Randomized comparison of reduced fat and reduced carbohydrate hypocaloric diets on intrahepatic fat in overweight and obese human subjects

Authors

  • Sven Haufe,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
    2. Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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  • Stefan Engeli,

    1. Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
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  • Petra Kast,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Jana Böhnke,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Wolfgang Utz,

    1. Franz Volhard Clinic, Charité University Medical School and Helios Klinikum, Berlin, Germany
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  • Verena Haas,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Mario Hermsdorf,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Anja Mähler,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Susanne Wiesner,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Andreas L. Birkenfeld,

    1. Department of Endocrinology, Diabetes and Nutrition, Charité University Medical School, Berlin, Germany, and German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
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  • Henrike Sell,

    1. Institute of Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Düsseldorf, Germany
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  • Christoph Otto,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Heidrun Mehling,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Friedrich C. Luft,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Juergen Eckel,

    1. Institute of Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Düsseldorf, Germany
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  • Jeanette Schulz-Menger,

    1. Franz Volhard Clinic, Charité University Medical School and Helios Klinikum, Berlin, Germany
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  • Michael Boschmann,

    1. Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical School and Max Delbrück Center for Molecular Medicine, Berlin, Germany
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  • Jens Jordan

    Corresponding author
    1. Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
    • Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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    • fax: +49-511-532 2750.


  • Potential conflict of interest: Nothing to report.

  • This study was part of a joint project between metanomics GmbH (Berlin, Germany) and Charité - University Medical School which was supported by the Federal Ministry of Education and Research (BMBF-0313868) and in part by the Commission of the European Communities (Collaborative Project ADAPT, Contract No. HEALTH-F2-2008-201100) and the German Obesity Network of Competence (Collaborative Project ADIPOSETARGET, 01 Gl0830) (to S.E. and J.J). Clinical trial number: ClinicalTrials.gov NCT00956566

Abstract

Obesity-related hepatic steatosis is a major risk factor for metabolic and cardiovascular disease. Fat reduced hypocaloric diets are able to relieve the liver from ectopically stored lipids. We hypothesized that the widely used low carbohydrate hypocaloric diets are similarly effective in this regard. A total of 170 overweight and obese, otherwise healthy subjects were randomized to either reduced carbohydrate (n = 84) or reduced fat (n = 86), total energy restricted diet (−30% of energy intake before diet) for 6 months. Body composition was estimated by bioimpedance analyses and abdominal fat distribution by magnetic resonance tomography. Subjects were also submitted to fat spectroscopy of liver and oral glucose tolerance testing. In all, 102 subjects completed the diet intervention with measurements of intrahepatic lipid content. Both hypocaloric diets decreased body weight, total body fat, visceral fat, and intrahepatic lipid content. Subjects with high baseline intrahepatic lipids (>5.56%) lost ≈7-fold more intrahepatic lipids compared with those with low baseline values (<5.56%) irrespective of diet composition. In contrast, changes in visceral fat mass and insulin sensitivity were similar between subgroups, with low and high baseline intrahepatic lipids. Conclusion: A prolonged hypocaloric diet low in carbohydrates and high in fat has the same beneficial effects on intrahepatic lipid accumulation as the traditional low-fat hypocaloric diet. The decrease in intrahepatic lipids appears to be independent of visceral fat loss and is not tightly coupled with changes in whole body insulin sensitivity during 6 months of an energy restricted diet. (HEPATOLOGY 2011)

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