Long-term effects of increased protein intake after weight loss on intrahepatic lipid content and implications for insulin sensitivity: a PREVIEW study

M. Drummen*, E. Dorenbos, A. C. E. Vreugdenhil, A. Raben, M. Fogelholm, M. S. Westerterp-Plantenga, T. C. Adam

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The aim of this study was to assess the effects of a weight maintenance period comprising two diets differing in protein intake, after weight loss, on intrahepatic lipid content and implications for insulin sensitivity. A total of 25 participants [body mass index (BMI): 31.1 (3.5 kg/m(2); intrahepatic lipid (IHL): 8.7 (8.3%; fasting glucose: 6.4 (0.6 mmol/l; homeostatic model assessment for insulin resistance (HOMA-IR): 3.7 (1.6; Matsuda index: 3.4 (2.9] started an 8-wk low-energy diet followed by a 2-yr weight maintenance period with either high protein or medium protein dietary guidelines. At baseline, after 6 mo, and after 2 yr, IHL, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were determined by magnetic resonance spectroscopy/imaging. Glucose and insulin concentrations, determined during an oral glucose challenge, were used to assess the HOMA-IR and Matsuda insulin sensitivity index (ISI). Protein intake was measured with 24-h urinary nitrogen excretion. Protein intake, BMI, IHL., VAT. SAT, HOMA-IR, and ISI did not change differently between the groups during the intervention. In the whole group. BMI, IHL., VAT, SAT, HOMA-IR. and ISI were favorably changed at 6 mo and 2 yr compared with baseline (P <0.05). Mixed-model analysis showed that independent of BMI, protein intake (g/d) at 6 mo was inversely related to IHL (coefficient: -0.04; P <0.05) and VAT (coefficient: -0.01; P <0.05). Overall, IHL was positively related to HOMA-IR (coefficient: 0.10; P <0.01) and inversely related to ISI (coefficient: -0.17; P <0.01), independent of BMI. A 2-yr medium-to high-protein energy-restricted diet reduced IHL and VAT. Independently of changes in BMI, IHL was inversely related to insulin sensitivity.

Original languageEnglish
Pages (from-to)E885-E891
Number of pages7
JournalAmerican Journal of Physiology : Endocrinology and Metabolism
Issue number5
Publication statusPublished - Nov 2018


  • body composition
  • insulin sensitivity
  • intrahepatic lipid content
  • protein intake
  • weight loss
  • DIET

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