Nutritional Counseling vs. Nutritional Supplements for NASH - a Randomized Prospective, Open Label Pilot Study

Inclusion Criteria: \- Elevated M30 antigen levels (cutoff: \>200 - 800 U/L) at screening AND hepatic steatosis on ultrasound OR histologically confirmed NASH \- Age 18 to 75 years Exclusion Criteria: * Alcohol intake of more than 30 g/d (men) or 20 g/d (women) * Treatment with ursodeoxycholic acid (UDCA), Vitamin E or other investigational NASH drugs 3 months prior to randomization * Treatment with medications or substances that may induce secondary NASH (e.g., tamoxifen, corticosteroids, amiodarone, methotrexate) or ameliorate NASH (TNF-antagonists) * Treatment with phenprocoumon or warfarin * Hepatocellular carcinoma or non-hepatic malignancy * Decompensated cirrhosis (Child B,C) or a history of decompensation * Liver disease unrelated to NASH, including chronic viral hepatitis B/D or C, autoimmune hepatitis, Wilson's disease or clinical manifest iron overload * Bariatric surgery within the last 5 years * BMI \<18,5 kg/m2 or BMI \>45 kg/m2 * Liver transplantation * Heart failure (New York Heart Association Class II - IV) * Myocardial infarction, instable coronary artery disease , coronary artery intervention or stroke in the previous 6 months * Instable chronic obstructive pulmonary disease, chronic inflammatory bowel disease or rheumatoid arthritis. * Instable renal insufficiency (changes in serum creatinin \> 50% in the last 3 month) or terminal renal insufficiency requiring dialysis * Uncontrolled hypertension (blood pressure \> 180/90 despite therapy) * Uncontrolled diabetes mellitus defined by hemoglobin A1c \> 9 * Food allergies requiring strictly dietary adherence * Pregnant or nursing women * Chronic pancreatitis or history of recurring acute pancreatitis