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J Res Med Sci. 2019 Mar 25;24:21. doi: 10.4103/jrms.JRMS_282_18. eCollection 2019.

A randomized controlled trial comparing effects of a low-energy diet with n-3 polyunsaturated fatty acid supplementation in patients with non-alcoholic fatty liver disease.

Author information

1
Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Food and Beverages Safety Research Center, Urmia, Iran.
2
Urmia Imam Khomeini University Hospital, Urmia University of Medical Sciences, Urmia, Iran.
3
Department of Gastroenterology and Hepatology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
4
Department of Endocrinology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

Abstract

Background:

Weight loss is the cornerstone of NAFLD management, but weight maintenance is difficult. Some studies have suggested that n-3 polyunsaturated fatty acid (n-3 PUFA) might have beneficial effects in NAFLD. We aim to compare the effects of a low-energy diet with n-3 PUFA supplementation on liver enzymes, body composition, and cardiometabolic risk factors in NAFLD.

Materials and Methods:

The study was a randomized controlled trial conducted in Urmia in Iran from October 2016 to May 2017. One hundred and fourteen eligible patients were randomly assigned to one of the three following groups: low-energy diet group, n-3 PUFA supplementation (fish oil) group (1500 mg/d), or control group for 12 weeks. Liver enzymes, lipid profile, insulin resistance, and body composition were assessed before and after the intervention.

Results:

One hundred and four patients completed the study. All groups lost weight, but the reductions were greater in the diet group (-2.97 ± 2.79 kg, P = 0.001). The diet group had significant decreases in fat mass compared to other groups. Insulin resistance, total cholesterol, and low-density lipoprotein cholesterol significantly decreased only in the diet group, and patients who lost weight ≥4% showed significantly larger decreases in serum liver enzymes. N-3 PUFA had no beneficial effects on the study outcomes.

Conclusion:

We found that 1500 mg/d n-3 PUFA supplied for 12 weeks, in contrast to 3.40 ± 2.98% weight loss, does not improve liver enzymes, body composition, and cardiometabolic risk factors in NAFLD patients.

KEYWORDS:

Body composition; diet; fatty acid omega-3; insulin resistance; nonalcoholic fatty liver disease; weight loss

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