Effects of time-restricted feeding (16/8) combined with a low-sugar diet on the management of non-alcoholic fatty liver disease: A randomized controlled trial

Objectives: Emerging studies have employed time-restricted feeding (TRF) and a low-sugar diet alone in the management of non-alcoholic fatty liver disease (NAFLD), but their combination has not been tested. The aim of this study was to investigate the effects of TRF combined with a low-sugar diet on NAFLD parameters, cardiometabolic and inflammatory biomarkers, and body composition in patients with NAFLD. Methods: A 12-wk randomized controlled trial was performed to compare the effects of TRF (16 h fasting/8 h feeding daily [16/8]) plus a low-sugar diet versus a control diet based on traditional meal distribution in patients with NAFLD. Changes in body composition, anthropometric indices, and liver and cardiometabolic markers were investigated. Results: TRF 16/8 with a low-sugar diet reduced body fat (26.7 + 5.4 to 24.2 + 4.9 kg), body weight (83.8 + 12.7 to 80.5 + 12.1 kg), waist circumference (104.59 +/- 10.47 to 101.91 +/- 7.42 cm), and body mass index (29.1 +/- 2.6 to 28 +/- 2.7 kg/m(2)), as well as circulating levels of fasting blood glucose and liver (alanine aminotransferase, 34 +/- 13.9 to 21.2 +/- 5.4 U/L; aspartate aminotransferase, 26.3 +/- 6.2 to 20.50 +/- 4 U/L; gamma-glutamyl transpeptidase, 33 +/- 15 to 23.2 +/- 11.1 U/L; fibrosis score, 6.3 +/- 1 to 5.2 +/- 1.2 kPa; and controlled attenuation parameter, 322.9 +/- 34.9 to 270.9 36.2 dB/m), lipids (triacylglycerols, 201.5 +/- 35.3 to 133.3 +/- 48.7 mg/dL; total cholesterol, 190 +/- 36.6 to 157.8 +/- 33.6 mg/dL; and low-density lipoprotein cholesterol, 104.6 +/- 27.3 to 84 +/- 26.3 mg/dL), and inflammatory markers (high-sensitivity C-reactive protein, 3.1 +/- 1.1 to 2 +/- 0.9 mg/L; and cytokeratin-18, 1.35 +/- 0.03 to 1.16 +/- 0.03 ng/mL). These results were statistically significant (P < 0.05) compared with the control group. Conclusions: TRF plus a low-sugar diet can reduce adiposity and improve liver, lipid, and inflammatory markers in patients with NAFLD. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study investigated the effects of time-restricted feeding (TRF) combined with a low-sugar diet on patients with non-alcoholic fatty liver disease (NAFLD). The results showed that TRF combined with a low-sugar diet can reduce adiposity, improve liver function, lipid profile, and inflammatory markers in patients with NAFLD.