In the Journals

Reduced-calorie diet yields long-term liver benefits despite weight regain

Overweight or obese patients who followed a reduced-calorie diet experienced improvements to liver fat and metabolism 2 years after the intervention, even after regaining lost weight, in a recent study.

Researchers evaluated 50 overweight or obese patients who adhered to a hypocaloric diet that reduced either fats or carbohydrates for 6 months. MRI was performed to assess body fat distribution, and liver function and insulin resistance were measured before and immediately after the diet, as well as after a mean of 24 months.

Energy intake decreased during the diet (P<.01), and patients experienced a decrease in body weight, but weight had increased significantly at follow-up, along with a partial regain of lost visceral adipose and abdominal subcutaneous tissue. Intrahepatic fat decreased during the diet, however, and did not return at follow-up. Investigators noted correlations between regained body weight and regained visceral (r=0.7; P<.001) and subcutaneous abdominal adipose tissue (r=0.9; P<.001), along with a less significant correlation between body weight and hepatic fat content (r=0.3; P<.05). Results were similar regardless of whether the patient consumed reduced fats or carbohydrates.

Along with hepatic fat, liver function, hepatic insulin resistance and whole-body insulin sensitivity also improved with dietary intervention, and these benefits remained despite weight regain at follow-up. Stratification according to nonalcoholic fatty liver disease status indicated similar results. Multivariate analysis revealed that changes to total body weight (P=.02) and hepatic fat (P<.001) following diet were predictive of intrahepatic fat loss.

“We conclude that hypocaloric dietary interventions have a long-lasting effect on intrahepatic lipid accumulation despite weight regain,” the researchers wrote. “Because obesity management programs commonly focus on body weight and anthropometric measurements, beneficial long-term effects of dietary interventions on human metabolism may be underestimated. We suggest that the beneficial response to reduced caloric intake in our study may be driven in large part by changes in liver metabolism.”

Disclosure: The researchers report no relevant financial disclosures.