Individuals with nonalcoholic fatty liver disease (NAFLD) have excess intrahepatic triglycerides. Although weight loss is currently recommended to treat NAFLD, little attention has been given to dietary carbohydrate restriction. This study was undertaken to determine the effectiveness of two weeks of dietary carbohydrate and calorie restriction at reducing hepatic triglycerides in 18 subjects with NAFLD. Subjects consumed a carbohydrate-restricted (<20 gram/day) or calorie-restricted (1200–1500 kcal/day) diet for two weeks. Mean weight loss was similar between the groups. Liver triglycerides decreased significantly with weight loss (P < 0.001) but decreased significantly more (P = 0.008) in carbohydrate-restricted subjects than in calorie-restricted subjects. Dietary fat (r = 0.643, P = 0.004), carbohydrate (r = −0.606, P = 0.008), post-treatment plasma ketones (r = 0.755, P = 0.006), and respiratory quotient (r = −0.797, P < 0.001) were related to a reduction in liver triglycerides. Plasma aspartate, but not alanine, aminotransferase decreased significantly with weight loss (P < 0.001). The authors concluded that two weeks of dietary intervention (≈4.3% weight loss) reduced hepatic triglycerides by ≈42% in subjects with NAFLD but reductions were significantly greater with dietary carbohydrate restriction. Am J Clin Nutr. 2011 May;93(5):1048-52. PMID: 21367948.
