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Effects of dietary macronutrients on liver fat content in adults: a systematic review and meta-analysis of randomized controlled trials

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DOI

  • Esther Winters-van Eekelen, Leiden Univ, Leiden University, Leiden University Medical Center (LUMC), Med Ctr, Dept Clin Epidemiol
  • ,
  • Inge Verkouter, Leiden Univ, Leiden University, Leiden University Medical Center (LUMC), Med Ctr, Dept Clin Epidemiol
  • ,
  • Harry P. F. Peters, Unilever Res Labs, Unilever
  • ,
  • Marjan Alssema, Unilever Res Labs, Unilever
  • ,
  • Babette G. de Roos, Leiden Univ, Leiden University, Leiden University Medical Center (LUMC), Med Ctr, Dept Clin Epidemiol
  • ,
  • Vera B. Schrauwen-Hinderling, Maastricht Univ, Maastricht University, Med Ctr, NUTRIM Sch Nutr Toxicol & Metab, Dept Radiol
  • ,
  • Kay H. M. Roumans, Maastricht Univ, Maastricht University, Maastricht University Medical Centre (MUMC), Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, Dept Nutr & Movement Sci
  • ,
  • Jan W. Schoones, Leiden Univ, Leiden University, Leiden University Medical Center (LUMC), Med Ctr, Walaeus Lib
  • ,
  • Peter L. Zock, Unilever Res Labs, Unilever
  • ,
  • Patrick Schrauwen, Maastricht Univ, Maastricht University, Maastricht University Medical Centre (MUMC), Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, Dept Nutr & Movement Sci
  • ,
  • Frits R. Rosendaal, Leiden Univ, Leiden University, Leiden University Medical Center (LUMC), Med Ctr, Dept Clin Epidemiol
  • ,
  • Olaf M. Dekkers
  • Renee de Mutsert, Leiden Univ, Leiden University, Leiden University Medical Center (LUMC), Med Ctr, Dept Clin Epidemiol

Dietary macronutrient composition may affect hepatic liver content and its associated diseases, but the results from human intervention trials have been equivocal or underpowered. We aimed to assess the effects of dietary macronutrient composition on liver fat content by conducting a systematic review and meta-analysis of randomized controlled trials in adults. Four databases (PubMed, Embase, Web of Science, and COCHRANE Library) were systematically searched for trials with isocaloric diets evaluating the effect of dietary macronutrient composition (energy percentages of fat, carbohydrates, and protein, and their specific types) on liver fat content as assessed by magnetic resonance techniques, computed tomography or liver biopsy. Data on change in liver fat content were pooled by random or fixed-effects meta-analyses and expressed as standardized mean difference (SMD). We included 26 randomized controlled trials providing data for 32 comparisons on dietary macronutrient composition. Replacing dietary fat with carbohydrates did not result in changes in liver fat (12 comparisons, SMD 0.01 (95% CI -0.36; 0.37)). Unsaturated fat as compared with saturated fat reduced liver fat content (4 comparisons, SMD -0.80 (95% CI -1.09; -0.51)). Replacing carbohydrates with protein reduced liver fat content (5 comparisons, SMD -0.33 (95% CI -0.54; -0.12)). Our meta-analyses showed that replacing carbohydrates with total fat on liver fat content was not effective, while replacing carbohydrates with proteins and saturated fat with unsaturated fat was. More well-performed and well-described studies on the effect of types of carbohydrates and proteins on liver fat content are needed, especially studies comparing proteins with fats.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Clinical Nutrition
Vol/bind75
Nummer4
Sider (fra-til)588-601
Antal sider14
ISSN0954-3007
DOI
StatusUdgivet - apr. 2021

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