Effect of Low-Carbohydrate Diet Compared With Calorie-Restricted Diet on Improving Nonalcoholic Fatty Liver Disease Associated With Type 2 Diabetes

Abstract

This study aimed to determine the effects of a low-carbohydrate diet (LCD) on nonalcoholic fatty liver disease (NAFLD) patients with type 2 diabetes (T2DM) compared with a calorie-restricted diet (CRD). We evaluated 28 patients with NAFLD and T2DM in this three-month-long, prospective, open-label, randomized comparative trial. Patients were randomly allocated to either the LCD group (70-130 g/day of carbohydrates; n =14) or CRD group (25 kcal/kg of ideal body weight per day; n =14). Abdominal computed tomography (CT) was used to evaluate the liver fat deposition by the liver-to-spleen attenuation ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA). Both diets significantly improved the L/S ratio, VFA, AST, ALT, body weight and HbA1c from baseline to 3 months (P < 0.05). There were no significant differences in any findings between the two diets, except for the fact that the VFA significantly decreased in the LCD group. Our findings suggest that LCD may be as effective as CRD in improving fatty liver in patients with NAFLD and T2DM.