That’s my primary assessment of an article I read in Current Opinion on Clinical Nutrition and Metabolic Care. The title is “Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease.”
The article’s more about mice than my patients.
The authors share some stats about nonalcoholic fatty liver disease (NAFLD):
- the earliest stage is fat build-up in the liver
- 15% of the nonobese population has NAFLD
- 65% of the obese have NAFLD
- it can progress to an inflammatory disorder (nonalcoholic steatohepatitis (NASH)
- about two out of 10 NASH patients progress to cirrhosis within 10 years
- NAFLD is an independent predictor of heart and vascular disease, an even stronger predictor than overall body fat mass (even visceral fat)
- insulin resistance is strongly linked to NAFLD
The Washington University School of Medicine authors say good things about low-carbohydrate ketogenic diets for weight loss and seizure control. They spend the rest of the article talking about rodent physiology and lab chows—right up Carbsane Evelyn‘s alley. But not mine. Bores me to tears.
They do mention the small Browning study that showed a very-low-carb ketogenic diet superior to a calorie-restricted diet for reducing liver fat in humans. Weight loss by various methods is a standard recommendation for humans with NAFLD; I wouldn’t be surprised multiple different diets worked. It may be the weight loss, not the diet, that does the trick. We have just one human study thus far indicating a ketogenic diet is more effective short-term.
If I were obese and had NAFLD, I’d go on a very-low-carb ketogenic diet (like this one).
Reference: Schugar, Rebecca, and Crawford, Peter. Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care, 2012, vol. 15. doi: 10.1097/MCO.0b013e3283547157