Effects of a Short-Term Meal Replacement Hypocaloric Diet in Subjects with Obesity and High Fatty Liver Index

Abstract

Introduction: Dietary changes play a role in metabolic response of patients with metabolic-associated fatty liver disease, and there is little evidence on the use of partial meal replacement (pMR) diets in this pathology.

Aim: We decided to evaluate the modifications in transaminases levels after a pMR hypocaloric diet in subjects with obesity and elevated fatty liver index (FLI).

Material and methods: A sample of 606 patients with obesity and FLI ≥ 60 were enrolled and treated during 3 months with a pMR diet. Patients were divided as group I (Alanine amino transferase (ALT) normal) or group II (ALT ≥ 43 UI/L).

Results: Body mass index, body weight, total fat mass, waist circumference, blood pressure, fasting glucose, total cholesterol, Low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, Homeostasis Model assessment (HOMA-IR), and FLI index improved significantly in the total group with pMR diet, without differences between group I and II. ALT, aspartate aminotransferase activity (AST), Gama glutamine transferase (GGT), and ratios of AST/ALT improved in both groups, too. This improvement was higher in group II (deltas group I vs. deltas group II); ALT (-4.2 ± 0.9 UI/L vs. -32.1 ± 5.7 UI/L: p = 0.01), AST (-4.8 ± 1.8 UI/L vs. -14.1 ± 1.9 UI/L: p = 0.02), GGT (-4.8 ± 1.4 UI/L vs. -37.1 ± 4.2 UI/L: p = 0.01), and AST/ALT ratio (-0.04 ± 0.002 units vs. -0.19 ± 0.04 units: p = 0.01).

Conclusions: We reported that a pMR diet is an effective method to lose weight and to improve metabolic parameters in patients with obesity and high FLI. The decrease in liver parameters was greater in patients with ALT ≥ 43 UI/L.

Keywords: fatty liver index; obesity; partial meal replacement diet; transaminases.