A low-fat or low-calorie diet combined with moderate physical activity has tangible health
benefits for people with hepatitis C virus (HCV) who are overweight,
research published in Nutrition
Journal shows. The study participants lost weight, experienced improvements in their
insulin and lipid profiles and the prevalence and severity of fatty liver
disease (steatosis) fell significantly.
“This study
demonstrated that lifestyle changes…improved the anthropometric parameters,
glucose parameters and lipid and liver profiles,” comment the authors. “Further
improvements was noted in the results of non-invasive liver fibrosis testing,
as well as improvement in the prevalence and severity of hepatic steatosis.”
Obesity in
people with HCV is associated with metabolic complications, type-2
diabetes, fatty liver disease and the progression of fibrosis.
Glossary
- steatosis
Abnormal fat deposits in the liver.
Investigators in
Bucharest, Romania, therefore wanted to see if a structured programme of lifestyle
changes incorporating a low-fat or low-calorie diet and moderate physical
activity had an impact on body weight, insulin resistance, lipid levels and
liver function.
They designed a
prospective study involving 120 people who received care between 2007 and
2010. All the patients were aged 35 or over, had chronic HCV infection and were
overweight or obese. Patients with HIV co-infection were excluded from
participation.
The participants
received nutritional counselling and were randomised to adopt either a low-calorie diet or a low-fat diet. Counselling was also provided regarding
physical activity, and the participants were recommended to take moderate exercise
in sessions lasting 30 minutes at least three times a week.
Baseline
assessments included weight, insulin resistance, blood lipids, steatosis and
fibrosis. These assessments were repeated after six and twelve months.
Between 40 and
45% of participants were classified as obese on entry to the study and all had
sedentary lifestyles.
After twelve
months, weight loss averaged 4kg for people on the low-calorie diet and 3kg
for people on the low-fat diet, a non-significant difference.
Physical activity
peaked during the first six months of the study and then declined. However, at
the twelve-month assessment, the study participants had significantly higher levels of
physical activity compared to baseline.
Insulin resistance
improved by 32% in the low-calorie group (p = 0.026) and by 26% in people on
the low-fat diet (p = 0.03).
Liver function also
improved with both diets.
Fatty liver disease
was present in between 46 and 56% of participants at baseline. Both diets were
associated with improvements in the prevalence and severity of steatosis (p
< 0.001).
Almost two-thirds
of participants (62%) had metabolic syndrome at the start of the study. By month
twelve, all parameters associated with metabolic syndrome had improved in both
groups (p < 0.005). At the end of the study, only 26% of people on the low-calorie diet and 27% of people on the low-fat diet showed signs of
metabolic syndrome.
“In CHC [chronic
hepatitis C] patients lifestyle changes through medical nutritional therapy and
physical activity led to an improvement in all metabolic parameters: reduced
insulin resistance, lower blood pressure, lower triglycerides, total serum
cholesterol, LDL-C, increased HDL-C, reducing systolic and diastolic blood
pressure,” write the authors. “Changes in food intake were sustainable,
associated with long-term metabolic benefits.”
They conclude: “Overweight
or obese patients with hepatitis C undergoing a lifestyle intervention
(specific dietary intervention and physical activity) for 1-year had
significant improvements in body weight, lipid and hepatic profiles.”