Role of intensive dietary and lifestyle interventions in... : European Journal of Gastroenterology & Hepatology (original) (raw)

Original Articles: Hepatology

Role of intensive dietary and lifestyle interventions in the treatment of lean nonalcoholic fatty liver disease patients

Hamurcu Varol, Pinara,,b; Kaya, Edac; Alphan, Emela; Yilmaz, Yusufc,,d

aDepartment of Nutrition and Dietetics, School of Health Sciencies, Istanbul Okan University

bDeparment of Nutrition and Dietetics, School of Health Sciences, Uskudar University

cLiver Research Unit, Institute of Gastroenterology

dDepartment of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey

Received 17 October 2019 Accepted 15 November 2019

Correspondence to Yusuf Yilmaz, MD, Marmara Universitesi Gastroenteroloji Enstitusu, P.K. 53, Basibuyuk, Maltepe, 34840 Istanbul, Turkey, Tel: +90 533 440 3995; fax: +90 216 688 6681; e-mail: [email protected]

Abstract

Background/aim

Although weight loss is recommended for the treatment of nonalcoholic fatty liver disease (NAFLD) in overweight and obese individuals, this treatment modality remains questionable in lean individuals. In this study, we investigated the effects of medical nutrition therapy (MNT) and intensive lifestyle interventions (ILIs) for NAFLD in lean versus obese patients.

Methods

In total, 35 patients (14 lean and 21 obese) were included in the study. All patients underwent transient elastography examinations, and controlled attenuation parameter (CAP) of >238 dB/m was indicative of hepatic steatosis. After 8 weeks of dietitian follow-up with MNT and ILI, the patients were compared with the baseline.

Results

Significant weight loss was recorded in both lean (5.4%) and obese patients (5.7%) with NAFLD. The mean BMI decreased from 23.9 (20.5–24.8) to 22.4 (19.5–24.2) kg/m2 (P = 0.001) in lean patients and from 34.0 (30.0–42.0) to 31.6 (26.9–42.5) kg/m2 (P < 0.001) in obese patients. The alanine aminotransferase level significantly decreased from 56 (15–163) to 28 (13–98) U/L (P = 0.010) in lean patients and from 27 (13–81) to 22 (13–46) U/L (P = 0.018) in obese patients. The median CAP decreased from 299 (246–360) to 236 (169–318) dB/m (P = 0.002) in lean patients and from 325 (258–400) to 253 (202–383) dB/m (P < 0.001) in obese patients. Moreover, remission of hepatic steatosis was detected in eight lean patients (57.1%) and eight obese patients (38.1%).

Conclusion

These results indicate that 5% body weight loss in effective in both obese and lean patients resulting in a similar NAFLD remission.