Liver fat is reduced by an isoenergetic MUFA diet in a controlled randomized study in type 2 diabetic patients.
OBJECTIVE
To evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes.


METHODS
With use of a factorial 2 × 2 randomized parallel-group design, 37 men and 8 women, aged 35-70 years, with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment were assigned to one of the following groups for an 8-week period: 1) high-carbohydrate/high-fiber/low-glycemic index diet (CHO/fiber group), 2) high-MUFA diet (MUFA group), 3) high-carbohydrate/high-fiber/low-glycemic index diet plus physical activity program (CHO/fiber+Ex group), and 4) high-MUFA diet plus physical activity program (MUFA+Ex group). Before and after intervention, hepatic fat content was measured by (1)H NMR.


RESULTS
Dietary compliance was optimal and body weight remained stable in all groups. Liver fat content decreased more in MUFA (-29%) and MUFA+Ex (-25%) groups than in CHO/fiber (-4%) and CHO/fiber+Ex groups (-6%). Two-way repeated-measures ANOVA, including baseline values as covariate, showed a significant effect on liver fat content for diet (P = 0.006), with no effects for exercise training (P = 0.789) or diet-exercise interaction (P = 0.712).


CONCLUSIONS
An isocaloric diet enriched in MUFA compared with a diet higher in carbohydrate and fiber was associated with a clinically relevant reduction of hepatic fat content in type 2 diabetic patients independent of an aerobic training program and should be considered for the nutritional management of hepatic steatosis in people with type 2 diabetes.
Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
Lutgarda
L
Bozzetto
Anna
A
Prinster
Giovanni
G
Annuzzi
Lucia
L
Costagliola
Anna
A
Mangione
Alessandra
A
Vitelli
Raffaella
R
Mazzarella
Margaret
M
Longobardo
Marcello
M
Mancini
Carlo
C
Vigorito
Gabriele
G
Riccardi
Angela A
AA
Rivellese
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy*; D015444:Exercise; D005223:Fats / Q000032:analysis; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D005234:Fatty Liver / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged
D005223:Fats; D005229:Fatty Acids, Monounsaturated; D008687:Metformin