TABLE 2.

Characteristics of the studies and effects of different lifestyle interventions on liver histology in NAFLD patients.

Author	Design	Sample size	Group	Mean age (years)	Mean BMI (kg/m2)	Intervention and comparator/control groups	Intervention characteristics	Intervention duration	Primary outcome
		Male n (%)
Calorie restriction diet (CR)
Promrat 2010, USA 48	RCT	31 14 (66.7%)	NASH	48.9	33.9	Intervention: Cal‐restricted dietary intervention Based on American Heart Association; American Diabetic Association; American College of sports medicine, and fluid guide pyramid. Sessions every week for the first 6 months, then biweekly for months 7–12. Control: Standard care (healthy diet lifestyle) sessions every 12 weeks	Diet food: commercial portion‐controlled foods (calorie restricted) Calorie restriction: 1000–1200 kcal/d < 91 kg BW 1200–1500 kcal/d > 91 kg BW (cal restricted) Physical activity: Moderate intensity 200 min/week. Unsupervised Behavior change: Stimulus control, problem solving and relapse prevention (cal restricted)	48 weeks	↓ HS, NAS, and ALT (intervention vs. control) ↓ ballooning injury and AST (both) HS: −1.1 ± 0.8% versus −0.3% ± 0.8% (intervention vs. control)
Low carbohydrate (LCH)—Low fat diet (LFD)
Eckard 2013, USA 62	RCT	56 6 (50%)	NAFLD (biopsy‐proven)	44	32.7	Intervention: LFD with moderate exercise (FAT 20%, 60% CHO, 20% PRO) Comparators: a) Moderate fat low processed carbohydrate diet (30% FAT, 50% CHO, 20% PRO) b) Moderate exercise only. Control: Standard care	Supplemental materials were provided to patients with healthy cooking, grocery shopping, and dining out. Received a set of measuring cups and spoons and were also instructed on estimating portion sizes using the MyPyramid serving size guidelines Physical activity (intervention, a) and b)): Exercise program, based on FITT (frequency, intensity, time and type) principles. 20–60 min, 4–7 days/week in a supervised environment.	6 months	↓ NAS score (ns for control)

Note: Number of males, mean age and BMI are data related to the intervention group.

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BW, body weight; CCT, clinical controlled trial; CHO, carbohydrate; HS, hepatic steatosis; NAFLD, non‐alcoholic fatty liver disease; NAS, non‐alcoholic fatty liver disease activity score; PRO, protein; RCT, randomized controlled trial.