Table 2 Effects of diet on metabolic parameters and hepatic steatosis.
| n | Year | Total calories/day | % carbohydrate | % fat | % protein | Study duration | Weight loss | F/U liver bx | Results | |
|---|---|---|---|---|---|---|---|---|---|---|
| Diet‐NAFLD | ||||||||||
| Drenick et al52 | 41 | 1970 | (1) total starvation (mean 71 days) | NA | NA | NA | 2.5–5 months | Fasting: 40.9 kg | Yes | Improved steatosis |
| (2) 500 kcal/day (average 5 months) | Low‐calorie diet: 59.5 kg | |||||||||
| (3) JI bypass or shunt | ||||||||||
| Palmer et al53 | 39 | 1990 | 600–800 | NA | NA | NA | Mean 16 months | 17/39 pts lost ⩾10% body weight | No | Improved liver enzymes, decreased hepatosplenomegaly |
| Tiikkainen et al63 | 47 | 2004 | 600–800 | 50 | 30 | 20 | 3–6 months | 8% | No | Insulin sensitivity, intra‐abdominal fat and subcutaneous fat decreased significantly |
| Westerbacka et al55 | 10 | 2005 | Isocaloric | 61 | 16 | 19 | 2 weeks | 1 kg | No | Decreased fasting serum insulin and 20% decrease in liver fat by MRS |
| Peterson et al54 | 8 | 2005 | 1200 | 50 | 3 | 42 | 3–12 weeks | 8% | No | Improved liver fat 81% by MRS |
| Tamura et al77 | 7 | 2005 | 27.9 kcal/kg/day | 60 | 25 | 15 | 2 weeks | NA | No | Improved liver fat 27% by MRS |
| Yancy et al56 | 45 | 2004 | Not mentioned | 8 | 68 | 26 | 6 months | 12.9% | No | Not assessed |
| Yancy et al56 | 60 | 2004 | Not mentioned | 52 | 29 | 19 | 6 months | 6.7% | No | Not assessed |
| Tendler et al57 | 5 | 2007 | Not mentioned | <20 | NA | NA | 6 months | 12.8 kg | Yes | Improved steatosis and inflammation |
| Diet‐NASH | ||||||||||
| Huang et al58 | 15 | 2005 | Not mentioned | 40–45 | 35–40 | 15–20 | 12 months | 7% in 9 pts with improved histology | Yes | Improved total NASH score and steatosis |
| Diet + pharmacotherapy‐NASH | ||||||||||
| Harrison et al60 | 10 | 2004 | 1400 | NA | NA | NA | 6 months | 10.3 kg | Yes | Improved BMI, HgbA1C, ALT, AST, steatosis (6/10), fibrosis (3/10) |
| Harrison et al62 | 37 | 2007 | 1400 | NA | NA | NA | 9 months | 8 vs 6.2% | Yes | Improved 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.