Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools

Gepner, Yftach; Shelef, Ilan; Schwarzfuchs, Dan; Zelicha, Hila; Tene, Lilac; Meir, Anat Yaskolka; Tsaban, Gal; Cohen, Noa; Bril, Nitzan; Rein, Michal; Serfaty, Dana; Kenigsbuch, Shira; Komy, Oded; Wolak, Arik; Chassidim, Yoash; Golan, Rachel; Avni-Hassid, Hilla; Bilitzky, Avital; Sarusi, Benjamin; Goshen, Eyal; Shemesh, Elad; Henkin, Yaakov; Stümvoll, Michael; Blüher, Matthias; Thiery, Joachim; Ceglarek, Uta; Rudich, Assaf; Stampfer, Meir J.; Shai, Iris

doi:10.1161/circulationaha.117.030501

Cited by 210 publications

(229 citation statements)

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“…Another longer trial found that subjects following a low‐carbohydrate MD had a greater reduction in HS than those following a low‐fat diet. However, the absolute magnitude of this difference was small (1.5%) . The significant caloric restriction, very low carbohydrate intake in the Mediterranean arm, greater weight loss, and inclusion criteria (only one half of subjects had NAFLD) are all meaningful differences from our trial.…”

Section: Discussionmentioning

confidence: 67%

“…However, the absolute magnitude of this difference was small (1.5%). (43) The significant caloric restriction, very low carbohydrate intake in the Mediterranean arm, greater weight loss, and inclusion criteria (only one half of subjects had NAFLD) are all meaningful differences from our trial. Importantly, our trial established the ability of subjects to achieve nutrient intakes comparable to documented traditional Mediterranean diets.…”

Section: Discussionmentioning

confidence: 70%

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Ad Libitum Mediterranean and Low‐Fat Diets Both Significantly Reduce Hepatic Steatosis: A Randomized Controlled Trial

et al. 2018

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Although diet-induced weight loss is first-line treatment for patients with nonalcoholic fatty liver disease (NAFLD), long-term maintenance is difficult. The optimal diet for improvement in either NAFLD or associated cardiometabolic risk factors, regardless of weight loss, is unknown. We examined the effect of two ad libitum isocaloric diets (Mediterranean [MD] or low fat [LF]) on hepatic steatosis (HS) and cardiometabolic risk factors. Subjects with NAFLD were randomized to a 12-week blinded dietary intervention (MD vs. LF). HS was determined by magnetic resonance spectroscopy (MRS). From a total of 56 subjects enrolled, 49 completed the intervention and 48 were included for analysis. During the intervention, subjects on the MD had significantly higher total and monounsaturated fat, but lower carbohydrate and sodium, intakes compared to LF subjects (P < 0.01). At week 12, HS had reduced significantly in both groups (P < 0.01), and there was no difference in liver fat reduction between groups (P = 0.32), with mean (SD) relative reductions of 25.0% (±25.3%) in LF and 32.4% (±25.5%) in MD. Liver enzymes also improved significantly in both groups. Weight loss was minimal and not different between groups (-1.6 [±2.1] kg in LF vs -2.1 [±2.5] kg in MD; P = 0.52). Within-group improvements in Framingham Risk Score (FRS), total cholesterol, serum triglyceride (TG), and glycated hemoglobin (HbA1c) were observed in the MD (all P < 0.05), but not with the LF diet. Adherence was higher for the MD compared to LF (88% vs. 64%; P = 0.048). Conclusion: Ad libitum low-fat and Mediterranean diets both improve HS to a similar degree.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 70%

Ad Libitum Mediterranean and Low‐Fat Diets Both Significantly Reduce Hepatic Steatosis: A Randomized Controlled Trial

et al. 2018

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“…9,16 The CENTRAL-MRI trial demonstrated that in a group of 278 sedentary adults (age = 48 years, 89% men, BMI 30.8 kg/m 2 ) with abdominal obesity (75%) or dyslipidemia, a Mediterranean lowcarbohydrate dietary pattern was superior to a low-fat diet in decreasing intrahepatic, intrapericardial, and pancreatic fat (P < 0.05 for all), and that exercise had an independent contribution to visceral AT loss. 27 Further to that, mobilization of ectopic fat depots was associated with improved cardiometabolic surrogate markers such as decreased expression of atherogenic dyslipidemia. 27,28 Skeletal muscle secretome.…”

Section: An Integrative View On Atherosclerosismentioning

confidence: 96%

High-Risk Atherosclerosis and Metabolic Phenotype: The Roles of Ectopic Adiposity, Atherogenic Dyslipidemia, and Inflammation

Lechner

McKenzie²,

Kränkel

et al. 2020

Metabolic Syndrome and Related Disorders

103

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Current algorithms for assessing risk of atherosclerotic cardiovascular disease (ASCVD) and, in particular, the reliance on low-density lipoprotein (LDL) cholesterol in conditions where this measurement is discordant with apoB and LDL-particle concentrations fail to identify a sizeable part of the population at high risk for adverse cardiovascular events. This results in missed opportunities for ASCVD prevention, most notably in those with metabolic syndrome, prediabetes, and diabetes. There is substantial evidence that accumulation of ectopic fat and associated metabolic traits are markers for and pathogenic components of high-risk atherosclerosis. Conceptually, the subset of advanced lesions in high-risk atherosclerosis that triggers vascular complications is closely related to a set of coordinated high-risk traits clustering around a distinct metabolic phenotype. A key feature of this phenotype is accumulation of ectopic fat, which, coupled with age-related muscle loss, creates a milieu conducive for the development of ASCVD: atherogenic dyslipidemia, nonresolving inflammation, endothelial dysfunction, hyperinsulinemia, and impaired fibrinolysis. Sustained vascular inflammation, a hallmark of high-risk atherosclerosis, impairs plaque stabilization in this phenotype. This review describes how metabolic and inflammatory processes that are promoted in large measure by ectopic adiposity, as opposed to subcutaneous adipose tissue, relate to the pathogenesis of high-risk atherosclerosis. Clinical biomarkers indicative of these processes provide incremental information to standard risk factor algorithms and advanced lipid testing identifies atherogenic lipoprotein patterns that are below the discrimination level of standard lipid testing. This has the potential to enable improved identification of high-risk patients who are candidates for therapeutic interventions aimed at prevention of ASCVD.

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“…is a secondary analysis of a large randomised clinical trial (RCT) (CENTRAL RCT), testing long-term dietary interventions with or without physical activity. 1 The current analysis focused on the possible role of liver fat in mediating the improvement in cardiovascular disease (CVD) risk factors induced by the Mediterranean diet (MD). Indeed, it has been well established that the MD improves insulin sensitivity and features of the metabolic syndrome 2,6 and reduces the incidence of CVD outcomes in both observational studies and RCTs.…”

mentioning

confidence: 99%

“…9,10 Support for these findings is needed from longer-term trials, such as the 18-month CEN-TRAL RCT. 1 Gepner et al have made an excellent attempt to clarify the mechanisms by which the MD achieves the observed CVD risk reduction. They have demonstrated that the MD combined with a low carbohydrate (LC) diet conferred a reduction in hepatic fat, which was associated with improvements in surrogate measures of CVD risk, beyond those seen with visceral fat loss.…”

mentioning

confidence: 99%