The Effect of a Very Low-Carbohydrate Diet on Intermuscular Adipose Tissue and Muscle Function in Older Adults With Obesity.
Carly E Drake, Barbara A Gower, Kevin R Fontaine et al.
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In 30 seconds
This randomized controlled trial compared a weight-maintaining very low-carbohydrate diet (VLCD) with a low-fat diet (LFD) over 8 weeks in adults aged 60 years or older with obesity. MRI assessed thigh intermuscular adipose tissue (IMAT), alongside measures of muscle strength and physical function. IMAT decreased more with the VLCD than the LFD (-24.4% vs. -1.0%, p < 0.01). Across participants, larger IMAT reductions were associated with greater improvements in hand grip strength, knee extension strength, and reach score, after adjustment for changes in thigh muscle volume and body weight.
Key findings
- IMAT decreased more in the VLCD group than the LFD group (-24.4% vs. -1.0%, p < 0.01).
- Greater IMAT reductions were associated with improved hand grip strength (r 2 = 0.95, p < 0.01).
- Greater IMAT reductions were associated with improved isometric knee extension (r 2 = 0.88, p < 0.05) and reach score (r 2 = 0.75, p < 0.05).
Why it matters
IMAT is linked to poorer muscle quality and declining mobility in older adults with obesity. These findings connect reductions in IMAT with improvements in several strength and function measures, suggesting that muscle fat may be a relevant target when studying strategies to preserve physical function. The associations do not establish that reducing IMAT itself caused the improvements.
What to keep in mind
The intervention lasted 8 weeks, and the reported associations between IMAT change and functional outcomes do not establish causation.