LAUSR

We read with interest the paper The effect of a fruit-rich diet on liver biomarkers, insulin resistance, and lipid profile in patients with non-alcoholic fatty liver disease: a randomized clinical trial by Farkhondeh Alami et al. and would like to commend them for it [1]. Additionally, we would like to raise a few points that we believe should be clarified to improve the interpretability of their results. We noticed that sugar consumption in the control group (CG) went up while documenting an opposite fruit-rich diet group (FRDG) and found this counter-intuitive. We would like to know if the instrument employed to assess sugar consumption considers sugar from fruit separately and if the glycaemic load was calculated from the 24-hour food recalls. On the other hand, we think it is desirable to have more details about the exact dietary recommendation or materials that were offered to both groups at baseline and during their follow-up calls and how the authors reconcile that the CG lost weight despite increasing their total energy consumption. Finally, we would like to know if it was considered in their analyses that peeling the fruits would reduce their fiber content or that consuming them after soaking for 20–30min in water could remove some protective molecules such as hydrosoluble vitamins. We think this recommendation was unnecessary [2] and hinders the representativity of usual fruit consumption in their study.