Beneficial effect of a weight-stable, low-fat/low-saturated fat/low-glycaemic index diet to reduce liver fat in older subjects
Open accessAbstract
Non-alcoholic fatty liver disease is associated with insulin resistance and dyslipidaemia and can progress to steatohepatitis and cirrhosis. We sought to determine whether dietary fat and saturated fat content alter liver fat in the absence of weight change in an older population. Liver fat was quantified by magnetic resonance spectroscopy before and after 4 weeks on an isoenergetic low-fat/low-saturated fat/low-glycaemic index (LGI) (LSAT: 23 % fat/7 % saturated fat/GI < 55) or a high-fat/high-saturated fat/high-GI (HSAT: 43 % fat/24 % saturated fat/GI>70) diet in older subjects. In the present study, twenty subjects (seven males/thirteen females; age 69·3 (sem 1·6) years, BMI 26·9 (sem 0·8) kg/m 2) were randomised to the LSAT diet and fifteen subjects (six males/nine females; age 68·6 (sem 1·8) years, BMI 28·1 (sem 0·9) kg/m 2) to the HSAT diet. Weight remained stable. Liver fat decreased significantly on the LSAT diet (median 2·2 (interquartile range (IQR) 3·1) to 1·7 (IQR 1·8) %,P= 0·002) but did not change on the HSAT diet (median 1·2 (IQR 4·1) to 1·6 (IQR 3·9) %). The LSAT diet lowered fasting glucose and total cholesterol, HDL-cholesterol and LDL-cholesterol and raised TAG (P< 0·05), while the HSAT diet had no effect on glucose or HDL-cholesterol but increased total cholesterol and LDL-cholesterol (P< 0·05). Fasting insulin and homeostasis model of insulin resistance did not change significantly on either diet, but the Matsuda index of insulin sensitivity improved on the LSAT diet (P< 0·05). Assignment to the LSAT v.HSAT diet was a predictor of changes in lipid parameters but not liver fat. We conclude that diet composition may be an important factor in the accumulation of liver fat, with a low-fat/low-saturated fat/LGI diet being beneficial.
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Changes in macronutrient composition towards a low-fat diet may reduce hepatic lipid content even under isocaloric conditions, i.e. without concurrent weight loss, while the high-fat component in a low-carb diet might adversely increase hepatic lipid content.
“Changes in macronutrient composition towards a low-fat diet may reduce hepatic lipid content even under isocaloric conditions, i.e. without concurrent weight loss, while the high-fat component in a low-carb diet might adversely increase hepatic lipid content [56][57][58].”
From Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease? (2024) · cites this paper as [56]
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Experimental — accuracy not yet measuredRegular aerobic exercise participation, body weight changes, caloric and dietary fat restrictions, or overfeeding modulate liver fat content.
“Regular aerobic exercise participation, body weight changes, caloric and dietary fat restrictions, or overfeeding have all been shown to modulate liver fat content (3-9).”
From Eucaloric diets enriched in palm olein, cocoa butter, and soybean oil did not differentially affect liver fat concentration in healthy participants: a 16-week randomized controlled trial. (2021) · cites this paper as [7]
The Abstract reports that overfeeding increases liver fat and weight loss decreases it; the study also found that a weight-stable, low-fat diet reduced liver fat in older subjects. The Dietary intervention section says participants maintained their usual physical activity, so this paper does not establish an effect of regular aerobic exercise. It also did not test caloric restriction separately from the weight-loss findings it reports. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOther studies used much higher total fat proportions ranging from ∼40%E to ∼60%E, often with disproportionate contents between diets with the SFA diets often higher in fat than the PUFA diets.
“Other studies, however, used much higher total fat proportions ranging from ∼ 40%E to ∼ 60%E (7, 10, 11, 13), often with disproportionate contents between diets with the SFA diets often higher in fat than the PUFA diets (7, 10, 13).”
From Eucaloric diets enriched in palm olein, cocoa butter, and soybean oil did not differentially affect liver fat concentration in healthy participants: a 16-week randomized controlled trial. (2021) · cites this paper as [7]
The Dietary intervention section reports a high-saturated-fat diet designed to provide 45% of energy from fat, compared with 25% for the low-fat diet; the Abstract reports 43% versus 23% in the diets used. This supports the higher-fat SFA comparison, but the comparator is described as a low-fat, low-saturated-fat diet, not a PUFA diet. No page number is available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredUtzschneider et al. showed no differences in liver fat between isocaloric low-fat/lowSFA/low-glycemic-index and high-fat/high-SFA/high-glycemic-index diets in older adults, albeit it is impossible to disentangle the SFA effects from the other dietary changes.
“Utzschneider et al. (7) showed no differences in liver fat between isocaloric low-fat/lowSFA/low-glycemic-index and high-fat/high-SFA/high-glycemicindex diets in older adults, albeit it is impossible to disentangle the SFA effects from the other dietary changes.”
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- Authors
- Utzschneider, K. M., Bayer-Carter, J. L., Arbuckle, M. D., Tidwell, J. M., Richards, T. L., & Craft, S.
- Affiliations
- University of Washington (US)
- VA Puget Sound Health Care System (US)
- Corresponding author
- Utzschneider, Kristina M.
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-07-31
- Volume
- 109
- Issue
- 6
- Pages
- 1096-1104
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- PMC
- PMC3909493
- OpenAlex
- W2051834805
- Semantic Scholar
- 69ad575477a6e969dcff9d61046b465cc9eb8273
- Cited by
- 81
- References
- 52
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 1 · 2021: 5 · 2020: 6 · 2019: 10 · 2018: 7 · 2017: 6 · 2016: 10 · 2015: 7 · 2014: 11 · 2013: 2
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Office of Research and Development
- University of Washington (P30DK017047, UL1 RR025014)
- National Institute on Aging (R37AG010880)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK017047)
- National Center for Research Resources (UL1RR025014)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- non-alcoholic fatty liver disease, liver fat, low-fat diet, saturated fat, glycemic index, older adults, dietary fat composition, insulin sensitivity, dyslipidemia, fasting insulin, Matsuda index, triglycerides, cholesterol, fasting blood glucose, steatohepatitis, cirrhosis prevention, dietary intervention
- MeSH terms
- Aged, Body Weight, Energy Intake, Diet, Double-Blind Method, Fatty Liver, Female, Humans, Insulin Resistance, Lipids, Male, Magnetic Resonance Spectroscopy, Body Mass Index, Diet, Fat-Restricted, Glycemic Index, Body Fat Distribution, Diet, High-Fat
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