Effects of lifestyle changes including specific dietary intervention and physical activity in the management of patients with chronic hepatitis C--a randomized trial.
Study Goal
The researchers aimed to compare the effects of a normoglucidic low-calorie diet (NGLCD) and a low-fat diet (LFD) on insulin resistance, steatosis, and fibrosis in patients with chronic hepatitis C (CHC).
Results Summary
Both diets led to significant improvements in weight loss, insulin resistance, liver enzymes (AST, ALT, GGT), steatosis severity, and fibrosis markers, with NGLCD showing greater initial weight loss but similar long-term outcomes.
Population
Patients over 35 years with chronic hepatitis C and BMI >25 kg/m² (n=120).
Effective Dosage
Not specified (dietary interventions only).
Duration
12 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
normoglucidic low-calorie diet (NGLCD) | decrease | weight | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | -5.02 ± 3.43 kg vs. -4.1 ± 2.6 kg | weight loss was greater | #1 |
low-fat diet (LFD) | decrease | weight | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | -4.1 ± 2.6 kg | weight loss | #2 |
normoglucidic low-calorie diet (NGLCD) | decrease | fasting plasma glucose, fasting plasma insulin, and HOMA-IR | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | significant improvements | #3 |
low-fat diet (LFD) | decrease | fasting plasma glucose, fasting plasma insulin, and HOMA-IR | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | significant improvements | #4 |
normoglucidic low-calorie diet (NGLCD) | decrease | aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | decreased with significant differences | #5 |
low-fat diet (LFD) | decrease | aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | decreased with significant differences | #6 |
normoglucidic low-calorie diet (NGLCD) | decrease | AST/ALT ratio, Forns fibrosis index | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | significant improvements | #7 |
low-fat diet (LFD) | decrease | AST/ALT ratio, Forns fibrosis index | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | significant improvements | #8 |
normoglucidic low-calorie diet (NGLCD) | decrease | steatosis | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | reduction of both the prevalence and the severity | #9 |
low-fat diet (LFD) | decrease | steatosis | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | reduction of both the prevalence and the severity | #10 |
normoglucidic low-calorie diet (NGLCD) | improve | total cholesterol, HDL-cholesterol, triglycerides | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | improved | #11 |
low-fat diet (LFD) | improve | total cholesterol, HDL-cholesterol, triglycerides | patients over 35 years with chronic hepatitis C with BMI over 25 kg/m² | - | improved | #12 |
lifestyle intervention (specific dietary intervention and physical activity) | improve | body weight, lipid and hepatic profile | Overweight or obese patients with CHC | - | significant improvements | #13 |
BACKGROUND: In patients with chronic hepatitis C (CHC), obesity is involved in the pathogenesis of insulin resistance, fatty liver disease and progression of fibrosis. The objective of this study was to compare a normoglucidic low-calorie diet (NGLCD) with a low-fat diet (LFD) among participants with CHC. Aimed to measure the impact of dietary changes in reduction of insulin resistance, obesity but also in steatosis and fibrosis. METHODS: Randomized, controlled trial in three medical centers with assessments at baseline, 6 months and 12 months. Participants were patients over 35 years with chronic hepatitis C (n = 120) with BMI over 25 kg/m². We evaluated the effects of NGLCD vs. LFD in weight management and metabolic improvement. The primary endpoint was to measure the impact of dietary changes through nutritional intervention in reversibility of insulin resistance, obesity, steatosis, and fibrosis. We performed anthropometric measurements, fasting glucose profile, serum lipids, liver profile, blood count at baseline, 6 and 12 months. Steatosis was evaluated using ultrasonographic criteria. Liver fibrosis was non-invasively assessed. RESULTS: After 6 and 12 months of intervention, both groups had a significant decrease in caloric consumption. At 6 months, weight loss was greater in the NGLCD group (-5.02 ± 3.43 kg vs. -4.1 ± 2.6 kg; p = 0.002) compared to the LFD group. At 1-year, however, weight loss was similar in both groups (-3.9 ± 3.3 kg vs. -3.1 ± 2.6 kg; p = 0.139). At 12 months, fasting plasma glucose, fasting plasma insulin, and HOMA-IR had significant improvements in both groups. With both diets aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) decreased with significant differences; also there were significant improvements in AST/ALT ratio, Forns fibrosis index. The two diets were associated with reduction of both the prevalence and the severity of steatosis (all p < 0.001). At 12 months, total cholesterol, HDL-cholesterol, triglycerides improved in both groups (all p < 0.05). CONCLUSIONS: The present study establishes the benefits of low-calorie diet and low-fat diet in management of patients with hepatitis C regarding improvement of insulin resistance, steatosis and also fibrosis.Overweight or obese patients with CHC undergoing a lifestyle intervention (specific dietary intervention and physical activity) for 1-year had significant improvements in body weight, lipid and hepatic profile. TRIAL REGISTRATION: PNCI2-3343/41008/2007.