Intrahepatic Fat and Weight Loss

Dysfunctional adipose tissues can lead to the accumulation of triglycerides (TG) in parenchymal cells of non-adipose-tissues. In the liver, intrahepatic-fat (IHF) that exceeds 5% is defined as liver steatosis (‘fatty liver’). Accumulation of fat in the liver is tightly associated with insulin resistance and metabolic syndrome parameters. The treatment for reducing IHF is mainly dietary and lifestyle change targeted, aiming for weight reduction with no specific diet recommended. Long-term dietary intervention trials and meta-analyses have suggested that Mediterranean (MED) diet may have several favorable effects on liver-related lipid (i.e. TG, total cholesterol) and glycemic (i.e. insulin, fasting plasma glucose) biomarkers. Physical activity (PA), as part of lifestyle change strategy, can also lead to reductions in liver fat, independent of weight loss. In our lifestyle intervention studies, conducted at Ben Gurion University, we assessed IHF using noninvasive methods (Magnetic Resonance Imaging, MRI). In the CENTRAL MRI trial, we examined the effect of distinct lifestyle interventions on mobilization of fat storage pools. 278 participants were randomized into one of two intervention groups: Low fat diet or MED/low carbohydrates diet. After 6 months of intervention, a second randomization was performed and each groups was divided into PA groups. Our findings suggest that a MED diet and being physically active can improve cardiometabolic risk variables through changes in ectopic fat depots, such as IHF, that are not reflected by body weight changes alone.