nonalcoholic fatty liver disease ( nafld ) as a silent killer with accumulating extra fat in hepatocytes more than 5% with no history of alcohol abuse , follows by creating inflammation , nonalcoholic steatohepatitis , which leads to liver fibrosis and finally liver cirrhosis . high prevalence of nafld in diabetic patients and obese individuals showed the relationship between nafld and these chronic diseases which insulin resistance considered as the main reason . due to 25%30% prevalence of total population , finding solutions for nafld has an exclusive importance in public health . even though life styles modifications such as weight lose are suggested , nutritional patterns changes are considered as important approaches in nafld management . simple carbohydrates , especially fructose and sucrose cause fat accumulation in body tissues such as liver . many studies assessed effect of nutrients such as vitamin d , symbiotic and green tea as a solution . plantago psyllium ( pp ) and ocimum basilicum ( ob ) as two types of high fiber and mucilage ( 10%15% ) , plant seeds can consider as the key solution of nafld by decreasing appetite with occupying stomach and decreasing food glysemic index . present study is a four - arm parallel , randomized , and single blind trial conducted in sedigheh tahereh , isfahan endocrine and metabolism research center in august 2014 to march 2015 . we selected new cases of nafld at their first time referral to fatty liver clinic . we recruited men and women between 27 and 74 years old diagnosed with fatty liver ultrasonography , a well - established technique . individuals with steady using of fiber supplements , insulin injection , and drugs such as corticosteroids , anticonvulsants , and antiepileptic , also pregnant , lactating , hemochromatosis , and cirrhosis patients were excluded . we supplied pp and ob seeds from the center of iran , isfahan , which packaged in 2 5 g parts for daily ( 10 g ) usage . each pack should be eaten 2030 min before lunch and dinner with only a glass of water and no additional sugar or even artificial sweeteners for 3 months . mucilage of pp and ob absorb water and get a sticky and viscose condition which leads to unpleasant feeling , so we lost participants and mentioned in figure 1 . flow diagram of the progress through the phases of study we measured macronutrients and fiber components of pp and ob . crude fiber by assessment tool ( pp : 33 and ob : 31% ) and dietary fiber by association of official analytical chemists ( aoac ) 199/43 method ( pp : 80 and ob : 59% ) , carbohydrate by fehling method ( pp : 0.5 and ob : 1% ) , protein by kjeldahl method ( pp : 18 and ob : 25% ) , and fat by soksele method ( pp : 1.5 and ob : 20% ) were measured at the beginning of study . heights were measured with a standard tape and without shoes to the nearest 0.5 cm . weight to the nearest 0.1 kg , percent body fat ( pbf % ) , body mass index ( bmi ) , soft lean mass ( slm kg ) , mass body fat ( mbf kg ) , and also both mbf and slm for trunk were all measured by body composition analyzer device ( janex medical company , ioi 353 model ) . then , 3-day food records of 2 usual days and 1 day off and a 2-day physical activity record were taken . physical activity was calculated as a metabolic equivalent task minute per day spent on all activities with accurate each activity time . we provided a list of randomized numbers that had 4 numbers in each group then , one blinded staff of fatty liver clinic put the selected patients in four different groups ( 1 : ob , 2 : pp , 3 : ob and pp mixed , and 4 : control ) secretly . because patients should pour the seeds into a glass of water , they could not be blinded . but , laboratory staff , one ultrasound specialist , and who explained the records and consumption structures of the intervention were blinded in this study . quantitative and qualitative variables were expressed as mean  standard error ( or median [ inter quartile range ] ) and frequency ( percentage ) . was conducted using paired samples t - test . for between group comparisons analysis of covariance ( ancova ) was used and baseline values of dependent variables , age and energy intake were adjusted . chi - square or fisher exact tests ( if appropriate ) were used for comparing the qualitative variables between groups . statistical analyses carried out by the use of statistical package for the social sciences ( spss ) version 16 ( spss , inc , chicago , il , usa ) . present study is a four - arm parallel , randomized , and single blind trial conducted in sedigheh tahereh , isfahan endocrine and metabolism research center in august 2014 to march 2015 . we selected new cases of nafld at their first time referral to fatty liver clinic . we recruited men and women between 27 and 74 years old diagnosed with fatty liver ultrasonography , a well - established technique . individuals with steady using of fiber supplements , insulin injection , and drugs such as corticosteroids , anticonvulsants , and antiepileptic , also pregnant , lactating , hemochromatosis , and cirrhosis patients were excluded . we supplied pp and ob seeds from the center of iran , isfahan , which packaged in 2 5 g parts for daily ( 10 g ) usage . each pack should be eaten 2030 min before lunch and dinner with only a glass of water and no additional sugar or even artificial sweeteners for 3 months . mucilage of pp and ob absorb water and get a sticky and viscose condition which leads to unpleasant feeling , so we lost participants and mentioned in figure 1 . crude fiber by assessment tool ( pp : 33 and ob : 31% ) and dietary fiber by association of official analytical chemists ( aoac ) 199/43 method ( pp : 80 and ob : 59% ) , carbohydrate by fehling method ( pp : 0.5 and ob : 1% ) , protein by kjeldahl method ( pp : 18 and ob : 25% ) , and fat by soksele method ( pp : 1.5 and ob : 20% ) were measured at the beginning of study . heights were measured with a standard tape and without shoes to the nearest 0.5 cm . weight to the nearest 0.1 kg , percent body fat ( pbf % ) , body mass index ( bmi ) , soft lean mass ( slm kg ) , mass body fat ( mbf kg ) , and also both mbf and slm for trunk were all measured by body composition analyzer device ( janex medical company , ioi 353 model ) . then , 3-day food records of 2 usual days and 1 day off and a 2-day physical activity record were taken . physical activity was calculated as a metabolic equivalent task minute per day spent on all activities with accurate each activity time . we provided a list of randomized numbers that had 4 numbers in each group then , one blinded staff of fatty liver clinic put the selected patients in four different groups ( 1 : ob , 2 : pp , 3 : ob and pp mixed , and 4 : control ) secretly . because patients should pour the seeds into a glass of water , they could not be blinded . but , laboratory staff , one ultrasound specialist , and who explained the records and consumption structures of the intervention were blinded in this study . quantitative and qualitative variables were expressed as mean  standard error ( or median [ inter quartile range ] ) and frequency ( percentage ) . was conducted using paired samples t - test . for between group comparisons analysis of covariance ( ancova ) was used and baseline values of dependent variables , age and energy intake were adjusted . chi - square or fisher exact tests ( if appropriate ) were used for comparing the qualitative variables between groups . statistical analyses carried out by the use of statistical package for the social sciences ( spss ) version 16 ( spss , inc , chicago , il , usa ) . eight participants could not tolerate pp and ob because of constipation , nausea or stomach - ache and were excluded from our study . moreover , 42 patients that were involved to exclusion criteria during the study or they did not want to continue were eliminated . there were no significant differences regarding sex distribution , smoking condition , education status , and body weight in four groups at baseline . however , age was the only factor that was significantly different among groups which was adjusted in our analysis . baseline demographic information of participants first of all , we compared before and after anthropometric measurements in different groups separately that some of them had been significantly decreased . weight ( p = 0.02 ) , bmi ( p = 0.01 ) , and mbf ( p = 0.04 ) in ob group were significantly reduced . moreover , weight ( p = 0.00 ) , bmi , slm , and lean body mass ( lbm ) ( p = 0.01 ) were lowered in pp group . in pp and ob mixed group weight , bmi , slm , and lbm were significantly different while , slm of trunk was marginally significant . similarly , control group data showed considerable reduction in weight and bmi p = 0.00 and 0.02 , respectively , we examined among group changes as more important aim in order to reach reliable consequences of our intervention that we did not see any significant effects among groups [ table 2 ] . result of within group and between groups comparison in addition , we averaged out a 3-day food and a 2-day record in order to controlled confounding such as a total dietary , total fiber , insoluble fiber , and soluble fiber intake [ table 3 ] and also , physical activity [ table 1 ] . none of the mean dietary confounding factors and mean of physical activity was significantly different among four groups . this study illustrates a 10 g increasing of pp , ob , or mix of them have no effects on weight , bmi , % pbf , or slm during 12 weeks . previous studies have recommended that increased fiber intake up to recommended dietary allowance ( rda ) amount ( 38 for men and 25 g for women leads to increased postmeal satiety . moreover , the gut hormone , ghrelin , gastrointestinal peptide , and glucagon - like peptide ( glp-1 ) were increased . however , the effects of fiber on weight loss are controversial . similar to our study , no protective effect of pp on weight change did not observed in 36 diabetic patients . likewise , when soluble fiber was compared against insoluble fiber neither of them have cause reduction in weight . high dose of pp ( 36 g daily ) demonstrated considerable decrease in weight , bmi , and , especially % body fat either with a diet modification or without that . similarly , both soluble ( 24 g pp ) and insoluble ( 28 g wheat bran ) elucidated a significantly weight loss after 6 weeks , while the participants had gone on a modified diet . as other studies some used drugs by patients to improve liver status , might fade the effects of pp and ob on anthropometric measures . our participants were new cases of nafld who may have gone on a diet unconsciously . the aim of present study was to demonstrate protective effect of pp and ob mixture on weight reduction but it was not observed which can be due to the low - dose of soluble fiber used in present study . in a similar meta - analysis , the effect of guar gum on body weight was evaluated rigorously . as a consequence , when 11 randomized controlled trials were put together , no significant robust effect of guar gum consumption on weight loss was observed . although most animal studies showed a significant effect of fiber on weight reduction , human studies have yielded inconsistent inferences . likewise , it is shown in another systematic review that soluble fiber has no effect on weight loss . however , it should be noted in our study and other similar studies , participant 's baseline weight was normal or overweight which may have precluded the expected results . this study has been registered both in iranian registry clinical trial ( irct2014101811763n17 ) and isfahan university of medical sciences ( 393583 ) . this study indicated that supplementation with 10 mg / day pp , 10 mg / day ob , and 10 mg / day pp and ob mixed for 12 weeks did not improve weight , bmi , slm , lbm , mbf , and pbf significantly . further trials should be done in this area with higher dose of pp and ob and also , in bigger population which draw a clear link between anthropometric measures and fiber supplementation . this study was funded by isfahan university of medical sciences and sedigheh tahereh , isfahan endocrine and metabolism research center was involved in data collection .
background : due to the attribution of fatty liver with some chronic diseases such as obesity , finding a way to control obesity can be useful for the management of fatty liver . 
 this study was performed to assess the effects of plantago psyllium ( pp ) and ocimum basilicum ( ob ) on anthropometric measurements in people with hepatic steatosis.methods:all patients with nonalcoholic fatty liver disease ( nafld ) were enrolled in this four - arm parallel , randomized , and single blind trial . 
 they randomly assigned into four groups receiving ( 1 ) ob 10 g / day ; ( 2 ) pp 10 g / day ; ( 3 ) mix of ob and pp 10 g / day ; and ( 4 ) control group without placebo for 12 weeks . 
 anthropometric measurements were assessed during study baseline and after 12 weeks intervention . 
 the data were analyzed using paired sample t - test for within group and analysis of covariance for between groups.results:in within group analysis , weight and body mass index show a significant reduction after 12 weeks intervention . 
 in addition , soft lean mass and lean body mass were decreased in pp and mixed of pp and ob groups significantly ; another group ( ob ) shows the same result for mass body fat . 
 although in intervention groups , we see considerable reduction , between group changes did not demonstrate the same consequences.conclusions:the results of this study showed that administration of ob , pp , or mix of them for 12 weeks does not affect any of the anthropometric measures in nafld .