Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction

Browning, Jeffrey D.; Baker, Jonathan A.; Rogers, Thomas E.; Davis, Jeannie; Satapati, Santhosh; Burgess, Shawn C.

doi:10.3945/ajcn.110.007674

Cited by 268 publications

(289 citation statements)

References 31 publications

(28 reference statements)

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“…However, intervention studies are needed to test a putative causal relationship between changes in ectopic lipid deposition and insulin sensitivity. Diet-induced weight loss in obese individuals is associated with reduction of fat in liver and skeletal muscle [3][4][5]. This has been linked to improved insulin sensitivity but has not been a universal finding.…”

Section: Introductionmentioning

confidence: 99%

A heterogeneous response of liver and skeletal muscle fat to the combination of a Paleolithic diet and exercise in obese individuals with type 2 diabetes: a randomised controlled trial

et al. 2018

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Aims/hypothesis The aim of the study was to investigate ectopic fat deposition and insulin sensitivity, in a parallel single-blinded randomised controlled trial, comparing Paleolithic diet alone with the combination of Paleolithic diet and exercise in individuals with type 2 diabetes. Methods Thirty-two individuals with type 2 diabetes with BMI 25-40 kg/m 2 and 30-70 years of age followed a Paleolithic diet ad libitum for 12 weeks. In addition, study participants were randomised by computer program to either supervised combined exercise training (PD-EX group) or standard care exercise recommendations (PD group). Staff performing examinations and assessing outcomes were blinded to group assignment. Thirteen participants were analysed in each group: hepatic and peripheral insulin sensitivity were measured using the hyperinsulinaemic-euglycaemic clamp technique combined with [6, H 2 ]glucose infusion, and liver fat was assessed by proton magnetic resonance spectroscopy; both analyses were secondary endpoints. Intramyocellular lipid (IMCL) content was measured by magnetic resonance spectroscopy as a secondary analysis. All examinations were performed at Umeå University Hospital, Umeå, Sweden. Results Both study groups showed a median body weight loss of 7 kg. Fat mass decreased by 5.7 kg in the PD group and by 6.5 kg in the PD-EX group. Maximum oxygen uptake increased in the PD-EX group only. Liver fat showed a consistent reduction (74% decrease) in the PD group, while the response in the PD-EX group was heterogeneous (p < 0.05 for the difference between groups). IMCL content of the soleus muscle decreased by 40% in the PD group and by 22% in the PD-EX group (p < 0.05 for the difference between groups). Both groups improved their peripheral and adipose tissue insulin sensitivity, but not their hepatic insulin sensitivity. Plasma fetuin-A decreased by 11% in the PD group (p < 0.05) and remained unchanged in the PD-EX group. Liver fat changes during the intervention were correlated with changes in fetuin-A (r S = 0.63, p < 0.01). Participants did not report any important adverse events caused by the intervention. Conclusions/interpretation A Paleolithic diet reduced liver fat and IMCL content, while there was a tissue-specific heterogeneous response to added exercise training.

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Section: Introductionmentioning

confidence: 99%

A heterogeneous response of liver and skeletal muscle fat to the combination of a Paleolithic diet and exercise in obese individuals with type 2 diabetes: a randomised controlled trial

et al. 2018

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“…Weight loss was similar between the groups. Liver TG decreased significantly with weight loss, but the reduction was more intense in the low-carbohydrate subjects compared with in the low-calorie group [60] . In order to evaluate the effects of an even more restricted carbohydrate diet (< 20 g/d of carbohydrate) on liver histology, a pilot study including 5 NAFLD obese subjects (confirmed by liver biopsy) were instructed to follow a ketogenic diet associated with nutritional supplementation for 6 mo.…”

Section: Intrahepatocellular Lipidsmentioning

confidence: 79%

“…The reduction of the ALT concentrations was associated with increasing in insulin sensitivity and decreasing in daily insulin requirement [63] . On the other hand, a 2-wk on VLCD (20 g/d) or calorie restriction (1200-1500 kcal/d) correlated with a reduction in the serum levels of AST, but not ALT, in patients with NAFLD [60] . The specific effect of a low-fructose diet was evaluated in both children and adults with NAFLD.…”

Section: Liver Enzymesmentioning

confidence: 89%

Dietary approach in the treatment of nonalcoholic fatty liver disease

Ferolla¹,

Silva²,

Ferrari³

et al. 2015

WJH

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Nonalcoholic fatty liver disease (NAFLD) has been identified as one of the most prevalent chronic liver disease in adults and children populations. NAFLD is usually associated with the metabolic syndrome (MS), which is chiefly related to insulin resistance and its consequences. Insulin resistance has a crucial role in the pathogenesis of hepatic steatosis and potentially nonalcoholic steatohepatitis (NASH). Because of the contemporary epidemics of MS and obesity, the burden of NAFLD is also expected to rise. Unhealthy diets, such as the so-called western diet, are enriched in fructose, trans-fatty acids and saturated fat and seem to be associated with the development of NAFLD. In human studies, certain dietary sugars, particularly fructose, are used as a substrate for lipogenesis leading to hepatic fatty infiltration, inflammation, and possibly fibrosis. Other investigations have shown that fat consumption especially cholesterol and trans/saturated fatty acids are also steatogenic and seem to increase visceral adiposity. The identification of specific dietary components that favor the development of NASH could be important for the management of this disorder. This review focuses on the effects of different dietary approaches to prevent and treat NAFLD emphasizing the macronutrients and energy composition.

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“…For example, significant reductions in hepatic triglyceride content (in excess of 50%) can be achieved within a few days of starting a low-carbohydrate diet. 30,31 Thus, using MR imaging to indirectly quantify IHF content, it may be possible to identify "high risk" patients preoperatively and initiate a low-carbohydrate diet to reduce the chances of post-resection mortality. The next platform of studies should test the reliability and reproducibility of intrahepatic fat measurement in CLM patients using non-invasive imaging and quantify reductions in triglyceride content following dietary intervention.…”

Section: Discussionmentioning

confidence: 99%

Digital histology quantification of intra-hepatic fat in patients undergoing liver resection

Parkin

O’Reilly

Plumb

et al. 2015

European Journal of Surgical Oncology (EJSO)

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Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction

Cited by 268 publications

References 31 publications

A heterogeneous response of liver and skeletal muscle fat to the combination of a Paleolithic diet and exercise in obese individuals with type 2 diabetes: a randomised controlled trial

A heterogeneous response of liver and skeletal muscle fat to the combination of a Paleolithic diet and exercise in obese individuals with type 2 diabetes: a randomised controlled trial

Dietary approach in the treatment of nonalcoholic fatty liver disease

Digital histology quantification of intra-hepatic fat in patients undergoing liver resection

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