Liver issues

Peer-Reviewed Scientific Articles​

The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study

URL: https://link.springer.com/article/10.1007%2Fs10620-006-9433-5

Journal: Digestive Diseases and Sciences

Publication Date: 02/2007

Summary: Nonalcoholic fatty liver disease is an increasingly common condition that may progress to hepatic cirrhosis. This pilot study evaluated the effects of a low-carbohydrate, ketogenic diet on obesity-associated fatty liver disease. Five patients with a mean body mass index of 36.4 kg/m2 and biopsy evidence of fatty liver disease were instructed to follow the diet (<20 g/d of carbohydrate) with nutritional supplementation for 6 months. Patients returned for group meetings biweekly for 3 months, then monthly for the second 3 months. The mean weight change was −12.8 kg (range 0 to −25.9 kg). Four of 5 posttreatment liver biopsies showed histologic improvements in steatosis (P=.02) inflammatory grade (P=.02), and fibrosis (P=.07). Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease. Further research is into this approach is warranted.

Key Takeaways

Low carbohydrate ketogenic diets can be an effective way to reverse fatty liver related to obesity and facilitate weight loss.

Fatty Liver Is Reversible With Ketogenic Diets

Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076656/

Journal: American Journal of Clinical Nutrition

Publication Date: 05/2011

Summary: Individuals with nonalcoholic fatty liver disease (NAFLD) have excess intrahepatic triglycerides. This is due, in part, to increased hepatic synthesis of fat from carbohydrates via lipogenesis. Although weight loss is currently recommended to treat NAFLD, little attention has been given to dietary carbohydrate restriction. The aim of this study was to determine the effectiveness of 2 wk of dietary carbohydrate and calorie restriction at reducing hepatic triglycerides in subjects with NAFLD. Eighteen NAFLD subjects (n = 5 men and 13 women) with a mean (±SD) age of 45 ± 12 y and a body mass index (in kg/m2) of 35 ± 7 consumed a carbohydrate-restricted (<20 g/d) or calorie-restricted (1200–1500 kcal/d) diet for 2 wk. Hepatic triglycerides were measured before and after intervention by magnetic resonance spectroscopy.  Mean (±SD) weight loss was similar between the groups (−4.0 ± 1.5 kg in the calorie-restricted group and −4.6 ± 1.5 kg in the carbohydrate-restricted group; P = 0.363). Liver triglycerides decreased significantly with weight loss (P < 0.001) but decreased significantly more (P = 0.008) in carbohydrate-restricted subjects (−55 ± 14%) than in calorie-restricted subjects (−28 ± 23%). Dietary fat (r = 0.643, P = 0.004), carbohydrate (r = −0.606, P = 0.008), posttreatment plasma ketones (r = 0.755, P = 0.006), and respiratory quotient (r = −0.797, P < 0.001) were related to a reduction in liver triglycerides. Plasma aspartate, but not alanine, aminotransferase decreased significantly with weight loss (P < 0.001). Two weeks of dietary intervention (≈4.3% weight loss) reduced hepatic triglycerides by ≈42% in subjects with NAFLD; however, reductions were significantly greater with dietary carbohydrate restriction than with calorie restriction. This may have been due, in part, to enhanced hepatic and whole-body oxidation.

Key Takeaways

Non-Alcoholic Fatty Liver Disease is partly caused by excess dietary carbohydrates, which leads to fat production in the liver. 18 subjects completed 2 weeks of either carbohydrates restricted diets or calorie restricted diets. Both diets showed weight loss and reduction in liver fat, but the low carbohydrate diet showed greater reduction in liver fat.

Low Carb Diets Effective In Treating NAFLD

Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679496/

Journal: Current Opinions in Clinical Nutrition and Metabolic Care

Publication Date: 07/2012

Summary: Obesity-associated nonalcoholic fatty liver disease (NAFLD) is highly prevalent, for which weight loss is the generally recommended clinical management. Low-carbohydrate ketogenic diets have been successful in promoting weight loss, but variations in the range of metabolic responses to these diets indicate that the effects of altering macronutrient content are not completely understood. This review focuses on the most recent findings that reveal the relationship between low-carbohydrate diets and NAFLD in rodent models and humans. Low-carbohydrate diets have been shown to promote weight loss, decrease intrahepatic triglyceride content, and improve metabolic parameters of patients with obesity. These ketogenic diets also provoke weight loss in rodents. However, long-term maintenance on a ketogenic diet stimulates the development of NAFLD and systemic glucose intolerance in mice. The relationship between ketogenic diets and systemic insulin resistance in both humans and rodents remains to be elucidated. Because low-carbohydrate ketogenic diets are increasingly employed for treatment of obesity, NAFLD, and neurological diseases such as epilepsy, understanding the long-term systemic effects of low-carbohydrate diets is crucial to the development of efficacious and safe dietary interventions.

Key Takeaways

Low Carbohydrate Ketogenic Diets are shown to be highly effective for weight loss and reduction of fatty liver. However, long term ketogenic diets in mice induced fatty liver. This study calls for further research in long term low carbohydrate diets to assess unintended health consequences. We must ask the question: Are outcomes in mice going to be the same in humans? Likely not as we are different species, which is why this study calls for more long term data in humans to assess safety.

Keto Causes NAFLD in Mice. Can We Assume This To Be True In Humans?

Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature

URL: https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13024

Journal: Obesity Reviews

Publication Date: 03/2020

Summary: Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease, characterized by hepatic fat accumulation and possible development of inflammation, fibrosis, and cancer. The ketogenic diet (KD), with its drastic carbohydrate reduction, is a now popular weight loss intervention, despite safety concerns on a possible association with fatty liver. However, KDs were also reported to be beneficial on hepatic pathology, with ketone bodies recently proposed as effective modulators of inflammation and fibrosis. If the beneficial impact of weight loss on NAFLD is established, less is known on the effect of macronutrient distribution on such outcome. In a hypocaloric regimen, the latter seems not to be crucial, whereas at higher calorie intake, macronutrient ratio and, theoretically, ketosis, may become important. KDs could positively impact NAFLD for their very low carbohydrate content, and whether ketosis plays an additional role is unknown. Indeed, several mechanisms may directly link ketosis and NAFLD improvement, and elucidating these aspects would pave the way for new therapeutic strategies. We herein aimed at providing an accurate revision of current literature on KDs and NAFLD, focusing on clinical evidence, metabolic pathways involved, and strict categorization of dietary interventions.

Key Takeaways

Low carbohydrate ketogenic diets can improve and reverse liver fat accumulation based on several studies with limited participants. Additionally, the notion that increased fat intake causes fatty liver has been disproven.

High Fat Diets Do Not Cause Fatty Liver

Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction

URL: https://www.ncbi.nlm.nih.gov/pubmed/21367948

Journal: American Journal of Clinical Nutrition

Publication Date: 05/2011

Summary: Individuals with nonalcoholic fatty liver disease (NAFLD) have excess intrahepatic triglycerides. This is due, in part, to increased hepatic synthesis of fat from carbohydrates via lipogenesis. Although weight loss is currently recommended to treat NAFLD, little attention has been given to dietary carbohydrate restriction. The aim of this study was to determine the effectiveness of 2 wk of dietary carbohydrate and calorie restriction at reducing hepatic triglycerides in subjects with NAFLD. Eighteen NAFLD subjects (n = 5 men and 13 women) with a mean (±SD) age of 45±12 y and a body mass index (in kg/m2) of 35±7 consumed a carbohydrate-restricted (≤20 g/d) or calorie- restricted (1200–1500 kcal/d) diet for 2 wk. Hepatic triglycerides were measured before and after intervention by magnetic resonance spectroscopy. Mean (±SD) weight loss was similar between the groups (24.0±1.5 kg in the calorie-restricted group and 24.6±1.5 kg in the carbohydrate-restricted group; P = 0.363). Liver triglycerides decreased significantly with weight loss (P < 0.001) but decreased significantly more (P = 0.008) in carbohydrate-restricted subjects (255±14%) than in calorie-restricted subjects (228±23%). Dietary fat (r = 0.643, P = 0.004), carbohydrate (r = 20.606, P = 0.008), posttreatment plasma ketones (r = 0.755, P = 0.006), and respiratory quotient (r = 20.797, P < 0.001) were related to a reduction in liver triglycerides. Plasma aspartate, but not alanine, aminotransferase decreased significantly with weight loss (P < 0.001). Two weeks of dietary intervention (≈4.3% weight loss) reduced hepatic triglycerides by ≈42% in subjects with NAFLD; however, reductions were significantly greater with dietary carbohydrate restriction than with calorie restriction. This may have been due, in part, to enhanced hepatic and whole-body oxidation

Key Takeaways

People with fatty liver benefit far greater from carbohydrate restrictive diets than calorie restrictive diets to reduce excess liver fat.

Low Carbohydrate Diets Outperform Calorie Restriction In Treatment of Fatty Liver

Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature

URL: https://onlinelibrary.wiley.com/doi/full/10.1111/obr.13024

Journal: Obesity Reviews

Date of Publication: 03/2020

Summary: Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease, characterized by hepatic fat accumulation and possible development of inflammation, fibrosis, and cancer. The ketogenic diet (KD), with its drastic carbohydrate reduction, is a now popular weight loss intervention, despite safety concerns on a possible association with fatty liver. However, KDs were also reported to be beneficial on hepatic pathology, with ketone bodies recently proposed as effective modulators of inflammation and fibrosis. If the beneficial impact of weight loss on NAFLD is established, less is known on the effect of macronutrient distribution on such outcome. In a hypocaloric regimen, the latter seems not to be crucial, whereas at higher calorie intake, macronutrient ratio and, theoretically, ketosis, may become important. KDs could positively impact NAFLD for their very low carbohydrate content, and whether ketosis plays an additional role is unknown. Indeed, several mechanisms may directly link ketosis and NAFLD improvement, and elucidating these aspects would pave the way for new therapeutic strategies. We herein aimed at providing an accurate revision of current literature on KDs and NAFLD, focusing on clinical evidence, metabolic pathways involved, and strict categorization of dietary interventions.

Key Takeaways

High fat diets do not cause fatty liver, and the available literature suggests that low carbohydrate ketogenic diets can play an important role in reversing fatty liver.

Ketogenic Diets Reverse Fatty Liver!

Potential effects of reduced red meat compared with increased fiber intake on glucose metabolism and liver fat content: a randomized and controlled dietary intervention study

URL: https://academic.oup.com/ajcn/article/109/2/288/5307117

Journal: The American Journal of Clinical Nutrition

Publication Date: 02/2019

Summary: Our data indicate that caloric restriction leads to a marked improvement in glucose metabolism and body-fat composition, including liver-fat content. The marked reduction in liver fat might be mediated via changes in ferritin levels. In the context of caloric restriction, there seems to be no additional beneficial impact of reduced red meat intake and increased fiber intake on the improvement in cardiometabolic risk parameters.

Key Takeaways

Reducing red meat has no impact on heart disease and metabolic disease. Increasing fiber also has no impact, but calorie restriction leads to improvement.

Fiber Isn't Helpful. Try Red Meat and Fasting Instead

Systematic review with meta-analysis: meat consumption and the risk of hepatocellular carcinoma

URL: https://www.ncbi.nlm.nih.gov/pubmed/24588342

Journal: Alimentary Physiology and Therapeutics

Publication Date: 03/2014

Summary: The present meta‐analysis indicates that a high level of white meat or fish consumption can reduce the risk of HCC significantly, while intake of red meat, processed meat or total meat is not associated with HCC risk.

Key Takeaways

Liver cancer risk can be reduced by eating white meat and fish. Red and processed meat consumption has no association with liver cancer.

Liver Cancer Risk is Reduced by Fish Consumption

Elevated serum insulin is an independent risk factor for hepatocellular carcinoma: a case control study from Nepal

URL: https://www.ncbi.nlm.nih.gov/m/pubmed/24460297/?i=2&from=/24568446/related

Journal: Asian Pacific Journal of Cancer Prevention

Publication Date: 02/2013

Summary: The effect of an insulin level in increasing HCC risk appeared consistent, influencing incidence, risk of recurrence, overall survival, and treatment-related complications in HCC patients.

Key Takeaways

Increased levels of insulin correlate with increased risk of getting liver cancer and negative outcomes in patients with liver cancer.

High Insulin Is Correlates With Risk of Liver Cancer

Creatine Supplementation Prevents the Accumulation of Fat in the Livers of Rats Fed a High-Fat Diet

URL: https://academic.oup.com/jn/article/141/10/1799/4630498

Journal: The Journal of Nutrition

Publication Date: 10/2011

Summary: The study investigated the effects on fatty liver development of feeding rats a control diet, a high-fat diet or a high-fat diet supplemented with creatine. Liver fat increased in the rats fed a high-fat diet over 3 weeks. This effect was prevented by supplementing the high-fat diet with creatine. 

Key Takeaways

When rats consumed a high fat diet, they showed an increase in liver fat. However, when the high fat diet was supplemented with creatine the increase in liver fat was prevented.

Creatine Prevents Rats From Getting Fatty Liver When Eating High Fat Diets

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