Effect of aerobic exercise and low carbohydrate diet on pre-diabetic non-alcoholic fatty liver disease in postmenopausal women and middle aged men--the role of gut microbiota composition: study protocol for the AELC randomized controlled trial.
Study Goal
The researchers aimed to determine whether a low-carbohydrate diet (LCh), alone or combined with aerobic exercise, reduces hepatic fat content and improves metabolic outcomes in pre-diabetic individuals with NAFLD by modifying gut microbiota.
Results Summary
The study suggests that individualized low-carbohydrate diet interventions, particularly when combined with aerobic exercise, may effectively reduce hepatic fat content and improve metabolic health in pre-diabetic individuals with NAFLD, potentially through gut microbiota modulation.
Population
Postmenopausal women and middle-aged men aged 50-65 with pre-diabetes and NAFLD.
Effective Dosage
Carbohydrate intake reduced to 30% of total energy intake, with a special lunch meal providing 40% of daily energy.
Duration
6-month intervention with a 6-month follow-up.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
individualized aerobic exercise (AEx) and low carbohydrate diet (LCh) intervention | neutral | hepatic fat content (HFC) | pre-diabetes | - | affect | #1 |
individualized aerobic exercise (AEx) and low carbohydrate diet (LCh) intervention | neutral | gut microbiota composition | pre-diabetes | - | modification | #2 |
specific individualized exercise and diet intervention | decrease | liver fat reduction | - | - | offers a more efficient approach for | #3 |
specific individualized exercise and diet intervention | neutral | diabetes prevention | - | - | offers a more efficient approach for | #4 |
specific individualized exercise and diet intervention | neutral | gut microbiota composition | - | - | via modification | #5 |
BACKGROUND: Pre-diabetes and non-alcoholic fatty liver disease (NAFLD) are associated with an unhealthy lifestyle and pose extremely high costs to the healthcare system. In this study, we aim to explore whether individualized aerobic exercise (AEx) and low carbohydrate diet (LCh) intervention affect hepatic fat content (HFC) in pre-diabetes via modification of gut microbiota composition and other post-interventional effects. METHODS/DESIGN: A 6-month randomized intervention with 6-month follow-up is conducted from January 2013 to December 2015. The target sample size for intervention is 200 postmenopausal women and middle-aged men aged 50-65 year-old with pre-diabetes and NAFLD. The qualified subjects are randomized into 4 groups with 50 subjects in each group: 1 = AEx, 2 = LCh, 3 = AEx + LCh, and 4 = control. In addition, two age-matched reference groups (5 = pre-diabetes without NAFLD (n = 50) and 6 = Healthy without pre-diabetes or NAFLD (n = 50)) are included. The exercise program consists of progressive and variable aerobic exercise (intensity of 60 to 75% of initial fitness level, 3-5 times/week and 30-60 min/time). The diet program includes dietary consultation plus supplementation with a special lunch meal (40% of total energy intake/day) which aims to reduce the amount of carbohydrate consumption (30%). The control and reference groups are advised to maintain their habitual habits during the intervention. The primary outcome measures are HFC, serum metabolomics and gut microbiota composition. The secondary outcome measures include body composition and cytokines. In addition, socio-psychological aspects, social support, physical activity and diet will be performed by means of questionnaire and interview. DISCUSSION: Specific individualized exercise and diet intervention in this study offers a more efficient approach for liver fat reduction and diabetes prevention via modification of gut microbiota composition. Besides, the study explores the importance of incorporating fitness assessment and exercise in the management of patients with pre-diabetes and fatty liver disorders. If our program is shown to be effective, it will open new strategies to combat these chronic diseases. TRIAL REGISTRATION: Current Controlled Trials: ISRCTN42622771.