Dietary fat content modifies liver fat in overweight nondiabetic subjects

Background: Fat accumulation in the liver has been shown to be closely correlated with hepatic insulin resistance and features of insulin resistance, even independent of body weight. The reason for interindividual variation in liver fat content is unknown. Cross-sectional data suggest that dietary fat content may influence liver fat, but this possibility has not been directly tested in humans. Design and methods: Liver fat (proton spectroscopy), intraabdominal and sc fat (magnetic resonance imaging), and markers of insulin sensitivity ( insulin, free fatty acids, and lipids) were determined in 10 normal, obese women (age, 43 +/- 5 yr, mean +/- SD; body mass index, 33 +/- 4 kg/m(2); range, 27-38 kg/m(2)) at baseline and after two 2-wk isocaloric periods containing either 16% (low-fat diet) or 56% (high-fat diet) of total energy as fat. Results: Liver fat at baseline averaged 10 +/- 7%. It decreased by 20 +/- 9% during the low-fat diet and increased by 35 +/- 21% during the high-fat diet (P = 0.014 for liver fat after low- vs. high-fat diets; P = 0.042 for change in liver fat by the low- vs. high-fat diet). Fasting serum insulin averaged 70 +/- 41 pmol/liter at baseline. It decreased to 60 +/- 24 pmol/liter during the low-fat diet (P = 0.007 vs. before low-fat diet) and increased to 81 +/- 44 pmol/liter during the high-fat diet (P = 0.040 vs. before high-fat diet; P = 0.005 for change in serum insulin during low- vs. high-fat diet). Serum lipids, free fatty acids, and intraabdominal and sc fat masses were unchanged. Conclusion: These data suggest that the amount of dietary fat influences liver fat content.