Table 2 Effects of diet on metabolic parameters and hepatic steatosis
nYearTotal calories/day% carbohydrate% fat% proteinStudy durationWeight lossF/U liver bxResults
Diet-NAFLD
Drenick et al52411970(1) total starvation (mean 71 days)NANANA2.5–5 monthsFasting: 40.9 kgYesImproved steatosis
(2) 500 kcal/day (average 5 months)Low-calorie diet: 59.5 kg
(3) JI bypass or shunt
Palmer et al53391990600–800NANANAMean 16 months17/39 pts lost ⩾10% body weightNoImproved liver enzymes, decreased hepatosplenomegaly
Tiikkainen et al63472004600–8005030203–6 months8%NoInsulin sensitivity, intra-abdominal fat and subcutaneous fat decreased significantly
Westerbacka et al55102005Isocaloric6116192 weeks1 kgNoDecreased fasting serum insulin and 20% decrease in liver fat by MRS
Peterson et al54820051200503423–12 weeks8%NoImproved liver fat 81% by MRS
Tamura et al777200527.9 kcal/kg/day6025152 weeksNANoImproved liver fat 27% by MRS
Yancy et al56452004Not mentioned868266 months12.9%NoNot assessed
Yancy et al56602004Not mentioned5229196 months6.7%NoNot assessed
Tendler et al5752007Not mentioned<20NANA6 months12.8 kgYesImproved steatosis and inflammation
Diet-NASH
Huang et al58152005Not mentioned40–4535–4015–2012 months7% in 9 pts with improved histologyYesImproved total NASH score and steatosis
Diet + pharmacotherapy-NASH
Harrison et al601020041400NANANA6 months10.3 kgYesImproved BMI, HgbA1C, ALT, AST, steatosis (6/10), fibrosis (3/10)
Harrison et al623720071400NANANA9 months8 vs 6.2%YesImproved steatosis, inflammation, NASH activity score
  • ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; HgbA1C; haemoglobin A1C; JI, jejuno-ileal; F/U liver bx, follow-up liver biopsy; MRS, magnetic resonance proton spectroscopy; NA, not available; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatosis; pts, patients.