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Protein and NAFLD

Increasing protein after weight loss may reduce fatty liver disease

Previous studies have found that short-term protein supplementation helps reduce the fat content in the liver, but there have been few studies on the long-term effects of protein on NAFLD

Increasing the amount of protein in the diet may reduce the liver's fat content and lower the risk of diabetes in people with non-alcoholic fatty liver disease (NAFLD), according researchers conducted a two-year study to determine the long-term impact of dietary protein on a fatty liver after weight loss.

Previous studies have found that short-term protein supplementation helps reduce the fat content in the liver, but there have been few studies on the long-term effects of protein on NAFLD. This study was part of the PREVIEW study, which aims to identify the most efficient lifestyle pattern for the prevention of type 2 diabetes in a population of pre-diabetic overweight or obese individuals.

The study, ‘Long-term effects of increased protein intake after weight loss on intrahepatic lipid content and implications for insulin sensitivity - a PREVIEW study’, published in the American Journal of Physiology - Endocrinology and Metabolism, included 25 adult volunteers, 15 of whom had been previously diagnosed with NAFLD, who participated in a low-calorie diet for eight weeks to lose up to eight percent of their body weight. After weight loss, the volunteers were directed to maintain their weight for two years and to follow either a moderate- or high-protein diet averaging from 0.8 to 1 grams of protein per kilogram (2.2 pounds) of body weight.

The research team took blood and urine samples and performed body scans to assess liver fat content and the amount of protein eliminated from the volunteers' bodies at three intervals: the start of the weight maintenance phase and again six months and then two years later.

The researchers found that protein intake, BMI, intrahepatic lipid (IHL), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), HOMA-IR and insulin sensitivity index (ISI) did not change differently between the groups during the intervention. In the whole group, BMI, IHL, VAT, SAT, HOMA-IR, and ISI were favourably changed at six months and two years compared to baseline (p<0.05). Mixed model analysis showed that independent of BMI, protein intake (g·d-1) at six months was inversely related to IHL (p<0.05) and VAT (p<0.05).

After two years maintaining their weight loss, the increase in dietary protein was associated with reduced liver fat content in the volunteers. In addition, more than half of the participants who were previously diagnosed with NAFLD no longer had a fatty liver.

"These findings stress the clinical implications and potential benefits of increased protein intake after weight loss for people with NAFLD at risk to develop diabetes," the researchers wrote.

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