Introduction Low glycaemic index diet improves insulin sensitivity and adiposity. Its effect on non-alcoholic fatty liver disease (NAFLD) is unclear.
Methods This was a single-blind, randomised controlled trial of NAFLD patients aged 18–70 years who were recruited through population screening. All patients were instructed to exercise around 90 min/week, and were randomised to participate in a low glycaemic index dietary intervention programme or receive usual care. The dietary intervention programme was led by dietitians and consisted of education on food components, interpretation of food labels, food exchanges, healthy eating out techniques and cooking methods. The primary endpoint was the proportion of patients with resolution of NAFLD at month 12, defined as intrahepatic triglyceride content (IHTG) <5% by proton-magnetic resonance spectroscopy.
Results At the time of analysis, 104 patients (51 in the intervention group and 53 in the control group) had completed month 12 assessment. The adherence to the intervention programme was excellent, with attendance over 80%. Resolution of NAFLD occurred in 35 (69%) patients in the intervention group and 11 (21%) in the control group (p<0.001). IHTG decreased from 11.7±6.2% to 4.8±4.6% in the intervention group but remained static from 11.7±6.9% to 9.7±6.7% in the control group (mean difference in IHTG change 4.9%; 95% CI 2.6% to 7.1%). Reduced body mass index (BMI) was observed in the intervention group first at month 3 and maintained through month 12. At month 12, BMI decreased by 9.2±7.8% from baseline in the intervention group, compared to 1.1±5.5% in the control group (p<0.001). By multivariate analysis, dietary intervention (OR 4.2; 95% CI 1.1 to 15.4), baseline IHTG (OR 0.82; 95% CI 0.72 to 0.93) and percentage change in BMI (OR 0.78; 95% CI 0.68 to 0.89) were independent factors associated with NAFLD resolution.
Conclusion Low glycaemic index dietary intervention is effective in reducing liver fat in NAFLD patients in the general population. (This study was supported in part by the Nutritional Research Foundation of the UK and the Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong.
Clinical trial registration number ClinicalTrials.gov number, NCT00868933.
Competing interests None declared.
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