Intramyocellular triacylglycerol accumulation across weight loss strategies; Sub-study of the CENTRAL trial

  • Yftach Gepner
  • , Ilan Shelef
  • , Dan Schwarzfuchs
  • , Noa Cohen
  • , Nitzan Bril
  • , Michal Rein
  • , Gal Tsaban
  • , Hila Zelicha
  • , Anat Yaskolka Meir
  • , Lilac Tene
  • , Benjamin Sarusy
  • , Philip Rosen
  • , Jay R. Hoffman
  • , Jeffrey R. Stout
  • , Joachim Thiery
  • , Uta Ceglarek
  • , Michael Stumvoll
  • , Matthias Blüher
  • , Meir J. Stampfer
  • , Iris Shai

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: Intramyocellular triacylglycerol (IMTG) is utilized as metabolic fuel during exercise and is linked to insulin resistance, but the long-term effect of weight loss strategies on IMTG among participants with abdominal fat, remain unclear. Methods: In an 18-month trial, sedentary participants with abdominal fat/dyslipidemia were randomized to either a low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC) diet (including 28gday-1 of walnuts). After 6-months, the participants were re-randomized to moderate intense physical activity (PA+) or non-physical activity (PA-). Magnetic resonance imaging (MRI) was used to quantify changes of IMTG, abdominal sub-depots, hepatic and intermuscular fats. Results: Across the 277 participants [86% men, age = 48 years, body-mass-index (BMI) = 31kg/m2, visceral fat = 33%] 86% completed the 18-m trial. At baseline, women had higher IMTG than men (3.4% vs. 2.3%, p<0.001) and increased IMTG was associated with aging and higher BMI, visceral and intermuscular fats, HbA1c%, HDL-c and leptin(p<0.05), but not with intra-hepatic fat. After 18 month of intervention and a -3 kg mean weight loss, participants significantly increased IMTG by 25%, with a distinct effect in the MED/LCPA+ group as compared to the other intervention groups (57% vs. 9.5–18.5%, p<0.05). Changes in IMTG were associated with visceral and intermuscular fat, metabolic syndrome, insulin and leptin (p<0.05 for all), however, these associations did not remain after adjustment for visceral fat changes. Conclusions: Lifestyle strategies differentially affect IMTG accumulation; combination of exercise with decreased carbohydrate/increased unsaturated fat proportion intake greatly increase IMTG. Our findings suggest that increased IMTG during diet-induced moderate weight loss may not be directly related to cardiometabolic risk. Trial registration: ClinicalTrials.gov

Original languageEnglish
Article numbere0188431
JournalPLOS ONE
Volume12
Issue number11
DOIs
StatePublished - 1 Nov 2017

ASJC Scopus subject areas

  • General

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