title: Long-lasting improvements in liver fat and metabolism despite body weight regain after dietary weight loss.
abstract: OBJECTIVE
  Weight loss reduces abdominal and intrahepatic fat, thereby improving metabolic and cardiovascular risk. Yet, many patients regain weight after successful diet-induced weight loss. Long-term changes in abdominal and liver fat, along with liver test results and insulin resistance, are not known.
  
  
  METHODS
  We analyzed 50 overweight to obese subjects (46 ± 9 years of age; BMI, 32.5 ± 3.3 kg/m2; women, 77%) who had participated in a 6-month hypocaloric diet and were randomized to either reduced carbohydrates or reduced fat content. Before, directly after diet, and at an average of 24 (range, 17-36) months follow-up, we assessed body fat distribution by magnetic resonance imaging and markers of liver function and insulin resistance.
  
  
  RESULTS
  Body weight decreased with diet but had increased again at follow-up. Subjects also partially regained abdominal subcutaneous and visceral adipose tissue. In contrast, intrahepatic fat decreased with diet and remained reduced at follow-up (7.8 ± 9.8% [baseline], 4.5 ± 5.9% [6 months], and 4.7 ± 5.9% [follow-up]). Similar patterns were observed for markers of liver function, whole-body insulin sensitivity, and hepatic insulin resistance. Changes in intrahepatic fat und intrahepatic function were independent of macronutrient composition during intervention and were most effective in subjects with nonalcoholic fatty liver disease at baseline.
  
  
  CONCLUSIONS
  A 6-month hypocaloric diet induced improvements in hepatic fat, liver test results, and insulin resistance despite regaining of weight up to 2 years after the active intervention. Body weight and adiposity measurements may underestimate beneficial long-term effects of dietary interventions.
authors: Corresponding author: Stefan Engeli, engeli.stefan@mh-hannover.de.
authors: Sven
authors: S
authors: Haufe
authors: Verena
authors: V
authors: Haas
authors: Wolfgang
authors: W
authors: Utz
authors: Andreas L
authors: AL
authors: Birkenfeld
authors: Stephanie
authors: S
authors: Jeran
authors: Jana
authors: J
authors: Böhnke
authors: Anja
authors: A
authors: Mähler
authors: Friedrich C
authors: FC
authors: Luft
authors: Jeanette
authors: J
authors: Schulz-Menger
authors: Michael
authors: M
authors: Boschmann
authors: Jens
authors: J
authors: Jordan
authors: Stefan
authors: S
authors: Engeli
mesh_terms: D050154:Adiposity; D000328:Adult; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008099:Liver / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000378:metabolism; D050177:Overweight / Q000178:diet therapy* / Q000378:metabolism*; D050507:Subcutaneous Fat, Abdominal / Q000378:metabolism; D016896:Treatment Outcome; D015430:Weight Gain / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology*
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