Low free sugar diet benefits obese/overweight patients with NAFLD

Overweight or obese patients with nonalcoholic fatty liver disease (NAFLD) may gain health benefits from a low free sugar diet, results of a trial have shown. Such diet helps reduce hepatic steatosis and fibrosis, as well as improve glycaemic indices and lower concentrations of biomarkers of inflammation, triglycerides (TG), and total cholesterol (TC) levels.

The investigators randomized individuals with FibroScan-proven NAFLD to a 12-week intervention of either low free sugar diet or usual diet. The primary outcome was change in hepatic steatosis measurement between baseline and week 12, while secondary ones included changes in lipid profile, anthropometric measurements, liver enzymes, and inflammatory factors.

Forty-three participants completed the 12-week intervention. Compared with usual diet, low free sugar diet resulted in a significant decrease in the concentrations of alanine aminotransferase (from 43.00 to 27.95 U/L), TG (from 172.86 to 144.19), TC (from 155.54 to 139.86 mg/dL), fasting blood sugar (from 103.95 to 91.00 mg/dL), insulin (from 14.37 to 8.92 mU/L), homeostatic model assessment of insulin resistance (from 3.81 to 1.80), high-sensitivity C-reactive protein (from 3.80 to 2.88 mg/L), tumour necrosis factor alpha (from 4.60 to 3.41 pg/mL), and nuclear factor kappa B (from 3.89 to 3.35).

In addition, a low free sugar diet reduced both fibrosis and steatosis scores and led to increased quantitative insulin sensitivity check index (p<0.05). However, no significant differences were noted in aspartate aminotransferase, gamma-glutamyltransferase, and high- and low-density lipoprotein cholesterols (p>0.05).