Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2006; 12(36): 5813-5819
Published online Sep 28, 2006. doi: 10.3748/wjg.v12.i36.5813
Effect of nutritional counselling on hepatic, muscle and adipose tissue fat content and distribution in non-alcoholic fatty liver disease
E Louise Thomas, Audrey E Brynes, Gavin Hamilton, Nayna Patel, Adam Spong, Robert D Goldin, Gary Frost, Jimmy D Bell, Simon D Taylor-Robinson
E Louise Thomas, Audrey E Brynes, Gavin Hamilton, Nayna Patel, Adam Spong, Robert D Goldin, Gary Frost, Jimmy D Bell, Simon D Taylor-Robinson, The Robert Steiner MR Unit, MRC Clinical Sciences Centre (ELT, GH, NP, AS, JDB, STR), Department of Nutrition and Dietetics (AEB, GF) and Division of Medicine (Medicine A), Faculty of Medicine (GH, NP, AS, STR), Imperial College London, Hammersmith Hospital, Du Cane Rd, London W12 0HS, United Kingdom and Histopathology Department (RDG), Faculty of Medicine, Imperial College London, St Mary’s Hospital, Praed Street, London W2 1NY, United Kingdom
Author contributions: All authors contributed equally to the work.
Supported by the British Medical Research Council, United Kingdom, No. MRC CEG G99000178
Correspondence to: Dr. E Louise Thomas, Robert Steiner MR Unit, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Rd, London W12 0HS, United Kingdom. louise.thomas@csc.mrc.ac.uk
Telephone: +44-20-83833772 Fax: +44-20-83833038
Received: May 23, 2006
Revised: August 5, 2006
Accepted: August 12, 2006
Published online: September 28, 2006
Abstract

AIM: To assess the effectiveness of the current UK clinical practice in reducing hepatic fat (IHCL).

METHODS: Whole body MRI and 1H MRS were obtained, before and after 6 mo nutritional counselling, from liver, soleus and tibialis muscles in 10 subjects with non-alcoholic fatty liver disease (NAFLD).

RESULTS: A 500 Kcal-restricted diet resulted in an average weight loss of 4% (-3.4 kg,) accompanied by significant reductions in most adipose tissue (AT) depots, including subcutaneous (-9.9%), abdominal subcutaneous (-10.2%) and intra-abdominal-AT (-11.4%). Intramyocellular lipids (IMCL) were significantly reduced in the tibialis muscle (-28.2%). Decreases in both IHCL (-39.9%) and soleus IMCL (-12.2%) content were also observed, although these were not significant. Several individuals showed dramatic decreases in IHCL, while others paradoxically showed increases in IHCL content. Changes in body composition were accompanied by improvements in certain liver function tests: serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Significant correlations were found between decreases in IHCL and reductions in both intra-abdominal and abdominal subcutaneous AT. Improvements in liver function tests were associated with reductions in intra-abdominal AT, but not with changes in IHCL.

CONCLUSION: This study shows that even a very modest reduction in body weight achieved through lifestyle modification can result in changes in body fat depots and improvements in LFTs.

Keywords: Intra-abdominal adipose tissue; Intrahepatic fat; Intramyocellular lipids; Weight loss; Magnetic resonance imaging