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Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial

INTRODUCTION: Treatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat...

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Autores principales: Della Pepa, Giuseppe, Vetrani, Claudia, Brancato, Valentina, Vitale, Marilena, Monti, Serena, Annuzzi, Giovanni, Lombardi, Gianluca, Izzo, Anna, Tommasone, Marianna, Cipriano, Paola, Clemente, Gennaro, Mirabelli, Peppino, Mancini, Marcello, Salvatore, Marco, Riccardi, Gabriele, Rivellese, Angela Albarosa, Bozzetto, Lutgarda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252961/
https://www.ncbi.nlm.nih.gov/pubmed/32448788
http://dx.doi.org/10.1136/bmjdrc-2020-001342
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author Della Pepa, Giuseppe
Vetrani, Claudia
Brancato, Valentina
Vitale, Marilena
Monti, Serena
Annuzzi, Giovanni
Lombardi, Gianluca
Izzo, Anna
Tommasone, Marianna
Cipriano, Paola
Clemente, Gennaro
Mirabelli, Peppino
Mancini, Marcello
Salvatore, Marco
Riccardi, Gabriele
Rivellese, Angela Albarosa
Bozzetto, Lutgarda
author_facet Della Pepa, Giuseppe
Vetrani, Claudia
Brancato, Valentina
Vitale, Marilena
Monti, Serena
Annuzzi, Giovanni
Lombardi, Gianluca
Izzo, Anna
Tommasone, Marianna
Cipriano, Paola
Clemente, Gennaro
Mirabelli, Peppino
Mancini, Marcello
Salvatore, Marco
Riccardi, Gabriele
Rivellese, Angela Albarosa
Bozzetto, Lutgarda
author_sort Della Pepa, Giuseppe
collection PubMed
description INTRODUCTION: Treatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat in T2D. RESEARCH DESIGN AND METHODS: According to a parallel design, 49 individuals with T2D, overweight/obese, with high waist circumference, 35–75 years-old, in satisfactory blood glucose control with diet or drugs not affecting liver fat content, were randomly assigned to an 8-week isocaloric intervention with a MUFA diet (n=26) or a multifactorial diet rich in fiber, MUFA, n-6 and n-3 polyunsaturated fatty acids, polyphenols, and vitamins D, E, and C (n=23). Before and after the intervention, liver fat content was evaluated by proton magnetic resonance spectroscopy ((1)H-MRS). (1)H-MRS complete data were available for n=21 (MUFA diet) and n=18 (multifactorial diet) participants. RESULTS: Adherence to dietary interventions was optimal. No significant differences between groups in body weight reduction, plasma glycated hemoglobin, insulin, glucose, lipids and liver enzymes were observed. Liver fat significantly decreased after both the multifactorial diet (9.18%±7.78% vs 5.22%±4.80%, p=0.003) and the MUFA diet (9.47%±8.89% vs 8.07%±8.52%, p=0.027) with a statistically significant difference between changes either in absolute terms (−4.0%±4.5% vs −1.4%±2.7%, p=0.035) or percent (−40%±33% vs −19%±25%, p=0.030). CONCLUSIONS: An isocaloric multifactorial diet including several beneficial dietary components induced a clinically relevant reduction of liver fat in patients with T2D, more pronounced than that induced by simply replacing saturated fat with MUFA. This suggests that the ‘optimal diet’ for NAFLD treatment in T2D should be based on synergic actions of different dietary components on multiple pathophysiological pathways. TRIAL REGISTRATION NUMBER: NCT03380416.
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spelling pubmed-72529612020-06-05 Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial Della Pepa, Giuseppe Vetrani, Claudia Brancato, Valentina Vitale, Marilena Monti, Serena Annuzzi, Giovanni Lombardi, Gianluca Izzo, Anna Tommasone, Marianna Cipriano, Paola Clemente, Gennaro Mirabelli, Peppino Mancini, Marcello Salvatore, Marco Riccardi, Gabriele Rivellese, Angela Albarosa Bozzetto, Lutgarda BMJ Open Diabetes Res Care Clinical Care/Education/Nutrition INTRODUCTION: Treatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat in T2D. RESEARCH DESIGN AND METHODS: According to a parallel design, 49 individuals with T2D, overweight/obese, with high waist circumference, 35–75 years-old, in satisfactory blood glucose control with diet or drugs not affecting liver fat content, were randomly assigned to an 8-week isocaloric intervention with a MUFA diet (n=26) or a multifactorial diet rich in fiber, MUFA, n-6 and n-3 polyunsaturated fatty acids, polyphenols, and vitamins D, E, and C (n=23). Before and after the intervention, liver fat content was evaluated by proton magnetic resonance spectroscopy ((1)H-MRS). (1)H-MRS complete data were available for n=21 (MUFA diet) and n=18 (multifactorial diet) participants. RESULTS: Adherence to dietary interventions was optimal. No significant differences between groups in body weight reduction, plasma glycated hemoglobin, insulin, glucose, lipids and liver enzymes were observed. Liver fat significantly decreased after both the multifactorial diet (9.18%±7.78% vs 5.22%±4.80%, p=0.003) and the MUFA diet (9.47%±8.89% vs 8.07%±8.52%, p=0.027) with a statistically significant difference between changes either in absolute terms (−4.0%±4.5% vs −1.4%±2.7%, p=0.035) or percent (−40%±33% vs −19%±25%, p=0.030). CONCLUSIONS: An isocaloric multifactorial diet including several beneficial dietary components induced a clinically relevant reduction of liver fat in patients with T2D, more pronounced than that induced by simply replacing saturated fat with MUFA. This suggests that the ‘optimal diet’ for NAFLD treatment in T2D should be based on synergic actions of different dietary components on multiple pathophysiological pathways. TRIAL REGISTRATION NUMBER: NCT03380416. BMJ Publishing Group 2020-05-24 /pmc/articles/PMC7252961/ /pubmed/32448788 http://dx.doi.org/10.1136/bmjdrc-2020-001342 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Clinical Care/Education/Nutrition
Della Pepa, Giuseppe
Vetrani, Claudia
Brancato, Valentina
Vitale, Marilena
Monti, Serena
Annuzzi, Giovanni
Lombardi, Gianluca
Izzo, Anna
Tommasone, Marianna
Cipriano, Paola
Clemente, Gennaro
Mirabelli, Peppino
Mancini, Marcello
Salvatore, Marco
Riccardi, Gabriele
Rivellese, Angela Albarosa
Bozzetto, Lutgarda
Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
title Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
title_full Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
title_fullStr Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
title_full_unstemmed Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
title_short Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
title_sort effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial
topic Clinical Care/Education/Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252961/
https://www.ncbi.nlm.nih.gov/pubmed/32448788
http://dx.doi.org/10.1136/bmjdrc-2020-001342
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