Liver fat is reduced by an isoenergetic MUFA diet in a controlled randomized study in type 2 diabetic patients

Diabetes Care. 2012 Jul;35(7):1429-35. doi: 10.2337/dc12-0033.


Objective: To evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes.

Research design and methods: With use of a factorial 2 × 2 randomized parallel-group design, 37 men and 8 women, aged 35-70 years, with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment were assigned to one of the following groups for an 8-week period: 1) high-carbohydrate/high-fiber/low-glycemic index diet (CHO/fiber group), 2) high-MUFA diet (MUFA group), 3) high-carbohydrate/high-fiber/low-glycemic index diet plus physical activity program (CHO/fiber+Ex group), and 4) high-MUFA diet plus physical activity program (MUFA+Ex group). Before and after intervention, hepatic fat content was measured by (1)H NMR.

Results: Dietary compliance was optimal and body weight remained stable in all groups. Liver fat content decreased more in MUFA (-29%) and MUFA+Ex (-25%) groups than in CHO/fiber (-4%) and CHO/fiber+Ex groups (-6%). Two-way repeated-measures ANOVA, including baseline values as covariate, showed a significant effect on liver fat content for diet (P = 0.006), with no effects for exercise training (P = 0.789) or diet-exercise interaction (P = 0.712).

Conclusions: An isocaloric diet enriched in MUFA compared with a diet higher in carbohydrate and fiber was associated with a clinically relevant reduction of hepatic fat content in type 2 diabetic patients independent of an aerobic training program and should be considered for the nutritional management of hepatic steatosis in people with type 2 diabetes.

Trial registration: NCT01025856.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Exercise
  • Fats / analysis
  • Fatty Acids, Monounsaturated / administration & dosage*
  • Fatty Liver / prevention & control*
  • Female
  • Humans
  • Liver / metabolism
  • Male
  • Metformin / therapeutic use
  • Middle Aged


  • Fats
  • Fatty Acids, Monounsaturated
  • Metformin

Associated data