A 24-week dietary and physical activity lifestyle intervention reduces hepatic insulin resistance in the obese with chronic hepatitis C

Background/Aims Obesity‐ and virus‐mediated insulin resistance (IR) are associated with adverse hepatic and metabolic outcomes in chronic hepatitis C (CHC). This study evaluates the tolerability and effects of a dietary and physical activity (PA) intervention in obese patients with insulin‐resistant CHC. Methods Obese patients (body mass index, BMI ≥30 kg/m2) with CHC were recruited prospectively. Non‐diabetic patients with IR (homeostasis model assessment of IR, HOMA‐IR >2.0) proceeded to a 24‐week lifestyle intervention comprising pedometer monitored increase in PA (≥10 000 steps/day) and an individualised dietary plan. Results Ten non‐cirrhotic and six cirrhotic patients [age 52 ± 8.5 years, BMI 35.9 (31.46–38.21)kg/m2] were recruited, of whom all 16 (100%) completed the 24‐week protocol. Increase in PA from 6853 (2440–9533) to 10 697 (7959–13566) steps/day (P = 0.001) and reduction in caloric intake from 2263 (1805.4–2697.0) to 1281 (1099.5–1856.3) kcal/day (equivalent to reduction of median 33% (25.3–49.8%), P