Table 1.
Lifestyle intervention trials for nonalcoholic fatty liver disease (NAFLD) treatment.
| Reference | Country | Study design | Patients, (% men) | Liver fat content evaluation | Intervention (type, time) | Effects on liver fat content | Effects on liver histological endpoints |
|---|---|---|---|---|---|---|---|
| DIET INTERVENTIONS | |||||||
| Huang et al. [2005] | USA | Intervention without control arm | 16 obese, (50) | Liver biopsy | NC, 12 months | No effect | Decreased ballooning/ inflammation |
| Kirk et al. [2009] | USA | RCT | 22 obese, (18) | MRS | Low calorie HCD versus LCD, 11 weeks | Decreased in HCD and LCD | NP |
| Haufe et al. [2011] | Germany | RCT | 102 obese, (18) | MRS | Low calorie LCD versus LFD, 6 months | Decreased in LCD and LFD | NP |
| Bozzetto et al. [2012] | Italy | RCT | 36 diabetic, (81) | MRS | CHO/fiber versus MUFA, CHO/fiber+ exercise, versus MUFA + exercise, 8 weeks | Decreased in MUFA and MUFA + exercise | NP |
| Ryan et al. [2013] | Australia | RCT | 12 obese, (50) | MRS | MD versus LF/HCD | Decreased | NP |
| Trovato et al. [2015] | Italy | Intervention without control arm | 90 obese, (49) | US | MD, 6 months | Decreased | NP |
| EXERCISE INTERVENTIONS | |||||||
| Johnson et al. [2009] | Australia | RCT | 19 obese, (NA) | MRS | Aerobic training versus regular stretching, 4 weeks | Decreased | NP |
| Van der Heijden et al. [2010] | USA | Intervention without control arm | 15 obese and 14 lean (58) | MRS | Aerobic training obese versus lean, 12 weeks | Decreased | NP |
| Slentz et al. [2011] | USA | RCT | 144 obese, (44) | CT | Resistance training versus aerobic training versus combined, 8 months | Decreased in aerobic arm and aerobic + resistance training | NP |
| Hallsworthet al. [2011] | UK | RCT | 19 obese, (NA) | MRS | Resistance training versus SC, 8 weeks | Decreased | NP |
| Bacchi et al. [2013] | Italy | RCT | 30 obese, (73.3) | MRS | Aerobic training versus resistance training, 4 months | Decreased | NP |
| Zelber-Sagiet al. [2014a] | Israel | RCT | 64 obese, (53.1) | US | Resistance training versus home stretching, 3 months | Decreased | NP |
| DIET AND EXERCISE INTERVENTIONS | |||||||
| Ueno et al. [1997] | Japan | Intervention without control arm | 25 obese, (52) | Liver biopsy | Restricted diet and exercise versus control, 3 months | Decreased | Decreased steatosis |
| Shah et al. [2009] | USA | RCT | 18 obese, (28) | MRS | Diet versus diet with exercises, 6 months | Decreased in both arms | NP |
| Oza et al. [2009] | Japan | Intervention without control arm | 22 overweight (54.5) | CT | Weight loss (caloric restriction), 3 or 6 months | Decreased | NP |
| Lazo et al. [2010] | USA | RCT | 96 obese, (51) | MRS | Weight loss (caloric restriction, increased physical activity) versus DSE, 12 months | Decreased | NP |
| Promrat et al. [2010] | USA | RCT | 31 obese, (71) | Liver biopsy | Weight loss (caloric restriction, increased physical activity) versus control, 48 weeks | Decreased | Decreased steatosis and ballooning, no change in fibrosis score |
| Browninget al. [2011] | USA | Intervention without control arm | 18 obese, (68) | MRS | Low calorie versus low carbohydrate, 2 weeks | Decreased in both arms | NP |
| Wong et al. [2013] | Hong-Kong | RCT | 154 normal weight, (25) | MRS | Weight loss (caloric restriction, increased physical activity) versus SC, 12 months | Decreased | NP |
| Vilar-Gomez et al. [2015] | Cuba | Intervention without control arm | 261 obese, (25) | Liver biopsy | Weight loss (caloric restriction, increased physical activity) versus SC, 52 weeks | Decreased | Decreased steatosis, ballooning and fibrosis |
CHO/fiber, high carbohydrate/high fiber/low glycemic index; CT, computed tomography; DSE, diabetes support and education; HCD, high carbohydrate diet; LCD, low carbohydrate diet; LFD, low fat diet; LF/HCD, low fat/high carbohydrate diet; MD, Mediterranean diet; MRS, magnetic resonance spectroscopy; MUFA, monounsaturated fatty acids; NA, not available; NC, nutritional counseling,; NP, not pertinent; RCT, randomized trial; SC, standard counseling; US, ultrasonography.