Study on Partial Meal Replacement Diet in Obese Patients with High Fatty Liver Index

In patients with obesity and high fatty liver index (FLI), a partial meal replacement (pMR) diet could be an effective way for weight loss and improve metabolic parameters, researchers state in a study published in the journal Nutrients.

The increasing prevalence of obesity is related to many obesity-related health comorbidities, including cardiovascular events, hyperlipidemia, blood hypertension, metabolic-associated fatty liver disease (MAFLD), and diabetes mellitus. MAFLD is defined as lipids storage, mainly in triacylglycerol, in people who do not drink significant amounts of alcohol and in whom other steatosis causes, such as certain drugs and toxins, have been excluded.

The most helpful treatment considered for MAFLD is weight loss. A reduction in body weight by 5% corresponds to a 25% steatosis improvement and >10% with regression of liver fibrosis. A low-calorie diet with exercise is the most commonly used method for obesity treatment, intending to reach a weight loss of at least 5% in the short term. Diets of partial meal replacements (pMRs) are among the options among low-calorie diets.

There is little evidence on pMR diets in patients with metabolic-associated fatty liver disease. To fill this knowledge gap, Daniel de Luis from the University of Valladolid in Valladolid, Spain, and colleagues aimed to evaluate the modifications in transaminase levels after a pMR hypocaloric diet in people with obesity and high fatty liver index.

For this purpose, the researchers enrolled 606 patients with obesity and fatty liver index ≥ 60. They were treated for a duration of 3 months with a pMR diet. The patients were divided into group I (Alanine aminotransferase (ALT) normal) or group II (ALT ≥ 43 UI/L).

Study Findings

• Body weight, body mass index, waist circumference, total fat mass, fasting glucose, blood pressure, total cholesterol, Low-density lipoprotein (LDL) cholesterol, insulin, triglycerides, FLI index, and Homeostasis Model assessment (HOMA-IR) improved significantly in the entire group with pMR diet, without differences between group I and II.
• Aspartate aminotransferase activity (AST), ALT, Gama glutamine transferase (GGT), and AST/ALT ratios improved in both groups, too. This improvement was more significant in group II (deltas group I vs. deltas group II); AST (-4.8 ± 1.8 UI/L vs. -14.1 ± 1.9 UI/L), ALT (-4.2 ± 0.9 UI/L vs. -32.1 ± 5.7 UI/L), GGT (-4.8 ± 1.4 UI/L vs. -37.1 ± 4.2 UI/L), and AST/ALT ratio (-0.04 ± 0.002 units vs. -0.19 ± 0.04 units).

"We reported that the pMR diet is effective for shedding extra kilos and improving metabolic data in obese patients with high FLI, with both normal and elevated baseline ALT levels," the authors wrote. "The decrease in liver enzymes was higher in patients with basal ALT > 43 UI/L."

Reference

Luis, D.d.; Primo, D.; Izaola, O.; Lopez, J.J. Effects of a Short-Term Meal Replacement Hypocaloric Diet in Subjects with Obesity and High Fatty Liver Index. Nutrients 2022, 14, 5353. https://doi.org/10.3390/nu14245353