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Open Access 01-03-2014 | Original Contribution

Dietary walnut oil modulates liver steatosis in the obese Zucker rat

Authors: Anja Fink, Corinna E. Rüfer, Julie Le Grandois, Alexander Roth, Dalal Aoude-Werner, Eric Marchioni, Achim Bub, Stephan W. Barth

Published in: European Journal of Nutrition | Issue 2/2014

Abstract

Purpose

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. We aimed to clarify the impact of dietary walnut oil versus animal fat on hepatic steatosis, representing the initial step of multistage pathogenesis of NAFLD, in Zucker obese rats.

Methods

Zucker lean ad libitum (a.l.), Zucker obese a.l. or Zucker obese pair fed (p.f.) to the lean received isocaloric diets containing 8 % walnut oil (W8), W14 or 14 % lard (L14) (n = 10/group). Body weight, clinical serology, liver weight, lipid content and fatty acid composition and hepatic lipid metabolism-related transcripts were evaluated.

Results

Compared to lean, Zucker obese a.l. and p.f. showed hepatic triacylglyceride (TAG) accumulation. In Zucker obese p.f., W14 compared to W8 and L14 reduced liver lipids, TAG as well as hepatic omega-6 (n-6)/n-3 ratio and SCD activity index [(C18:0 + C18:1)/C18:0 ratio] paralleled by decreased lipoprotein lipase mRNA in obese p.f. and elevated microsomal triglyceride transfer protein mRNA in lean and obese. Further, W14 elevated the fasting blood TAG and reduced cholesterol levels in obese.

Conclusions

In our model, consumption of W14 inhibited hepatic lipid accumulation along with modulated hepatic gene expression implicated in hepatic fatty acid influx or lipoprotein assembly. These results provide first indication that dietary lipids from walnut oil are modulators of hepatic steatosis as the initial step of progressive NAFLD pathogenesis.

Byrne CD, Olufadi R, Bruce KD, Cagampang FR, Ahmed MH (2009) Metabolic disturbances in non-alcoholic fatty liver disease. Clin Sci (Lond) 116:539–564CrossRef

Chechi K, Yasui N, Ikeda K, Yamori Y, Cheema K (2010) Flax oil-mediated activation of PPAR-gamma correlates with reduction of hepatic lipid accumulation in obese spontaneously hypertensive/NDmcr-cp rats, a model of the metabolic syndrome. Br J Nutr 104:1313–1321CrossRef

Molendi-Coste O, Legry V, Leclercq IA (2010) Dietary lipids and NAFLD: suggestions for improved nutrition. Acta Gastroenterol Belg 73:431–436

Day CP (2011) Non-alcoholic fatty liver disease: a massive problem. Clin Med 11:176–178CrossRef

Della CC, Alisi A, Iorio R, Alterio A, Nobili V (2011) Expert opinion on current therapies for nonalcoholic fatty liver disease. Expert Opin Pharmacother 12:1901–1911CrossRef

Lewis JR, Mohanty SR (2010) Nonalcoholic fatty liver disease: a review and update. Dig Dis Sci 55:560–578CrossRef

Petta S, Muratore C, Craxi A (2009) Non-alcoholic fatty liver disease pathogenesis: the present and the future. Dig Liver Dis 41:615–625CrossRef

Yki-Jarvinen H (2010) Nutritional modulation of nonalcoholic fatty liver disease and insulin resistance: human data. Curr Opin Clin Nutr Metab Care 13:709–714CrossRef

Krawczyk M, Bonfrate L, Portincasa P (2010) Nonalcoholic fatty liver disease. Best Pract Res Clin Gastroenterol 24:695–708CrossRef

10.

Musso G, Gambino R, Cassader M (2009) Recent insights into hepatic lipid metabolism in non-alcoholic fatty liver disease (NAFLD). Prog Lipid Res 48:1–26CrossRef

11.

Postic C, Girard J (2008) The role of the lipogenic pathway in the development of hepatic steatosis. Diabetes Metab 34:643–648CrossRef

12.

Vanni E, Bugianesi E, Kotronen A, De MS, Yki-Jarvinen H, Svegliati-Baroni G (2010) From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis 42:320–330CrossRef

13.

Cohen JC, Horton JD, Hobbs HH (2011) Human fatty liver disease: old questions and new insights. Science 332:1519–1523CrossRef

14.

Musso G, Gambino R, De MF, Cassader M, Rizzetto M, Durazzo M, Faga E, Silli B, Pagano G (2003) Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis. Hepatology 37:909–916CrossRef

15.

Parker HM, Johnson NA, Burdon CA, Cohn JS, O’Connor HT, George J (2011) Omega-3 supplementation and non-alcoholic fatty liver disease: a systematic review and meta-analysis. J Hepatol. doi:10.1016/j.jhep.2011.08.018

16.

Toshimitsu K, Matsuura B, Ohkubo I, Niiya T, Furukawa S, Hiasa Y, Kawamura M, Ebihara K, Onji M (2007) Dietary habits and nutrient intake in non-alcoholic steatohepatitis. Nutrition 23:46–52CrossRef

17.

Wall R, Ross RP, Fitzgerald GF, Stanton C (2010) Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev 68:280–289CrossRef

18.

Araya J, Rodrigo R, Videla LA, Thielemann L, Orellana M, Pettinelli P, Poniachik J (2004) Increase in long-chain polyunsaturated fatty acid n-6/n-3 ratio in relation to hepatic steatosis in patients with non-alcoholic fatty liver disease. Clin Sci (Lond) 106:635–643CrossRef

19.

Xu J, Cho H, O’Malley S, Park JH, Clarke SD (2002) Dietary polyunsaturated fats regulate rat liver sterol regulatory element binding proteins-1 and -2 in three distinct stages and by different mechanisms. J Nutr 132:3333–3339

20.

Zivkovic AM, German JB, Sanyal AJ (2007) Comparative review of diets for the metabolic syndrome: implications for nonalcoholic fatty liver disease. Am J Clin Nutr 86:285–300

21.

El-Badry AM, Graf R, Clavien PA (2007) Omega 3–Omega 6: what is right for the liver? J Hepatol 47:718–725CrossRef

22.

Riediger ND, Othman R, Fitz E, Pierce GN, Suh M, Moghadasian MH (2008) Low n-6:n-3 fatty acid ratio, with fish- or flaxseed oil, in a high fat diet improves plasma lipids and beneficially alters tissue fatty acid composition in mice. Eur J Nutr 47:153–160CrossRef

23.

Sekiya M, Yahagi N, Matsuzaka T, Najima Y, Nakakuki M, Nagai R, Ishibashi S, Osuga J, Yamada N, Shimano H (2003) Polyunsaturated fatty acids ameliorate hepatic steatosis in obese mice by SREBP-1 suppression. Hepatology 38:1529–1539CrossRef

24.

Maguire LS, O’Sullivan SM, Galvin K, O’Connor TP, O’Brien NM (2004) Fatty acid profile, tocopherol, squalene and phytosterol content of walnuts, almonds, peanuts, hazelnuts and the macadamia nut. Int J Food Sci Nutr 55:171–178CrossRef

25.

Bolling BW, McKay DL, Blumberg JB (2010) The phytochemical composition and antioxidant actions of tree nuts. Asia Pac J Clin Nutr 19:117–123

26.

Amaral JS, Casal S, Pereira JA, Seabra RM, Oliveira BP (2003) Determination of sterol and fatty acid compositions, oxidative stability, and nutritional value of six walnut (Juglans regia L.) cultivars grown in Portugal. J Agric Food Chem 51:7698–7702CrossRef

27.

Tapsell LC, Gillen LJ, Patch CS, Batterham M, Owen A, Bare M, Kennedy M (2004) Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes. Diabetes Care 27:2777–2783CrossRef

28.

Iwamoto M, Sato M, Kono M, Hirooka Y, Sakai K, Takeshita A, Imaizumi K (2000) Walnuts lower serum cholesterol in Japanese men and women. J Nutr 130:171–176

29.

Wu H, Pan A, Yu Z, Qi Q, Lu L, Zhang G, Yu D, Zong G, Zhou Y, Chen X, Tang L, Feng Y, Zhou H, Chen X, Li H, Demark-Wahnefried W, Hu FB, Lin X (2010) Lifestyle counseling and supplementation with flaxseed or walnuts influence the management of metabolic syndrome. J Nutr 140:1937–1942CrossRef

30.

Shimoda H, Tanaka J, Kikuchi M, Fukuda T, Ito H, Hatano T, Yoshida T (2009) Effect of polyphenol-rich extract from walnut on diet-induced hypertriglyceridemia in mice via enhancement of fatty acid oxidation in the liver. J Agric Food Chem 57:1786–1792CrossRef

31.

Tapsell LC, Batterham MJ, Teuss G, Tan SY, Dalton S, Quick CJ, Gillen LJ, Charlton KE (2009) Long-term effects of increased dietary polyunsaturated fat from walnuts on metabolic parameters in type II diabetes. Eur J Clin Nutr 63:1008–1015CrossRef

32.

Gillen LJ, Tapsell LC, Patch CS, Owen A, Batterham M (2005) Structured dietary advice incorporating walnuts achieves optimal fat and energy balance in patients with type 2 diabetes mellitus. J Am Diet Assoc 105:1087–1096CrossRef

33.

Ma Y, Njike VY, Millet J, Dutta S, Doughty K, Treu JA, Katz DL (2010) Effects of walnut consumption on endothelial function in type 2 diabetic subjects: a randomized controlled crossover trial. Diabetes Care 33:227–232CrossRef

34.

Ros E, Nunez I, Perez-Heras A, Serra M, Gilabert R, Casals E, Deulofeu R (2004) A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Circulation 109:1609–1614CrossRef

35.

Feldman EB (2002) The scientific evidence for a beneficial health relationship between walnuts and coronary heart disease. J Nutr 132:1062–1101

36.

Canales A, Sanchez-Muniz FJ, Bastida S, Librelotto J, Nus M, Corella D, Guillen M, Benedi J (2011) Effect of walnut-enriched meat on the relationship between VCAM, ICAM, and LTB4 levels and PON-1 activity in ApoA4 360 and PON-1 allele carriers at increased cardiovascular risk. Eur J Clin Nutr 65:703–710CrossRef

37.

Anderson KJ, Teuber SS, Gobeille A, Cremin P, Waterhouse AL, Steinberg FM (2001) Walnut polyphenolics inhibit in vitro human plasma and LDL oxidation. J Nutr 131:2837–2842

38.

Shimoda H, Tanaka J, Kikuchi M, Fukuda T, Ito H, Hatano T, Yoshida T (2008) Walnut polyphenols prevent liver damage induced by carbon tetrachloride and d-galactosamine: hepatoprotective hydrolyzable tannins in the kernel pellicles of walnut. J Agric Food Chem 56:4444–4449CrossRef

39.

EN ISO 12228 (1999) Animal and vegetable fats and oils—determination of individual and total sterols contents—gas chromatographic method

40.

Skrivanova E, Marounek M, De SS, Raes K (2007) Influence of dietary selenium and vitamin E on quality of veal. Meat Sci 76:495–500CrossRef

41.

Hara A, Radin NS (1978) Lipid extraction of tissues with a low-toxicity solvent. Anal Biochem 90:420–426CrossRef

42.

R Core Team (2013) R: A language and environment for statistical computing. Vienna, Austria

43.

Pinheiro J, Bates D, DebRoy S, Deepayan S, R Core Team (2012) nlme: linear and nonlinear mixed effects models. R package version 3.1-106

44.

Fan JG, Qiao L (2009) Commonly used animal models of non-alcoholic steatohepatitis. Hepatobiliary Pancreat Dis Int 8:233–240

45.

Hebbard L, George J (2011) Animal models of nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 8:35–44CrossRef

46.

Anstee QM, Goldin RD (2006) Mouse models in non-alcoholic fatty liver disease and steatohepatitis research. Int J Exp Pathol 87:1–16CrossRef

47.

Takahashi Y, Soejima Y, Fukusato T (2012) Animal models of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol 18:2300–2308CrossRef

48.

Liu Y, Meyer C, Xu C, Weng H, Hellerbrand C, Ten DP, Dooley S (2013) Animal models of chronic liver diseases. Am J Physiol Gastrointest Liver Physiol 304:G449–G468CrossRef

49.

Levy JR, Clore JN, Stevens W (2004) Dietary n-3 polyunsaturated fatty acids decrease hepatic triglycerides in Fischer 344 rats. Hepatology 39:608–616CrossRef

50.

Oosterveer MH, van Dijk TH, Tietge UJ, Boer T, Havinga R, Stellaard F, Groen AK, Kuipers F, Reijngoud DJ (2009) High fat feeding induces hepatic fatty acid elongation in mice. PLoS One 4:e6066–e6075CrossRef

51.

Yang ZH, Miyahara H, Takeo J, Hatanaka A, Katayama M (2011) Pollock oil supplementation modulates hyperlipidemia and ameliorates hepatic steatosis in mice fed a high-fat diet. Lipids Health Dis 10:189–198CrossRef

52.

Abete I, Goyenechea E, Zulet MA, Martinez JA (2011) Obesity and metabolic syndrome: potential benefit from specific nutritional components. Nutr Metab Cardiovasc Dis 21(Suppl 2):B1–B15CrossRef

53.

Lamaziere A, Wolf C, Barbe U, Bausero P, Visioli F (2013) Lipidomics of hepatic lipogenesis inhibition by omega 3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 88:149–154CrossRef

54.

Nergiz-Unal R, Kuijpers MJ, de Witt SM, Heeneman S, Feijge MA, Garcia Caraballo SC, Biessen EA, Haenen GR, Cosemans JM, Heemskerk JW (2013) Atheroprotective effect of dietary walnut intake in ApoE-deficient mice: involvement of lipids and coagulation factors. Thromb Res 131:411–417

55.

Mensenkamp AR, Jong MC, van Goor H, van Luyn MJ, Bloks V, Havinga R, Voshol PJ, Hofker MH, van Dijk KW, Havekes LM, Kuipers F (1999) Apolipoprotein E participates in the regulation of very low density lipoprotein-triglyceride secretion by the liver. J Biol Chem 274:35711–35718CrossRef

56.

Kuipers F, Jong MC, Lin Y, Eck M, Havinga R, Bloks V, Verkade HJ, Hofker MH, Moshage H, Berkel TJ, Vonk RJ, Havekes LM (1997) Impaired secretion of very low density lipoprotein-triglycerides by apolipoprotein E-deficient mouse hepatocytes. J Clin Invest 100:2915–2922CrossRef

57.

Masterton GS, Plevris JN, Hayes PC (2010) Review article: omega-3 fatty acids—a promising novel therapy for non-alcoholic fatty liver disease. Aliment Pharmacol Ther 31:679–692CrossRef

58.

Hussein N, Ah-Sing E, Wilkinson P, Leach C, Griffin BA, Millward DJ (2005) Long-chain conversion of [13C]linoleic acid and alpha-linolenic acid in response to marked changes in their dietary intake in men. J Lipid Res 46:269–280CrossRef

59.

Burdge GC, Wootton SA (2002) Conversion of alpha-linolenic acid to eicosapentaenoic, docosapentaenoic and docosahexaenoic acids in young women. Br J Nutr 88:411–420CrossRef

60.

Harris WS (1989) Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res 30:785–807

61.

Wong SH, Nestel PJ, Trimble RP, Storer GB, Illman RJ, Topping DL (1984) The adaptive effects of dietary fish and safflower oil on lipid and lipoprotein metabolism in perfused rat liver. Biochim Biophys Acta 792:103–109CrossRef

62.

Harris WS, Bulchandani D (2006) Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol 17:387–393CrossRef

63.

Brown AM, Wiggins D, Gibbons GF (1999) Glucose phosphorylation is essential for the turnover of neutral lipid and the second stage assembly of triacylglycerol-rich ApoB-containing lipoproteins in primary hepatocyte cultures. Arterioscler Thromb Vasc Biol 19:321–329CrossRef

64.

Arca M, Pigna G, Favoccia C (2012) Mechanisms of diabetic dyslipidemia: relevance for atherogenesis. Curr Vasc Pharmacol 10:684–686CrossRef

65.

Podrini C, Borghesan M, Greco A, Pazienza V, Mazzoccoli G, Vinciguerra M (2012) Redox homeostasis and epigenetics in non-alcoholic fatty liver disease (NALFD). Curr Pharm Des 19:2737–2746

66.

Botham KM, Zheng X, Napolitano M, Avella M, Cavallari C, Rivabene R, Bravo E (2003) The effects of dietary n-3 polyunsaturated fatty acids delivered in chylomicron remnants on the transcription of genes regulating synthesis and secretion of very-low-density lipoprotein by the liver: modulation by cellular oxidative state. Exp Biol Med (Maywood) 228:143–151

67.

Moran-Ramos S, Avila-Nava A, Tovar AR, Pedraza-Chaverri J, Lopez-Romero P, Torres N (2012) Opuntia ficus indica (nopal) attenuates hepatic steatosis and oxidative stress in obese Zucker (fa/fa) rats. J Nutr 142:1956–1963CrossRef

68.

Nagao K, Inoue N, Wang YM, Shirouchi B, Yanagita T (2005) Dietary conjugated linoleic acid alleviates nonalcoholic fatty liver disease in Zucker (fa/fa) rats. J Nutr 135:9–13

69.

Ahn J, Lee H, Chung CH, Ha T (2011) High fat diet induced downregulation of microRNA-467b increased lipoprotein lipase in hepatic steatosis. Biochem Biophys Res Commun 414:664–669CrossRef

70.

Pardina E, Baena-Fustegueras JA, Llamas R, Catalan R, Galard R, Lecube A, Fort JM, Llobera M, Allende H, Vargas V, Peinado-Onsurbe J (2009) Lipoprotein lipase expression in livers of morbidly obese patients could be responsible for liver steatosis. Obes Surg 19:608–616CrossRef

71.

Benhizia F, Hainault I, Serougne C, Lagrange D, Hajduch E, Guichard C, Malewiak MI, Quignard-Boulange A, Lavau M, Griglio S (1994) Effects of a fish oil-lard diet on rat plasma lipoproteins, liver FAS, and lipolytic enzymes. Am J Physiol 267:E975–E982

72.

Blasiole DA, Davis RA, Attie AD (2007) The physiological and molecular regulation of lipoprotein assembly and secretion. Mol BioSyst 3:608–619CrossRef

73.

Raabe M, Veniant MM, Sullivan MA, Zlot CH, Bjorkegren J, Nielsen LB, Wong JS, Hamilton RL, Young SG (1999) Analysis of the role of microsomal triglyceride transfer protein in the liver of tissue-specific knockout mice. J Clin Invest 103:1287–1298CrossRef

74.

Chen Z, Newberry EP, Norris JY, Xie Y, Luo J, Kennedy SM, Davidson NO (2008) ApoB100 is required for increased VLDL-triglyceride secretion by microsomal triglyceride transfer protein in ob/ob mice. J Lipid Res 49:2013–2022CrossRef

75.

Sampath H, Miyazaki M, Dobrzyn A, Ntambi JM (2007) Stearoyl-CoA desaturase-1 mediates the pro-lipogenic effects of dietary saturated fat. J Biol Chem 282:2483–2493CrossRef

76.

Dobrzyn A, Ntambi JM (2005) The role of stearoyl-CoA desaturase in the control of metabolism. Prostaglandins Leukot Essent Fatty Acids 73:35–41CrossRef

77.

Banel DK, Hu FB (2009) Effects of walnut consumption on blood lipids and other cardiovascular risk factors: a meta-analysis and systematic review. Am J Clin Nutr 90:56–63CrossRef

78.

Torabian S, Haddad E, Cordero-MacIntyre Z, Tanzman J, Fernandez ML, Sabate J (2010) Long-term walnut supplementation without dietary advice induces favorable serum lipid changes in free-living individuals. Eur J Clin Nutr 64:274–279CrossRef

79.

Davis PA, Vasu VT, Gohil K, Kim H, Khan IH, Cross CE, Yokoyama W (2012) A high-fat diet containing whole walnuts (Juglans regia) reduces tumour size and growth along with plasma insulin-like growth factor 1 in the transgenic adenocarcinoma of the mouse prostate model. Br J Nutr 108:1764–1772CrossRef

80.

Iwamoto M, Kono M, Kawamoto D, Tomoyori H, Sato M, Imaizumi K (2002) Differential effect of walnut oil and safflower oil on the serum cholesterol level and lesion area in the aortic root of apolipoprotein E-deficient mice. Biosci Biotechnol Biochem 66:141–146CrossRef

81.

Sampath H, Ntambi JM (2005) Polyunsaturated fatty acid regulation of genes of lipid metabolism. Annu Rev Nutr 25:317–340CrossRef

82.

Wu T, Fu J, Yang Y, Zhang L, Han J (2009) The effects of phytosterols/stanols on blood lipid profiles: a systematic review with meta-analysis. Asia Pac J Clin Nutr 18:179–186

83.

Kim HJ, Kim JH, Lee JW (1998) Steroid receptor coactivator-1 interacts with serum response factor and coactivates serum response element-mediated transactivations. J Biol Chem 273:28564–28567CrossRef

84.

Thakur ML, Sharma S, Kumar A, Bhatt SP, Luthra K, Guleria R, Pandey RM, Vikram NK (2012) Nonalcoholic fatty liver disease is associated with subclinical atherosclerosis independent of obesity and metabolic syndrome in Asian Indians. Atherosclerosis 223:507–511CrossRef

85.

Sookoian S, Castano GO, Burgueno AL, Rosselli MS, Gianotti TF, Mallardi P, Martino JS, Pirola CJ (2010) Circulating levels and hepatic expression of molecular mediators of atherosclerosis in nonalcoholic fatty liver disease. Atherosclerosis 209:585–591CrossRef

86.

Ito S, Yukawa T, Uetake S, Yamauchi M (2007) Serum intercellular adhesion molecule-1 in patients with nonalcoholic steatohepatitis: comparison with alcoholic hepatitis. Alcohol Clin Exp Res 31:S83–S87CrossRef

87.

Yachi R, Igarashi O, Kiyose C (2010) Protective effects of vitamin E analogs against carbon tetrachloride-induced fatty liver in rats. J Clin Biochem Nutr 47:148–154CrossRef

88.

Jacobs DR, Tapsell LC (2013) Food synergy: the key to a healthy diet. Proc Nutr Soc 72:200–206

89.

Musso G, Anty R, Petta S (2013) Antioxidant therapy and drugs interfering with lipid metabolism: could they be effective in NAFLD patients? Curr Pharm Des 19:5297–5313

Title: Dietary walnut oil modulates liver steatosis in the obese Zucker rat
Authors: Anja Fink
Corinna E. Rüfer
Julie Le Grandois
Alexander Roth
Dalal Aoude-Werner
Eric Marchioni
Achim Bub
Stephan W. Barth
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 2/2014
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-013-0573-z

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