Rapid Hepatic Function Improvement with Culturally Adapted Low-Carbohydrate Paleolithic Diet in South Asian Adults with Metabolic Dysfunction: A 12-Week Prospective Study with Predictive Modeling

Background: Non-alcoholic fatty liver disease (NAFLD) affects 25-30% of South Asian adults, with limited predictive tools for dietary intervention success. Identifying baseline predictors of hepatic response could enable personalized treatment approaches.
Objective: To evaluate hepatic function benefits of culturally adapted low-carbohydrate Paleolithic diet in South Asian adults with metabolic dysfunction and develop predictive models for treatment response.
Methods: 103 overweight/obese South Asian adults followed a culturally adapted Paleolithic diet for 12 weeks. Primary outcomes were hepatic function improvements (ALT, ALP, hepatic steatosis index). Multiple regression analysis identified predictors of hepatic response. ROC analysis determined optimal baseline cutoffs for treatment success, defined as ≥20% ALT reduction.
Results: Significant hepatic improvements occurred: ALT decreased 17.1% (p<0.05), ALP decreased 7.4% (p<0.01), hepatic steatosis index improved 10.7% (p<0.01). Multiple regression revealed baseline ALT (β=0.58, p<0.001), insulin resistance (β=0.34, p<0.01), and triglycerides (β=0.28, p<0.05) as independent predictors of hepatic response (R²=0.64). ROC analysis showed baseline ALT >28.5 U/L had 81.3% sensitivity and 74.6% specificity for predicting treatment success (AUC=0.82, p<0.001). Concurrent benefits included 9.4kg weight loss and 41% insulin resistance improvement.
Conclusion: Culturally adapted Paleolithic diet produces rapid hepatic function improvements in South Asian adults, with baseline ALT >28.5 U/L predicting optimal treatment response. These findings enable personalized intervention strategies for NAFLD management.