MCF Posted April 23, 2011 Report Share Posted April 23, 2011 ? 2011 American Society for Nutrition Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction1,2,3 Jeffrey D Browning, Jonathan A Baker, Thomas Rogers, Jeannie Davis, Santhosh Satapati, and Shawn C Burgess + Author Affiliations 1From the Departments of Internal Medicine (JDB), Pathology (JAB and TR), and Pharmacology (SCB), The Advanced Imaging Research Center (JDB, JD, SS, and SCB), The University of Texas Southwestern Medical Center at Dallas, Dallas, TX. + Author Notes ↵2 Supported by the Clinical and Translational Science Award at The University of Texas Southwestern (UL1RR024982), the Task Force for Obesity Research (TORS) at The University of Texas Southwestern (5UL1DE019584), the TORS Human Biology Core (5PL1DK081183), the TORS Molecular and Metabolic Mouse Phenotyping Core (5PL1DK081182), and NIH grants 5RL1DK081187 (to JDB and SCB), 1K23DK074396 (to JDB), RR02584 (to SCB), R01DK078184 (to SCB), and DK082872 (to TR). ↵3 Address reprint requests and correspondence to JD Browning, Department of Internal Medicine, Division of Digestive and Liver Diseases and the Advanced Imaging Research Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8568. E-mail: email@example.com. Abstract Background: Individuals with nonalcoholic fatty liver disease (NAFLD) have excess intrahepatic triglycerides. This is due, in part, to increased hepatic synthesis of fat from carbohydrates via lipogenesis. Although weight loss is currently recommended to treat NAFLD, little attention has been given to dietary carbohydrate restriction. Objective: The aim of this study was to determine the effectiveness of 2 wk of dietary carbohydrate and calorie restriction at reducing hepatic triglycerides in subjects with NAFLD. Design: Eighteen NAFLD subjects (n = 5 men and 13 women) with a mean (?SD) age of 45 ? 12 y and a body mass index (in kg/m2) of 35 ? 7 consumed a carbohydrate-restricted (<20 g/d) or calorie-restricted (1200?1500 kcal/d) diet for 2 wk. Hepatic triglycerides were measured before and after intervention by magnetic resonance spectroscopy. Results: Mean (?SD) weight loss was similar between the groups (−4.0 ? 1.5 kg in the calorie-restricted group and −4.6 ? 1.5 kg in the carbohydrate-restricted group; P = 0.363). Liver triglycerides decreased significantly with weight loss (P < 0.001) but decreased significantly more (P = 0.008) in carbohydrate-restricted subjects (−55 ? 14%) than in calorie-restricted subjects (−28 ? 23%). Dietary fat (r = 0.643, P = 0.004), carbohydrate (r = −0.606, P = 0.008), posttreatment plasma ketones (r = 0.755, P = 0.006), and respiratory quotient (r = −0.797, P < 0.001) were related to a reduction in liver triglycerides. Plasma aspartate, but not alanine, aminotransferase decreased significantly with weight loss (P < 0.001). Conclusions: Two weeks of dietary intervention (≈4.3% weight loss) reduced hepatic triglycerides by ≈42% in subjects with NAFLD; however, reductions were significantly greater with dietary carbohydrate restriction than with calorie restriction. This may have been due, in part, to enhanced hepatic and whole-body oxidation. This trial was registered at clinicaltrials.gov as NCT01262326. Received November 4, 2010. Accepted February 14, 2011. Quote Link to comment Share on other sites More sharing options...
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