RANDOMIZED CONTROLLED TRIAL OF LOW CALORIE VS. LOW CARBOHYDRATE DIET ON METABOPHENOTYPE IN LIVER TRANSPLANT RECIPIENTS WITH OBESITY
Weight gain after liver transplantation (LT) is common and predisposes patients to metabolic complications that negatively affects both their lifespan and healthspan. There is currently a paucity of data evaluating weight loss strategies in LT recipients. Thus, we evaluated the impact of low calorie vs. low carbohydrate diet on weight loss in LT recipients with obesity.
Adult LT recipients with obesity were randomized to either calorie restrictive diet (CRD) with total calorie goal of less than 1200-1500 calorie/day irrespective of macronutrient content or a low carbohydrate diet (LCD) with 20g/day carbohydrate restriction for 24 weeks. Patients with end stage disease (i.e. heart, liver, kidney), terminal disease (i.e. cancer), on weight loss medications or uncontrolled psychiatric illness that would interfere with adherence were excluded. All patients were advised to maintain same level of physical activity, which was measured via 7-day accelerometery. Study measures including weight measurements, blood, and whole body MRI for metabophenotyping, which included visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), muscle fat infiltration (MFI), fat free muscle volume (FFMV), and proton density fat fraction (PDFF), performed at baseline and end of study. The current data is an interim analysis of 27 patients (LCD=14, CRD=13) who have completed study procedures.
The demographics, clinical and anthropometric data was similar between the two groups at study enrollment. The diet interventions were well tolerated and no significant change in renal function was noted in either cohort at study completion. The mean±SD weight loss was -7.6±7.8 kg for LCD compared to -0.6±5.3kg for CRD cohort (p=0.02). Compared to CRT, the LCD cohort had significant improvement in VAT, ASAT, and MFI. The FFMV decreased in LCD cohort but not CRT. The change in liver (PDFF) in LCD (-0.53%) compared to CRT (+0.46%) did not reach statistical significance (p=0.08). The LCD positive affected the metobophenotype profile, particularly fat depots and is presented as % change from baseline in figure.
LCD is an effective and well-tolerated dietary intervention for weight loss in LT recipients with obesity and improves the metabophenotype profile. Upon completion of current study, we hope to provide foundation data regarding safety and efficacy of LCD to combat the cardiometabolic burden in LT recipients.
Related Speaker and SessionDr. Mohammad S Siddiqui, DO, Virginia Commonwealth University, Division of Gastroenterology, Hepatology and Nutrition
Date: Saturday, November 5th
Time: 9:00 - 10:30 AM EDT