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Wernicke, C.* ; Pohrt, A.* ; Pletsch-Borba, L.* ; Apostolopoulou, K.* ; Hornemann, S.* ; Meyer, N.* ; Machann, J. ; Gerbracht, C.* ; Tacke, F.* ; Pfeiffer, A.F.* ; Spranger, J.* ; Mai, K.*

Effect of unsaturated fat and protein intake on liver fat in people at risk of unhealthy aging: 1-year results of a randomized controlled trial.

Am. J. Clin. Nutr. 117, 785-793 (2023)
Publ. Version/Full Text DOI PMC
BACKGROUND: Short-term trials indicate improvement of intrahepatic lipids (IHLs) and metabolism by dietary protein or unsaturated fatty acids (UFAs) beyond weight loss. OBJECTIVES: We aimed to assess the effect of a dietary intervention high in protein and UFAs on IHLs and metabolic outcome after 12 mo, as long-term effects of such a combined intervention are unknown. METHODS: Within a 36-mo randomized controlled trial, eligible subjects (aged 50 to 80 y, ≥1 risk factor for unhealthy aging) were randomly assigned to either intervention group (IG) with high intake of mono-/poly-UFAs [15-20 percent of total energy (%E)/10%-15%E, respectively], plant protein (15%-25%E), and fiber (≥30 g/d), or control group [CG, usual care, dietary recommendations of the German Nutrition Society (fat 30%E/carbohydrates 55%E/protein 15%E)]. Stratification criteria were sex, known cardiovascular disease, heart failure, arterial hypertension, type 2 diabetes, and cognitive or physical impairment. Nutritional counseling and supplementation of foods mirroring the intended dietary pattern were performed in the IG. Diet-induced effects on IHLs, analyzed by magnetic resonance spectroscopy, as well as on lipid and glucose metabolism were predefined secondary endpoints. RESULTS: IHL content was analyzed in 346 subjects without significant alcohol consumption at baseline and in 258 subjects after 12 mo. Adjusted for weight loss, sex, and age, we observed a comparable decline of IHLs in IG and CG (-33.3%; 95% CI: -49.3, -12.3%; n = 128 compared with -21.8%; 95% CI: -39.7, 1.5%; n = 130; P = 0.179), an effect that became significant by comparing adherent IG subjects to adherent CG subjects (-42.1%; 95% CI: -58.1, -20.1%; n = 88 compared with -22.2%; 95% CI: -40.7, 2.0%; n = 121; P = 0.013). Compared with the CG, decline of LDL cholesterol (LDL-C) and total cholesterol (TC) was stronger in the IG (for LDL-C P = 0.019, for TC P = 0.010). Both groups decreased in triglycerides and insulin resistance (P for difference between groups P = 0.799 and P = 0.124, respectively). CONCLUSIONS: Diets enriched with protein and UFAs have beneficial long-term effects on liver fat and lipid metabolism in adherent older subjects. This study was registered at the German Clinical Trials Register, https://www.drks.de/drks_web/setLocale_EN.do, DRKS00010049. Am J Clin Nutr 20XX;xx:xx-xx.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Mufa ; Pufa ; Diet ; Dietary Proteins ; Healthy Aging ; Magnetic Resonance Spectroscopy ; Non-mediterranean Population ; Nonalcoholic Fatty Liver Disease; Dietary; Glucose; Epidemiology; Inflammation; Prevalence; Plasma
ISSN (print) / ISBN 0002-9165
e-ISSN 1938-3207
Journal American Journal of Clinical Nutrition
Quellenangaben Volume: 117, Issue: 4, Pages: 785-793 Article Number: , Supplement: ,
Publisher American Society for Nutrition
Publishing Place Ste 800, 230 Park Ave, New York, Ny 10169 Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Grants German Research Foundation[DFG]
German Federal Ministry of Education and Research (BMBF)
Federal Ministry of Education and Research (BMBF)
Competence Cluster Nutrition Research Berlin-Potsdam