Dietary approaches to stop hypertension (DASH) diet improves hepatic fibrosis, steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: a randomized controlled trial

Eur J Nutr. 2024 Feb;63(1):95-105. doi: 10.1007/s00394-023-03221-w. Epub 2023 Oct 19.

Abstract

Purpose: Recent evidence suggests that adherence to dietary approaches to stop hypertension (DASH) diet can be effective in managing non-alcoholic fatty liver disease (NAFLD). We investigated the effect of DASH diet on hepatic fibrosis, steatosis and liver enzymes in patients with NAFLD.

Methods: This 12-week randomized controlled trial was conducted among seventy patients with NAFLD who were randomly assigned into two groups including intervention group (DASH diet containing 50-55% carbohydrate, 15-20% protein, and 30% total fat) and the control group (a healthy diet containing 50-55% carbohydrate, 15-20% protein, and 30% total fat). Both diets were calorie-restricted (500-700 kcal lower than the energy requirement). The primary outcomes included hepatic fibrosis, hepatic steatosis, alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transpeptidase (GGT).

Results: At the baseline, there was no significant difference between two groups in the level of hepatic fibrosis (P = 0.63), hepatic steatosis (P = 0.53), ALT (P = 0.93), AST (P = 0.18) and GGT (P = 0.76). A significant reduction was found in the intervention group compared to the control group in hepatic fibrosis (23 grades reduction vs. 7 grades reduction; P = 0.008) and hepatic steatosis (31 grades reduction vs. 9 grades reduction; P = 0.03) after intervention. In addition, a significant change was observed in the intervention group compared to control group in ALT ( - 8.50 ± 8.98 vs. - 2.09 ± 7.29; P = 0.002), and AST ( - 5.79 ± 6.83 vs. - 0.51 ± 6.62; P = 0.002).

Conclusions: Adherence to DASH diet may be effective in management of NAFLD.

Trial registration: The trial was registered on 06 February 2022 at Iranian Registry of Clinical Trials (IRCT20170117032026N3) with URL: https://www.irct.ir/trial/60887 .

Keywords: DASH diet; Fibrosis; Liver enzymes; Non-alcoholic fatty liver disease; Steatosis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Alanine Transaminase
  • Aspartate Aminotransferases
  • Carbohydrates
  • Diet
  • Dietary Approaches To Stop Hypertension*
  • Humans
  • Iran
  • Liver / pathology
  • Liver Cirrhosis
  • Non-alcoholic Fatty Liver Disease*
  • gamma-Glutamyltransferase

Substances

  • gamma-Glutamyltransferase
  • Alanine Transaminase
  • Aspartate Aminotransferases
  • Carbohydrates

Associated data

  • IRCT/IRCT20170117032026N3