Background and aim
Cross-sectional studies have shown that obesity is associated with a lower intestinal cholesterol absorption and a higher endogenous cholesterol synthesis. These metabolic characteristics have also been observed in patients with type 2 diabetes, the metabolic syndrome, steatosis or cholestasis. The number of intervention studies evaluating the effect of weight-loss is however limited, while the role of the different fat compartments has not been studied into detail.

Methods
Abdominally obese men (N=54) therefore followed a 6-week very low caloric (VLCD) diet, followed by a 2-week of weight maintenance period. Non-cholesterol sterols were measured at baseline and after 8 weeks and compared to levels in lean participants (N=25).

Results
After weight loss, total cholesterol-standardized cholestanol levels increased and those of campesterol and lathosterol decreased. Moreover, after weight-loss, lathosterol and cholestanol levels were comparable to those of lean men. Increases in cholestanol after weight loss were significantly associated with changes in waist circumference, weight, body mass index and visceral fat, but not with subcutaneous and liver fat.

Conclusions
Diet-induced weight loss decreased cholesterol synthesis and increased cholesterol absorption. Whether these metabolic changes ameliorate other metabolic risk factors needs further study. Changes in cholestanol levels were not only related to weight loss, but in particular to a decrease in visceral fat volume.