@Article{info:doi/10.2196/60051,
author="Saslow, Laura R
and Krinock, Jamie
and O'Brien, Alison
and Raymond, Kaitlyn
and Bayandorian, Hovig
and Moskowitz, Judith T
and Daubenmier, Jennifer
and Oliveri, Antonino
and Marriott, Deanna J
and Griauzde, Dina H
and Speliotes, Elizabeth K",
title="A Very Low--Carbohydrate Program in Adults With Metabolic Dysfunction--Associated Steatotic Liver Disease and Phospholipase Domain--Containing Protein 3 Risk Genotype: Pre-Post Intervention Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="10",
volume="9",
pages="e60051",
keywords="metabolic dysfunction--associated steatotic liver disease; ketogenic diet; low carbohydrate; adult; genotype; insulin; insulin resistance; metabolic dysfunction; dietary pattern; type 2 diabetes; T2DM; single-arm pilot trial; liver function test; genome; non-alcoholic fatty liver disease",
abstract="Background: Insulin resistance and the G allele of rs738409 interact to create a greater risk of metabolic dysfunction--associated steatotic liver disease. Objective: This study aims to confirm that one promising way to reduce insulin resistance is by following a very low--carbohydrate (VLC) dietary pattern. Methods: Adults with rs738409-GG or -CG with liver steatosis and elevated liver function tests, were taught an ad libitum VLC diet, positive affect and mindful eating skills, goal setting, and self-monitoring and given feedback and coaching for 4 months. We measured liver steatosis, anthropometric, serum metabolic diet adherence, and quality of life measures. Results: In this small pilot trial, of the 11 participants enrolled, 9 (82{\%}) participants completed outcomes. All 11 participants viewed at least 1 session of the intervention, and 8 (73{\%}) participants viewed at least half of the sessions. Among the 9 participants who provided 4-month self-report information, intervention satisfaction was high (mean 6.22, 95{\%} CI 5.58-6.85), with 5 (56{\%}) participants rating the intervention the top score, and 4 (44{\%}) participants reporting they did not plan to stop following the VLC diet. Across participants with a 4-month hepatic liver fat percent measurement, the percent change in liver fat was −33.17{\%} (95{\%} CI −86.48 to 20.14), and in only the participants who were adherent to the eating pattern, the percent change in liver fat was −53.12{\%} (95{\%} CI −71.25 to −34.99). Amongst participants with a 4-month hepatic liver fat percent measurement, 6 out of 8 (75{\%}) participants were considered responders, with a relative decline in liver fat ≥30{\%}, and of the 9 participants with a 4-month body weight, 9 (100{\%}) participants lost ≥5{\%} of their body weight. There were no serious adverse events. Conclusions: Results suggest the feasibility, acceptability, and preliminary efficacy of the VLC intervention in adults with higher genetic risk for metabolic dysfunction--associated steatotic liver disease, although there is a need for further studies given the small sample size and the high risk of substantial biases in this small pilot study. ",
issn="2561-326X",
doi="10.2196/60051",
url="https://formative.jmir.org/2025/1/e60051",
url="https://doi.org/10.2196/60051"
}