Personalized Lifestyle Interventions can Improve Liver Steatosis in Overweight/obese NAFLD Patients

Nonalcoholic fatty liver disease (NAFLD) is a growing global health crisis, with lifestyle modifications often recommended as the primary treatment. A new study compared the benefits of following an intensive lifestyle intervention (ILI) program with personalized nutrition counseling to a balanced diet combined with standard counseling – on liver steatosis and extrahepatic metabolic health in overweight and obese Chinese patients with NAFLD.

This was a multicenter randomized controlled trial (RCT) conducted across seven hospitals in China – that included 226 participants with a body mass index (BMI) over 25. Here, participants were randomly assigned to either an ILI group––a low-carbohydrate, high-protein calorie-restricted diet (CRD) combined with exercise and intensive dietitian counseling, or a control group––a balanced CRD, exercise, and standard counseling. The primary measure was a change in the fat attenuation parameter (FAP) from baseline to week 12. Secondary measures included changes in BMI, liver stiffness measurement (LSM), and various metabolic indices. 

Overall, 167 participants completed the study. Compared to the control group, ILI participants showed a significant reduction in FAP and BMI but not in LSM improvement. The ILI group also showed substantial improvements in secondary outcomes, including ALT, AST, GGT, body fat mass, muscle mass, skeletal muscle mass, triglycerides, fasting blood glucose, fasting insulin, HbA1c, HOMA-IR, HOMA-β, blood pressure, and homocysteine. Subgroup analyses revealed that ILI led to more significant FAP reductions, particularly in patients with hypertension.

The results demonstrated that the 12-week ILI significantly improved liver steatosis and various metabolic indicators in overweight and obese Chinese patients with NAFLD. Compared to standard interventions, personalized diet and exercise therapy were more effective. 

Source:Liu Z, Jin P, Liu Y, et al. Nutrition Journal. 2024 Jun 13;23(1):64.