Effect of Low-Carbohydrate Diet on Non-Alcoholic Fatty Liver Disease

Abstract

Background: Non-alcoholic fatty liver disease has become a common cause of chronic liver disease, and is commonly associated with metabolic comorbidities. Objectives: Due to the potential for progression to fibrosis and hepatocellular carcinoma, non-alcoholic fatty liver disease is managed through several different aspects, and there is a growing need to assess the effect of dietary interventions on the disease. Materials and Methods: This single-arm study was conducted in Sulaymaniyah in between 2023-2024 among patients visiting an obesity clinic who met our inclusion criteria. Each participant was put on a low-carbohydrate diet and measures of weight, body mass index, and visceral fat area were taken before and after the intervention and compared, dietary compliance was assessed verbally. After data collection it was entered into a Google Sheets sheet and data analysis was done using Google Sheets and R (v4.4.0), the statistical significance of our results were measured using a 2-tailed paired t-test, 2-tailed independent t-test, Wilcoxon Signed Rank test, Mann-Whitney test as well as a chi-square test. Comparison of interest in this study was the mean and median change in weight, BMI, and visceral fat area, overall and among genders. Results: Majority (52%) of our participants were female, Arabs constituted the majority ethnicity (68%). 44% of participants reported a good dietary adherence. changes were: median change in weight: -6.6 kg ± 6.55, mean change in body mass index: -3 ± 2.5, mean change in visceral fat area -21 ± 23.8, p-value for these changes were < 0.05. Conclusion: This study shows that a low-carbohydrate diet may have beneficial effects on non-alcoholic fatty liver disease. On average, participants experienced significant reductions in weight, BMI, and visceral fat. No statistically significant difference was seen in changes of body metrics and visceral fat between genders. The diet may also have beneficial effects in other chronic conditions, as majority of subjects reported discontinuing their medications whilst on the diet.