Dynamics of intrapericardial and extrapericardial fat tissues during long-term, dietary-induced, moderate weight loss

Abstract

In view of evidence linking pericardial fat accumulation with increased cardiovascular disease risk, strategies to reduce its burden are needed. Data comparing the effects of specific long-term dietary interventions on pericardial fat tissue mobilization are sparse. We sought to evaluate intrapericardial-fat (IPF) and extrapericardial-fat (EPF) changes during weight-loss interventions by different dietary regimens. During 18 mo of a randomized controlled trial, we compared a Mediterranean/low-carbohydrate (MED/LC) diet plus 28 g walnuts/d with a calorically equal low-fat (LF) diet among randomly assigned participants with moderate abdominal obesity. We performed whole-body MRI and volumetrically quantified IPF and EPF among 80 participants to follow the 18-mo changes. The participants [mean age: 48.6 y; mean body mass index (BMI; in kg/m); 31.7; 90% men] had baseline IPF and EPF (mean ± SD) volumes of 172.4 ± 53.3 mL and 194.9 ± 71.5 mL, respectively. The 18-mo moderate weight loss of 3.7 kg was similar in both groups, but the reduction in waist circumference was higher in the MED/LC group (-6.9 ± 6.6 cm) than in the LF diet group (-2.3 ± 6.5 cm; = 0.01). After 18 mo, the IPF volume had reduced twice as much in the MED/LC group compared with the LF group [-37 ± 26.2 mL (-22% ± 15%) compared with -15.5 ± 26.2 mL (-8% ± 15%), respectively; < 0.05, after adjustment for changes in weight or visceral adipose tissue]. The EPF volume had reduced similarly in both groups [-41.6 ± 30.2 mL (-23% ± 16%) in the MED/LC group compared with -37.9 ± 28.3 mL (-19% ± 14%) in the LF group; > 0.1]. After controlling for weight loss, IPF and EPF volume reduction paralleled changes in lipid profile but not with improved glycemic profile variables: the IPF relative reduction was associated with a decrease in triglycerides (TGs) (β = 0.090; 95% CI: 0.026, 0.154; = 0.007) and the ratio of TGs to high-density lipoprotein (HDL) cholesterol (β = 2.689; 95% CI: 0.373, 5.003; = 0.024), and the EPF relative reduction was associated with an increase in HDL cholesterol (β = -0.452; 95% CI: -0.880, -0.023; = 0.039) and a decrease in total cholesterol and HDL cholesterol (β = 3.766; 95% CI: 1.092, 6.440; = 0.007). Moderate but persistent dietary-induced weight loss substantially decreased both IPF and EPF volumes. Reduction of pericardial adipose tissues is independently associated with an improved lipid profile. The Mediterranean diet, rich in unsaturated fats and restricted carbohydrates, is superior to an LF diet in terms of the IPF burden reduction. This trial was registered at clinicaltrials.gov as NCT01530724.

Can Diet Help Non-Obese Individuals with Non-Alcoholic Fatty Liver Disease (NAFLD)?

“…Giugliano and Esposito have suggested that Mediterranean diet could also be beneficial in chronic inflammation associated with visceral obesity, type 2 diabetes, and metabolic syndrome [ 14 ]. Recently, the Mediterranean diet was also found superior to a low-fat diet in reducing intrapericardial-fat burden in a randomized controlled trial [ 15 ], hinting their potential in preventing cardiovascular events.…”

High-Risk Atherosclerosis and Metabolic Phenotype: The Roles of Ectopic Adiposity, Atherogenic Dyslipidemia, and Inflammation

“…27 Further to that, mobilization of ectopic fat depots was associated with improved cardiometabolic surrogate markers such as decreased expression of atherogenic dyslipidemia. 27,28 Skeletal muscle secretome. Upon contraction, skeletal muscle fibers express and release cytokines and other peptides, which encompass a group of hormone-like substances referred to as myokines.…”

Quantitative Imaging of Body Composition

“…80 Moreover, a significant association between pericardial adipose tissue and the SAT ratio with insulin resistance was found, independent of body mass index and VAT, 81 and total intrathoracic adipose volume proved to be associated with cardiac contractile dysfunction in patients with coronary artery disease. 82 Interestingly, dietary-induced reduction of pericardial adipose tissue was independently associated with an improved lipid profile, 83 indicating that intrathoracic adipose depots, like VAT and SAT, are dynamic compartments that can decrease with lifestyle modification. 83…”

“…82 Interestingly, dietary-induced reduction of pericardial adipose tissue was independently associated with an improved lipid profile, 83 indicating that intrathoracic adipose depots, like VAT and SAT, are dynamic compartments that can decrease with lifestyle modification. 83…”