Abstract:
Background: Currently the treatment of Nonalcoholic Fatty Liver Disease is based on weight loss through lifestyle change, through exercise combined with calorie-restricted dieting.
Objectives: To assess the effects of a commercially available weight loss program based on a Very Low-Calorie Ketogenic Diet plus physical activity on Visceral Adipose Tissue and liver fat content compared to a standard Low-Calorie diet. As a secondary aim we evaluated the effect on liver stiffness measurements.
Methods: Randomized, controlled, prospective pilot study. Patients were randomized and treated either with a Low-Calorie diet or a Very Low-Calorie Ketogenic Diet and received orientation and encouragement to physical activity equally for both. Visceral Adipose Tissue, liver fat fraction and liver stiffness were measured at baseline and after 2 months of treatment using Magnetic Resonance Imaging.
Results: 39 patients (20 with Very Low-Calorie Ketogenic Diet and 19 with Low-Calorie Diet) completed 2-month of follow-up. Mean of weight loss at 2 months were -9,70 kg in Very Low-Calorie Ketogenic Diet group and -1,67 kg in LC group (p<0.001). Mean of reductions in Visceral Adipose Tissue were -32.0 cm2 for Very Low-Calorie Ketogenic Diet group and -12.58 cm2 for Low-Calorie Diet group (p<0.05). Reductions in liver fat fraction were significantly higher in the Very Low-Calorie Ketogenic Diet group than in LC group (4.77% vs 0.79%; p<0.005).
Conclusion: Patients undergoing a Very Low-Calorie Ketogenic Diet achieved superior weight losses, with significant VAT and liver fat fraction reductions when compared to standard low-calorie diet controls. The weight loss and rapid mobilization of liver fat demonstrated with Very Low-Calorie Ketogenic Diet, could serve as an effective alternative for the treatment of Nonalcoholic Fatty Liver Disease.
