A fasting-mimicking diet programme reduces liver fat and liver inflammation/fibrosis measured by magnetic resonance imaging in patients with type 2 diabetes
A secondary analysis of liver imaging outcomes in 89 participants of a randomized trial in type 2 diabetes.
Clin Nutr, 2025. van den Burg EL, et al.
Funding and competing interests (as published with the paper): Conflict of interest All authors declare: financial support was received from Health ∼ Holland, Top Sector Life Sciences & Health, the Dutch Diabetes Foundation, and L-Nutra for the project; HL has received consulting fees from Royal Philips and was member of the board of trustees of the SCMR and UEMS section Radiology without payment; no other relationships or activities that could appear to have influenced the submitted work.
- Study type
- Human clinical trial (randomized, secondary analysis, n=89)
- Journal
- Clin Nutr
- Published
- 2025
- Authors
- van den Burg EL, et al.
- DOI
- 10.1016/j.clnu.2025.02.017
- PubMed ID
- 40020647
Summary
This paper analyses secondary outcomes of the Fasting In diabetes Treatment trial, a randomized, assessor-blinded trial in which people with type 2 diabetes using metformin only and/or diet alone were assigned to monthly 5-consecutive-day cycles of a Fasting Mimicking Diet (FMD) alongside usual care, or to usual care only, for twelve months. Laboratory and body measurements and MRI were performed at baseline, 6 and 12 months. Two MRI-derived liver biomarkers were measured: proton density fat fraction for liver fat, and iron-corrected T1 for liver inflammation and fibrosis. Data were available for 89 participants, 48 in the diet group and 41 in the control group.
The authors reported estimated treatment effects at twelve months favouring the diet group on both liver biomarkers. Across the two groups combined, they reported that each percentage point decrease in liver fat fraction was associated with decreases in HbA1c, fasting glucose, triglycerides, total cholesterol and weight, and that each millisecond decrease in the T1 measure was associated with decreases in HbA1c, fasting glucose and weight.
These are secondary outcomes of a trial designed around other endpoints. The associations between the liver biomarkers and the metabolic measures pool both study groups, and they are associations rather than evidence that changing one changes the other. The biomarkers are MRI estimates of liver fat and of inflammation and fibrosis, not a diagnosis of liver disease. Participants were people with type 2 diabetes, not a general wellness population. L-Nutra, Prolon's parent company, provided part of the funding for the project.
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