Original Article

Digestive Diseases and Sciences

, Volume 52, Issue 2, pp 589-593

The Effect of a Low-Carbohydrate, Ketogenic Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study

  • David TendlerAffiliated withDivision of Gastroenterology, Department of Medicine, Duke University Health System
  • , Sauyu LinAffiliated withDivision of Gastroenterology, Department of Medicine, Duke University Health System
  • , William S. YancyJr.Affiliated withDivision of General Internal Medicine, Department of Medicine, Duke University Health SystemCenter for Health Services Research in Primary Care, Department of Veterans’ Affairs Medical Center
  • , John MavropoulosAffiliated withDivision of General Internal Medicine, Department of Medicine, Duke University Health System
  • , Pam SylvestreAffiliated withDivision of Gastroenterology, Department of Medicine, Duke University Health System
  • , Don C. RockeyAffiliated withDivision of Gastroenterology, Department of Medicine, Duke University Health System
  • , Eric C. WestmanAffiliated withDivision of General Internal Medicine, Department of Medicine, Duke University Health SystemDuke University Medical Center Email author 

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Abstract

Nonalcoholic fatty liver disease is an increasingly common condition that may progress to hepatic cirrhosis. This pilot study evaluated the effects of a low-carbohydrate, ketogenic diet on obesity-associated fatty liver disease. Five patients with a mean body mass index of 36.4 kg/m2 and biopsy evidence of fatty liver disease were instructed to follow the diet (<20 g/d of carbohydrate) with nutritional supplementation for 6 months. Patients returned for group meetings biweekly for 3 months, then monthly for the second 3 months. The mean weight change was −12.8 kg (range 0 to −25.9 kg). Four of 5 posttreatment liver biopsies showed histologic improvements in steatosis (P=.02) inflammatory grade (P=.02), and fibrosis (P=.07). Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease. Further research is into this approach is warranted.

Keywords

Nonalcoholic fatty liver disease NASH Low-carbohydrate ketogenic diet Cirrhosis Fatty liver