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This version published online on November 20, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-2015
A more recent version of this article appeared on February 1, 2008
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Submitted on September 7, 2007
Accepted on November 13, 2007

Progressive Caloric Restriction Induces Dose Dependent Changes in Myocardial Triglyceride Content and Diastolic Function in Healthy Men

Sebastiaan Hammer*, Rutger W. van der Meer, Hildo J. Lamb, Michael Schär, Albert de Roos, Jan W.A. Smit, and Johannes A. Romijn

Departments of Endocrinology & Metabolism and Radiology, Leiden University Medical Center, Leiden, The Netherlands, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, US; Philips Medical Systems, Cleveland, OH, US

* To whom correspondence should be addressed. E-mail: S.Hammer{at}LUMC.nl.

Context: In animal experiments, high plasma concentrations of free fatty acids (FFA) are associated with increased triglyceride (TG) stores in liver and heart, and impaired cardiac function. In humans caloric restriction increases plasma FFA levels.

Objective: To assess the effects of progressive caloric restriction on myocardial and hepatic TG content (%TG) and myocardial function.

Design: Prospective intervention study.

Participants: 10 Lean healthy men.

Interventions: 3 Days of partial (471 kcal/day) and complete starvation.

Outcome measures: Plasma levels of FFA, myocardial and hepatic %TG and myocardial function.

Results: Plasma FFA increased from 0.6 ± 0.4 to 1.2 ± 0.4 and to 1.9 ± 0.7 mmol/l, after partial and complete starvation, resp (P < 0.001). Myocardial %TG increased from 0.35 ± 0.14 to 0.59 ± 0.27, and 1.26 ± 0.49%, resp (P < 0.01). Diastolic E/A ratio decreased from 2.2 ± 0.4 to 2.1 ± 0.38 (P = 0.7) and 1.8 ± 0.4, resp (P < 0.01) and diastolic early deceleration from 3.4 ± 0.7 to 2.9 ± 0.5 and 2.8 ± 0.9 ml/s2 x 10-3, resp (P < 0.05). Hepatic %TG decreased after partial starvation (from 2.23 ± 2.24% to 1.43 ± 1.33%, P < 0.05), but did not change upon complete starvation.

Conclusion: Progressive caloric restriction induces a dose dependent increase in myocardial %TG and a dose dependent decrease in diastolic function in lean healthy men. Hepatic %TG showed a differential response to progressive caloric restriction, indicating that redistribution of endogenous TG stores is tissue specific.
Key words: starvation • free fatty acids • magnetic resonance imaging • spectroscopy






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