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A low carbohydrate diet is an effective
treatment for fatty liver disease


Approximately one quarter of all adults have fatty liver disease, increasing the risk of cirrhosis, liver cancer, type 2 diabetes and coronary heart disease. A Swedish study now shows that a strict low carbohydrate way of eating can eliminate the fat from the liver within two weeks. It is a major breakthrough in treatment of the disease.

Today, there is no medical therapy available for fatty liver disease, and it is considered a chronic disorder. Advice given to patients is to lose weight, but few manage to in the long run. A study, carried out at the Sahlgrenska University Hospital in Gothenburg, Sweden, now shows that a strict low carbohydrate approach can be of great help for sufferers.

“We demonstrate that a low carbohydrate diet quickly and effectively decreases the amount of liver fat and improves health markers for coronary heart disease”, says Jan Borén, professor at the Department of molecular and clinical medicine at Gothenburg University, responsible for the study, published in Cell Metabolism.

Fatty liver disease follows in the footsteps of obesity, and the predominant hypothesis is that patients develop a fatty liver as they gain weight and store fat in the body. Simultaneously, another theory regards a disordered gut flora as a cause, whereas a third idea concerns fructose as the culprit. Fructose makes up half of white sugar and is processed in the liver. Excess consumption of fructose causes the liver to produce fat.  

In the newly published study, the participants continued to eat as many calories as before, while decreasing the amount of carbohydrates consumed and instead increasing the amount of protein. Participants losing weight were encouraged to consume more food, in order to maintain the weight. Despite this, fat was eliminated from the liver. The researchers saw a positive trend already on the first day.

“The effect is likely due to the low intake of carbohydrates, which decreases the production of fat in the liver and increases the degradation of fatty acids. It is though important to note that the diet we gave the participants included more protein and a slightly different lipid profile. These changes could also have had an impact”, says Jan Borén.

The gut bacteria started to produce of folic acid

The scientists also detected a drastic change in gut flora. A surprising discovery was that the gut bacteria increased the production of folic acid.

“Folic acid is needed to metabolise fatty acids in the liver, playing a significant role in the decreased liver fat”, according to Jan Borén.

A third significant discovery of the study was decreased inflammation, which, in turn, is likely to lower the risk for cirrhosis and liver cancer.

Hannes Hagström, researcher at Gastrocentrum at Karolinska University Hospital in Stockholm, Sweden, finds the results of the study interesting.

“It is an extremely detailed mapping of what happens to the liver when you eat low levels of carbohydrates for a short period of time”, Hannes says.

The study lacked a control group, however. DSF recently informed that we will support a study conducted by Hannes Hagströms team, in which they will examine the effects of low carbohydrate eating and intermittent fasting (5:2) on fatty liver disease. The study is less detailed, but will incorporate a control group, more participants and will carry on for a longer period of time. Thus it will complete the study from Sahlgrenska.

More and more children are affected

A new treatment of fatty liver disease would be an amazing development. An increasing number of teenagers now suffer from the disorder and we are seeing a rise in the need for liver transplants in USA, for example. A crucial next step will be to see if any particular part of the diet change is more significant than others. When children suffering from fatty liver disease decreased the amount of added sugar in their diet, their liver fat was also rapidly reduced. Patients also need to know whether they need to continue their strict diet, or if it is enough to exclude refined carbohydrates to retain the positive effects.

There are many questions. It is very exciting that a change of diet can cause gut bacteria to produce increased amounts of folic acid. This shows that the food we eat truly impacts us in many different ways!

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