Combined treatment with time-restricted feeding and a low-sugar diet for patients with nonalcoholic fatty liver disease (NAFLD) improves cardiovascular biomarkers and inflammation and reduces obesity, according to study results in feed.
While previous research has investigated TRF and the low-sugar diet separately, data for a combination of both treatments for the management of NAFLD have been missing.
Researchers conducted a 12-week randomized controlled trial to monitor the combined effects of TRF treatment (16 hours of fasting and 8 hours of eating daily) and a low-sugar diet on markers of cardiac metabolism and inflammation as well as body composition in patients with NAFLD.
The patients were 18 to 50 years old, and the body mass index (BMI) was 27 to 40 kg/m2grade 2 NAFLD, had no recent participation in a weight loss diet, and had not received treatment with any medications for at least 1 week prior to enrollment in the study.
106 patients were identified, 52 were included in the study. Participants were stratified by BMI and age and then randomly assigned to the TRF group, the low-sugar diet group (treatment; n = 27) or the control group (n = 25).
The low-sugar diet follows guidelines set by the World Health Organization, which limits the addition of monosaccharides and polysaccharides to foods and drinks, including sugars from natural sources. Conventional diets have been evaluated by a dietitian.
For both groups, the daily intake of the macronutrient was 55% carbohydrates, 30% fat, and 15% protein with 9 servings, fruits and vegetables.
By the end of the experiment, 4 participants from the treatment group and 3 participants from the control group withdrew. The mean age of patients in both groups was 42.8 ± 7.9 years and a mean BMI of 29.9 ± 2.9 kg/m2.
An analysis was performed for each protocol, and researchers saw significant differences in body weight, with an average weight loss of 3.21 kg in the treatment group (s <.001) compared to a decrease of 1.02 kg in the control group)s = .064). A significant decrease in BMI was recorded, with an average decrease of 1.11 (s <.0001) in the treatment group and a decrease of 0.34 in the control group (s = .063).
Participants in the treatment group experienced a decrease of 2.47 kg (s = .001) in mean body fat, and the control group experienced a mean increase of 1.72 kg (s = .041).
The differences between the group were significant in the same body weight categories (s = .029), BMI (s = .013) and fat mass (s = .025).
Total fibrosis scores were reduced in the treatment group (6.33 ± 1.01 kPa; s = .024) compared to the control group (5.15 ± 1.15 kPa; s = .009). Similar trends were observed in the steatosis scores or the controlled attenuation factor, with the treatment group experiencing decreases of 322.9 ± 34.9 dB/m (P < .001) compared to the control group (a decrease of 270.9 ± 36.16 dB/m). [P <.001]).
The treatment group showed a significant decrease in triglycerides with 201.5 ± 35.34 mg/dL (s <.001) compared to a reduction of 133.27 ± 48.67 mg/dL)s <.001) in the control group. decrease in total cholesterol (s = .001 in both groups) and LDL-C (treatment group, P = .017; control group, s = .014).
Inflammatory biomarkers also showed significant between-group differences in hs-CRP and CK-18 (s < .001 for both tags).
Study limitations include a small sample size, a relatively short study period, and the inability to measure the effects of TRF and a low-sugar diet separately.
The study authors noted, “Combining TRF with a low-sugar diet is a new nutritional strategy in NAFLD research, and our study sheds light on a potential range of dietary strategies considered for this population.” “While many low-carb strategies have emerged to promote improved health and metabolic modification, the low-sugar diet used in this study does not restrict carbohydrate intake as many of these programs do.”
Varkaneh HK, Salehisahlabadi A, Tinsley GM, Santos HO, Hekmatdoost A. Effects of time-restricted feeding (16/8) combined with a low-sugar diet on the management of nonalcoholic fatty liver disease: a randomized controlled trial.. feed. Published online September 13, 2022. doi: 10.1016/j.nut.2022.111847
This article originally appeared Gastroenterology Consultant
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