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Limiting carbs, not calories to reverse fatty liver

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? 2011 American Society for Nutrition

Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction1,2,3

Jeffrey D Browning, Jonathan A Baker, Thomas Rogers, Jeannie Davis, Santhosh Satapati, and Shawn C Burgess

+ Author Affiliations

 

1From the Departments of Internal Medicine (JDB), Pathology (JAB and TR), and Pharmacology (SCB), The Advanced Imaging Research Center (JDB, JD, SS, and SCB), The University of Texas Southwestern Medical Center at Dallas, Dallas, TX.

+ Author Notes

 

↵2 Supported by the Clinical and Translational Science Award at The University of Texas Southwestern (UL1RR024982), the Task Force for Obesity Research (TORS) at The University of Texas Southwestern (5UL1DE019584), the TORS Human Biology Core (5PL1DK081183), the TORS Molecular and Metabolic Mouse Phenotyping Core (5PL1DK081182), and NIH grants 5RL1DK081187 (to JDB and SCB), 1K23DK074396 (to JDB), RR02584 (to SCB), R01DK078184 (to SCB), and DK082872 (to TR).

 

↵3 Address reprint requests and correspondence to JD Browning, Department of Internal Medicine, Division of Digestive and Liver Diseases and the Advanced Imaging Research Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8568. E-mail: jeffrey.browning@utsouthwestern.edu.

 

Abstract

 

Background: 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.

 

Objective: 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.

 

Design: 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.

 

Results: 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).

 

Conclusions: 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. This trial was registered at clinicaltrials.gov as NCT01262326.

 

Received November 4, 2010.

Accepted February 14, 2011.

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Thanks for the abstract. So could a low-carb diet could help Cushies with fatty liver even if the diet doesn't necessarily help them with weight loss?

 

I had fatty liver and got rid of it on a no-carb diet (it was a little extreme, but it was mainly due to food allergies). I also lost tons of weight on it (90 lbs.) despite having Cushing's, somehow. I'm guessing in my case fatty liver would have gone away just thanks to all the weight loss regardless (since it was so drastic), or am I wrong?

Edited by Azul

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Yes, in my experience. Carbs cause elevated triglycerides, that's what the liver converts excess glucose to for storage. In a two week study with only 10lbs weight loss, that first ten lbs for the low carbers is usually water weight, mostly.

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i have been on a low carb diet since january and have lost 3 stone and 4lbs so yes it does work but you need every bit of will power to do it only diet that has worked for me so far also liver tests look better

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I was told I have a fatty liver and just recenly I have an enlarged liver now it went from 2 cm to 21 in 3 months. I've never had this before but since I might have cushing's I'm guessing it's all the things my body is going through. Plus why am I always so hungry??! And for sweets and carbs? It's like I need it to live and I've never been like that. What kind of diet do you suggest I try to just calm my body down from all the carbs and sweets. The cravings are the worse!

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I don't eat carbs and I'm almost never hungry...mainly because it hurts to eat. But I have a fatty liver!! It hurts too! Anyone else?

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I was told I have a fatty liver and just recenly I have an enlarged liver now it went from 2 cm to 21 in 3 months. I've never had this before but since I might have cushing's I'm guessing it's all the things my body is going through. Plus why am I always so hungry??! And for sweets and carbs? It's like I need it to live and I've never been like that. What kind of diet do you suggest I try to just calm my body down from all the carbs and sweets. The cravings are the worse!

 

All bets are off with Cushing's, but most folks find that by cutting out starches and sugars, the cravings disappear, and so does fatty liver. The liver converts excess glucose from foods into fatty acids for storage. No excess, less fat storage.

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I don't eat carbs and I'm almost never hungry...mainly because it hurts to eat. But I have a fatty liver!! It hurts too! Anyone else?

 

I don't know exactly where the liver is but I have this weird pain in my back but its not a muscle pain its more inside my body..it flutters and hurts..maybe its my enlarged liver who knows..

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