Low-Carb Diet Better Than Low-Cal for Fatty Liver

Loss of excess weight is a mainstay of therapy for nonalcoholic fatty liver disease.  A very-low-carb diet works better than a reduced-calorie diet, according to a recent study in the American Journal of Clinical Nutrition.

Nonalcoholic fatty liver disease (NAFLD) occurs in 20 to 40% of the general population, with most cases occuring between the ages of 40 and 60.  It’s an accumulation of triglycerides in the liver. 

Nonalcoholic steatohepatitis (NASH) is a subset of NAFLD, perhaps 30% of those with NAFLD.  Steatohepatitis involves an inflammatory component, progressing to cirrhosis in 3 to 26% of cases. 

ResearchBlogging.orgResearchers at the University of Texas Southwestern Medical Center assigned 18 obese subjects (average BMI 35) to either a very-low-carb diet (under 20 grams a day) or a low-calorie diet  (1200 to 1500 calories a day) for two weeks.  Liver fat was measured by magnetic resonance technology.  The low-carb groups’ liver fat decreased by 55% compared to 28% in the other group.  Weight loss was about the same for both groups (4.6 vs 4 kg). 

Bottom Line

This small study needs to be replicated, ideally with a larger group of subjects studied over a longer period.  Nevertheless, it appears that a very-low-carb diet may be one of the best dietary approaches to nonalcoholic fatty liver disease.  And I bet it’s more sustainable than severe calorie restriction.  The Ketogenic Mediterranean Diet, by the way, provides 20-30 grams of carb daily.

Steve Parker, M.D. 

Refernce:  Browning JD, Baker JA, Rogers T, Davis J, Satapati S, & Burgess SC (2011). Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction. The American journal of clinical nutrition, 93 (5), 1048-52 PMID: 21367948


Filed under ketogenic diet, Overweight and Obesity, Weight Loss

12 responses to “Low-Carb Diet Better Than Low-Cal for Fatty Liver

  1. It’s worth mentioning that it’s not clear why some patients progress to NASH and some stay at NAFLD. While it’s presumed that lowering triglyceride content in the liver will reduce progression to NASH (and presumably cirrhosis), that still needs to be established in a dietary context. Did they look at enzymes?

  2. I agree with your bottom line here doc! Two weeks is inconsequential in the overall scheme of things. It’s nothing new that a transition from any way of eating to very-low-carb induces dramatic changes in the short term.

  3. Any views on fructose vs other carbs? Killing carbs across the board might be overkill if most of the damage is done by fructose after all…

  4. Have you read Dr. Neal Barnard’s Program for Reversing Diabetes. I thought you had a review for it, but couldn’t find. Maybe I was mistaken. I’m reading it right now.

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