Randomised controlled trialindependent cross-checkabstract checked I-WHT-117 standard review
Switching to whole grains improved fatty liver in a trial
Whole-grain consumption and its effects on hepatic steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: a randomised controlled clinical trial.
Overview
Dorosti M et al.. Br J Nutr 2020 · PMID 31685037 · DOI 10.1017/S0007114519002769
In 112 NAFLD patients, advice to eat half of cereals as whole grains for 12 weeks lowered fatty-liver grade and liver enzymes.
Does the study support the specific claim? Yes · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Whole grains in NAFLD.
- How was the study done?
Open-label RCT.
- How many people, animals or samples were studied?
112 patients.
- What was actually found?
Better liver grade and enzymes.
- How large was the observed effect?
P<0.001.
- What do the results mean in everyday life?
Whole grains may help fatty liver.
- What are the study's limitations?
Not blinded.
- What does it say about Elawady's specific claim?
Supports the claim.
- Do the results apply to Germany and Europe?
Moderate.
- What can explicitly not be concluded from this study?
Cannot isolate the effect of white flour.
Scientific in-depth review
1. Full reference
- Authors
- Dorosti M et al.
- Journal
- Br J Nutr
- Year
- 2020
- Identifier
- PMID 31685037 DOI 10.1017/S0007114519002769
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Does whole-grain consumption improve hepatic steatosis in NAFLD?
3. Study design and population
- Study design
- Randomised controlled trial – Open-label randomised controlled trial
- Population
Adults with NAFLD (mean BMI 32.2)
- Country
not stated in abstract
- Period
not stated in abstract
- Sample size
112
- Inclusion and exclusion criteria
NAFLD patients
4. Methods and endpoints
- Exposure / intervention
Advice to obtain at least half of cereal servings from whole grains for 12 weeks
- Comparator
Usual cereals (advice)
- Endpoints
NAFLD grade, liver enzymes
- Statistical methods
Between-group comparisons, adjusted
5. Actual results
- Results
NAFLD grade decreased significantly in the intervention group (P<0.001); ALT (P<0.001), AST (P<0.001), GGT (P=0.009), SBP and DBP decreased versus control; no differences in lipids, glycaemia or anthropometry after adjustment.
- Absolute risks
not reported
- Authors' conclusion
Whole grains for 12 weeks benefited hepatic steatosis and liver enzymes in NAFLD.
6. Strengths
- Randomised
- Patients with NAFLD
7. Weaknesses
- Open-label
- Ultrasound grading (subjective)
- Advice-based
8. Risk of bias
- Orienting tool
- RoB 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- high
- Rationale
Open label with subjective grading.
9. Assessment of the statistical interpretation
Only P values in abstract; effect sizes not reported.
10. Relevance to the specific claim
Supports that replacing refined cereals with whole grains improves fatty liver.
11. Independent contrary findings
12. Transferability to Germany and Europe
Moderate.
13. Overall methodological judgement
Supportive but high risk of bias.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | high |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Blinded replication.
15. Linked fact checks
- Heavy white-flour intake is linked to fatty liver (NAFLD). – Studies supporting the claim