Effect of a moderately carbohydrate-restricted diet on liver enzymes, steatosis and fibrosis in normal-weight individuals with non-alcoholic fatty liver disease: study protocol for a parallel randomised controlled clinical trial.

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a hepatic condition that is considerably prevalent across the world. Dietary intakes, in which macronutrient composition is precisely planned, might be able to reduce inflammation, steatosis and fibrosis among patients with NAFLD. A moderately carbohydrate restricted diet with weight loss has been demonstrated to improve liver fat content among overweight or obese patients. However, there is no information about the appropriateness of such a restriction, without weight loss, in normal-weight patients. This randomised clinical trial will be aimed at assessing the effect of moderate carbohydrate restriction on liver enzymes, liver steatosis and fibrosis in normal-weight patients with NAFLD. METHODS AND ANALYSIS: This randomised controlled clinical trial will be conducted to evaluate the impact of a moderately carbohydrate restricted diet on liver enzymes, steatosis and fibrosis in 52 eligible normal-weight individuals with NAFLD. Transient elastography and controlled attenuation parameter with FibroScan will be applied to diagnose NAFLD. After individual matching based on body mass index, age and sex, patients will be randomly assigned to receive a moderately carbohydrate restricted diet or an isocaloric diet without carbohydrate restriction for 12 weeks. The primary and secondary outcomes in this study will be liver function indices, including liver steatosis and fibrosis, metabolic parameters and anthropometric measures. All these variables will be assessed at study baseline and postintervention. ETHICS AND DISSEMINATION: The present clinical trial study was accepted by the ethics committee of TUMS (Tehran University of Medical Sciences) (code: IR.TUMS.MEDICINE.REC.1400.116). TRIAL REGISTRATION NUMBER: IRCT20210119050086N1.

The association between dietary patterns and depression in adolescents: A cross-sectional study.

INTRODUCTION AND PURPOSE: So far, few studies have examined the relationship between dietary patterns and depression in adolescents. The aim of the present study was to determine this relationship in a sample of adolescent Iranian girls. MATERIALS AND METHODS: 347 female high school students aged 14-17 years living in Shiraz, Iran participated in this cross-sectional study. General and physical activity questionnaires, 3-d dietary recalls, and Beck Depression Inventory-Second Edition (BDI-II) were completed for all individuals and their anthropometric characteristics were measured. The major dietary patterns were then identified using principal component factor analysis. FINDINGS: In total, 2 major dietary patterns were identified. After adjusting for potential confounders in multivariate linear regression analysis, the Western pattern (characterized by high consumption of French fries, hydrogenated fats, mayonnaise, sweets and desserts, high-fat dairy, refined grains, red or processed meats, pickles, organ meats and soft drinks and low consumption of low-fat dairy) was positively (standardized ß coefficient: 0.510, P < 0.001) and the healthy pattern (characterized by high intake of vegetables, legumes, boiled potatoes, poultry, fish, vegetable oils, olives, fruits and fruit juices and low-fat dairy and low intake of refined grains) was inversely associated (standardized ß coefficient: -0.508, P < 0.001) with BDI-II score. CONCLUSION: Overall, findings of this study indicate that certain dietary patterns are associated with depression in adolescent Iranian girls. However, more studies are needed to further confirm these findings.