Role of Fasting in the Management of Non-alcoholic Fatty Liver Disease (NAFLD): A Systematic Review of Clinical Trials
Bibliographic record
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease. Lifestyle changes, especially dietary, have been recognized as important measures for managing the condition. This systematic review aimed at assessing the effectiveness of fasting protocols, including time-restricted feeding (TRF), alternate-day fasting (ADF), the 5:2 diet, and other lifestyle interventions in enhancing metabolic and hepatic profiles. The search for randomized controlled trials (RCTs) was extended to include PubMed, Scopus, ScienceDirect, and Google Scholar for articles published between 2019 and 2024. The studies that included participants with fatty liver disease and examined the effects of fasting on hepatic steatosis, metabolic markers, and liver enzymes were included, and the quality of the studies was evaluated using the Cochrane risk of bias tool. Out of the 12 RCTs that were included in the study, there was a significant reduction in hepatic steatosis, an increase in insulin sensitivity, and a decrease in inflammatory markers. TRF and ADF were found to be effective forms of calorie restriction, as they were well tolerated by the patients. The combination of ADF with aerobic exercise and TRF with low-sugar diets was seen to have potent effects on the liver and other metabolic parameters. However, certain drawbacks include the variation in the fasting protocols, small subject numbers, and brief follow-up periods. The current study highlights that intermittent fasting is a viable non-pharmacological option for the management of NAFLD with a focus on the timing and content of eating periods. The following are needed to strengthen the evidence and to guide the clinicians in its application: standardized fasting protocols and long-term trials.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.041 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".