Diet prescription for non‐alcoholic fatty liver disease: Is it worth the effort? A systematic review

Abstract

AbstractAim: The objective of this review was to assess the effectiveness of diet interventions for improving disease severity in non‐alcoholic fatty liver disease. A secondary aim was to identify the effectiveness of different methods of dietetic service delivery for achieving weight reduction in this patient group.Methods: A review of studies from 1999 to 2009 was conducted. Studies were included if they reported non‐alcoholic fatty liver disease diagnosis by either liver histology analysis, imaging or by persistent hypertransaminasaemia, were English language studies of human adults, ≥18 years, that had implemented a dietary component in the intervention.Results: From the 102 papers identified, 20 met inclusion criteria: two randomised controlled trials, two controlled trials (allocation method not disclosed), two non‐randomised experimental studies and 14 case series. Methods of diet prescription differed substantially among studies. Weight reduction appeared to be associated with a reduction in steatosis; however, improvements in other features of liver disease remain unclear. There appeared to be a relationship between the intensity of dietetic contact and weight loss.Conclusion: There is limited evidence available to assess the effectiveness of diet interventions on histological severity of non‐alcoholic fatty liver disease. There is good evidence that clinically significant weight reduction can improve steatosis and risk factors for non‐alcoholic fatty liver disease. A relationship may exist between the frequency of dietetic consultations and amount of weight reduction achieved in patients with non‐alcoholic fatty liver disease. Fortnightly intervention for a minimum of three months to achieve at least 5% weight loss is recommended.