Liver Fat Is Reduced by an Isoenergetic MUFA Diet in a Controlled Randomized Study in Type 2 Diabetic Patients
- Lutgarda Bozzetto, MD1,
- Anna Prinster, PHD2,
- Giovanni Annuzzi, MD1,
- Lucia Costagliola, RD1,
- Anna Mangione, BS1,
- Alessandra Vitelli, MD3,
- Raffaella Mazzarella, MD1,
- Margaret Longobardo, MD4,
- Marcello Mancini, MD2,
- Carlo Vigorito, MD3,
- Gabriele Riccardi, MD1 and
- Angela A. Rivellese, MD1⇓
- 1Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
- 2Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
- 3Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy
- 4Department of Biomorphological and Functional Science, Federico II University, Naples, Italy
- Corresponding author: Angela A. Rivellese, .
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.
RESEARCH DESIGN AND 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 1H 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.
- Received January 5, 2012.
- Accepted March 22, 2012.
- © 2012 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.