Non-alcoholic steatohepatitis (NASH) is a worldwide health problem and imposes a high cost on healthcare system, and NASH is associated with an unhealthy lifestyle. This study investigated whether low carbohydrate diet intervention physical activity and affect intrahepatic fat content and hepatic enzymes. The current interventional study included participants who were over 18 years with NASH (n= 30) with BMI over 25 kg/m2. The effects of proper nutritional therapy (moderate caloric restriction, low carbohydrate) was tested through personal dietary and physical assessment,
parameters of the metabolic syndrome and insulin resistance in addition to liver biochemical and imaging study . The assessment was done at baseline and at 3 months by the same observer. The results showed that after 3 months of intervention, patients had a significant decrease in caloric consumption, weight loss (p < 0.001) and HOMA-IR had significant improvements. Lipid profile after 3 months showed significant reduction including cholesterol and triglycerides
levels (p < 0.05). Regarding liver profile significant decrease observed in aminotransferases levels; also there were significant improvements in AST/ALT ratio with decrease in severity of liver steatosis.