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Effects of an isoenergetic low Glycaemic Index (GI) diet on liver fat accumulation and gut microbiota composition in patients with non-alcoholic fatty liver disease (NAFLD): A study protocol of an efficacy mechanism evaluation

Al-Awadi, Amina; Grove, Jane; Taylor, Moira; Valdes, Ana; Vijay, Amrita; Bawden, Stephen; Gowland, Penny; Aithal, Guruprasad

Effects of an isoenergetic low Glycaemic Index (GI) diet on liver fat accumulation and gut microbiota composition in patients with non-alcoholic fatty liver disease (NAFLD): A study protocol of an efficacy mechanism evaluation Thumbnail


Authors

Amina Al-Awadi

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JANE GROVE jane.grove@nottingham.ac.uk
Assistant Professor



Abstract

Introduction A Low Glycaemic Index (LGI) diet is a proposed lifestyle intervention in non-alcoholic fatty liver diseases (NAFLD) which is designed to reduce circulating blood glucose levels, hepatic glucose influx, insulin resistance and de novo lipogenesis. A significant reduction in liver fat content through following a 1-week LGI diet has been reported in healthy volunteers. Changes in dietary fat and carbohydrates have also been shown to alter gut microbiota composition and lead to hepatic steatosis through the gut-liver axis. There are no available trials examining the effects of an LGI diet on liver fat accumulation in patients with NAFLD; nor has the impact of consuming an LGI diet on gut microbiota composition been studied in this population. The aim of this trial is to investigate the effects of LGI diet consumption on liver fat content and its effects on gut microbiota composition in participants with NAFLD compared with a High Glycaemic Index (HGI) control diet. Methods and analysis A 2×2 cross-over randomised mechanistic dietary trial will allocate 16 participants with NAFLD to a 2-week either HGI or LGI diet followed by a 4-week wash-out period and then the LGI or HGI diet, alternative to that followed in the first 2 weeks. Baseline and postintervention (four visits) outcome measures will be collected to assess liver fat content (using MRI/S and controlled attenuation parameter-FibroScan), gut microbiota composition (using 16S RNA analysis) and blood biomarkers including glycaemic, insulinaemic, liver, lipid and haematological profiles, gut hormones levels and short-chain fatty acids. Ethics and dissemination Study protocol has been approved by the ethics committees of The University of Nottingham and East Midlands Nottingham-2 Research Ethics Committee (REC reference 19/EM/0291). Data from this trial will be used as part of a Philosophy Doctorate thesis. Publications will be in peer-reviewed journals. Trial registration number NCT04415632.

Journal Article Type Article
Acceptance Date Sep 13, 2021
Online Publication Date Oct 7, 2021
Publication Date Oct 7, 2021
Deposit Date Oct 20, 2021
Publicly Available Date Oct 20, 2021
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ
Peer Reviewed Peer Reviewed
Volume 11
Issue 10
Article Number e045802
DOI https://doi.org/10.1136/bmjopen-2020-045802
Keywords General Medicine
Public URL https://nottingham-repository.worktribe.com/output/6504977
Publisher URL https://bmjopen.bmj.com/content/11/10/e045802

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Effects of an isoenergetic low Glycaemic Index (GI) diet on liver fat accumulation and gut microbiota composition in patients with non-alcoholic fatty liver disease (NAFLD): a study protocol of an efficacy mechanism evaluation (635 Kb)
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https://creativecommons.org/licenses/by/4.0/





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