor Arifin  1 , Zheng Feei Ma  1 , Yeong Yeh Lee  4
Affiliations
Randomized Controlled Trial

A Randomised Controlled Trial on the Effectiveness and Adherence of Modified Alternate-day Calorie Restriction in Improving Activity of Non-Alcoholic Fatty Liver Disease

Muhammad Izzad Johari et al. Sci Rep. .

Erratum in

Abstract

Currently, there is no effective therapy for non-alcoholic fatty liver disease (NAFLD), although intensive calorie restriction is typically recommended but dietary adherence is an issue. The current study aimed to determine the effectiveness and adherence of eight weeks of modified alternate-day calorie restriction (MACR) in the control of NAFLD activity. This was a randomized controlled trial with MACR as the intervention and normal habitual diet as control. The outcome measures were body mass index (BMI), blood lipids, fasting blood sugar (FBS), liver enzymes (ALT and AST), and ultrasonographic measurements of liver steatosis and shear wave elastography (SWE). Per-protocol (PP) and intention-to-treat (ITT) analysis were performed within and between-groups with P < 0.05 as significant. 43 individuals with NAFLD satisfied study entry criteria, 33 were randomized to MACR and 10 to control group, and, 30 from MACR and 9 from control group completed PP. In between-group analysis of MACR vs. control, BMI were reduced in PP (P = 0.02) and ITT (P = 0.04). Only ALT was reduced in between-group analysis of MACR vs. control, both PP and ITT (P = 0.02 and 0.04 respectively). No reductions in all lipid parameters and FBS were found in between-group analyses (PP and ITT, all P > 0.22). Both liver steatosis grades and fibrosis (SWE) scores were reduced in between-group analyses of MACR vs. controls (PP and ITT, all P < 0.01). Adherence level remained between 75-83% throughout the study. As conclusion, 8 weeks of MACR protocol appears more effective than usual habitual diet in the control of NAFLD activity and with good adherence rate.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
MACR protocol for the 8 weeks duration.
Figure 3
Figure 3
Ultrasonography assessment of steatosis and shear wave elastography of liver.
Figure 4
Figure 4
Pre- and post-intervention (MACR vs. control) box plots of (A) weight (B) ALT level and (C) liver fibrosis (shear wave elastography or SWE).
Figure 5
Figure 5
Adherence to MACR protocol.
See this image and copyright information in PMC

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