Low free sugar diet improves clinical biomarkers in NAFLD patients

In overweight/obese patients with nonalcoholic fatty liver disease (NAFLD), a low free sugar diet may result in decreased hepatic steatosis and fibrosis, as well as better glycaemic indices and lower concentrations of biomarkers of inflammation, triglycerides (TG), and total cholesterol (TC) levels, suggests a recent study.

“Although the role of a diet rich in fructose and saccharose in development of NAFLD is well known, the effects of a low free sugar diet in the management of the disease have not yet been investigated in adult patients with NAFLD,” the authors said.

To address this, participants with FibroScan-proven NAFLD were randomly assigned to either of the two 12-week dietary interventions: low free sugar diet or usual diet. The authors then assessed the change in hepatic steatosis measurement between baseline and 12 weeks (primary outcome), as well as changes in anthropometric measurements, lipid profile, glycaemic indices, liver enzymes, and inflammatory factors (secondary outcomes).

Of the participants, 43 completed the 12-week intervention. Compared with usual diet, low free sugar diet led to a significant reduction in the concentrations of alanine transaminase (43.00 to 27.95 U/L), TG (172.86 to 144.19), TC (155.54 to 139.86 mg/dL), fasting blood sugar (103.95 to 91.00 mg/dL), insulin (14.37 to 8.92 mU/L), Homeostatic Model Assessment for Insulin Resistance (3.81 to 2.06), high-sensitivity C-reactive protein (3.80 to 2.88 mg/L), tumour necrosis factor alpha (4.60 to 3.41 pg/mL), and nuclear factor kappa-light-chain-enhancer of activated B cells (3.89 to 3.35).

Low free sugar diet also reduced fibrosis and steatosis scores, with increased quantitative insulin sensitivity check index (p<0.05). Of note, no significant between-group differences were observed in aspartate aminotransferase, gamma-glutamyl transferase, and high- and low-density lipoprotein cholesterols (p>0.05).