Qualitative aspects of diet affecting visceral and subcutaneous abdominal adipose tissue: a systematic review of observational and controlled intervention studies

CONTEXT: Knowledge of the role that qualitative as opposed to energy aspects of diet play in the accumulation of visceral abdominal adipose tissue (VAT) and subcutaneous abdominal adipose tissue (SAAT) is limited and not conclusive. OBJECTIVE: A systematic review was conducted to evaluate and summarize the existing literature investigating the relationships between qualitative aspects of diet, from single dietary components to overall dietary patterns, and VAT and SAAT. DATA SOURCES: The PubMed, Web of Science, Embase, and Cochrane databases were searched. STUDY SELECTION: Observational and controlled intervention studies that assessed healthy adults or adolescents using magnetic resonance imaging, computed tomography, dual-energy X-ray absorptiometry, or ultrasound were eligible for inclusion. After quality assessment of all eligible studies, 20 observational and 23 controlled intervention studies were included. DATA SYNTHESIS: Considering study quality, including nutritional and abdominal adipose tissue assessment, about 30 caloric and noncaloric qualitative aspects of diet were found "to be associated with or affect" VAT and/or SAAT, most notably, medium-chain triacylglycerols, dietary fiber, calcium, phytochemicals, and dietary patterns; for fructose and alcohol, the relationships were less clear. CONCLUSION: Additional well-designed prospective studies are warranted to confirm current findings and to identify further qualitative aspects of diet that may influence VAT and SAAT accumulation.