Approximately 65% of obese individuals have non-alcoholic fatty liver disease (NAFLD), and this condition is strongly related to the development of insulin resistance and diabetes. Innovative lifestyle strategies to treat NAFLD are critically needed. The proposed research will demonstrate that alternate day fasting (ADF) combined with exercise is an effective non-pharmacological therapy to treat NAFLD.
Nonalcoholic fatty liver disease (NAFLD) is characterized by an accumulation of fat in the liver (not resulting from excessive alcohol consumption). Approximately 65% of obese individuals have NAFLD, and this condition is strongly related to the development of insulin resistance and type 2 diabetes. While certain pharmacological agents have been shown to reduce liver fat (i.e. thiazolidinediones), there is mounting concern regarding the safety and weight-gaining effects of these compounds. In light of this, recent research has focused on non-pharmacological lifestyle therapies to reduce hepatic steatosis, such as daily calorie restriction combined with aerobic exercise. Evidence from clinical trials suggest that this combination is an effective lifestyle therapy improve liver fat content and hepatic insulin sensitivity. More recently, it's been shown that intermittent fasting may produce even greater improvements in hepatic steatosis and hepatic insulin sensitivity, when compared to conventional calorie restriction. For instance, intrahepatic lipid accumulation was lower and insulin sensitivity was higher in mice fasted every other day, when compared to mice who were energy restricted every day. Moreover, data from human trials show that adults with obesity experience greater decreases in insulin and insulin resistance with intermittent fasting versus daily restriction. These findings suggest that intermittent fasting may be a more effective diet therapy to reduce hepatic steatosis and improve insulin sensitivity, when compared to daily calorie restriction. Although these findings are very promising, these data still require confirmation by a randomized controlled clinical trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
80
The diet involves consuming 600 kcal on the "fast day" and eat ad libitum at home on alternating "feed days".
The exercise intervention involves supervised aerobic exercise program 5 times per week, 40-60 min per session, 60-85% HRmax.
University of Illinois Chicago
Chicago, Illinois, United States
Change in Hepatic Steatosis
Hepatic steatosis will be measured by magnetic resonance imaging (MRI-PDFF)
Time frame: Change from week 1 to week 12
Change in Body Weight
Measured by digital scale
Time frame: Change from week 1 to week 12
Change in Alanine Aminotransferase (ALT)
Measured by a commercial lab (Medstar, Inc)
Time frame: Change from week 1 to week 12
Change in Aspartate Aminotransferase (AST)
Measured by a commercial lab (Medstar, Inc)
Time frame: Change from week 1 to week 12
Change in Fasting Glucose
Measured by a commercial lab (Medstar, Inc)
Time frame: Change from week 1 to week 12
Change in Fasting Insulin
Measured by a commercial lab (Medstar, Inc)
Time frame: Change from week 1 to week 12
Change in Insulin Resistance
Measured by Homeostatic model assessment of insulin resistance (HOMA-IR). The HOMA-IR value was calculated using the formula: \[HOMA-IR = glucose (mg/dL) × insulin (mU/L)/405\]. Interpretation of HOMA-IR Scores: \< 1.0: Normal insulin sensitivity; 1.0-1.9: Mild insulin resistance; \> 2.0: Moderate to severe insulin resistance.
Time frame: Change from week 1 to week 12
Change in HbA1c
Measured by a commercial lab (Medstar, Inc)
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Time frame: Change from week 1 to week 12