Keto for fatty liver

science
motivation

(Kathleen Newcombe) #1

One of the most heartbreaking parts of this keto life is watching others you love suffer from ailments that could be significantly improved if they would really learn about keto. Such is the case with my long time friend who has dabbled in keto and wants to believe. However…

Her doctor is telling her she has fatty liver. She just completed an MRI and now has a biopsy scheduled. Her doctor is telling her to go back to a low-fat diet. She is scared not to comply.

I know this low-fat advice would be contradictory to that of Drs. Cywes, Fung, Berry, Unwin, Ludwig…the list goes on… but in trying to tell her this, I appear like a zealot. And while I am funneling all the good information her way, she has to do some of her own learning so she too can become the same zealot :). Meanwhile, in terms of her health, time’s a wasting. I have spent three years in constant education. She needs to fast track.

I have heard about fatty liver many, many times in hours of podcasts and pages of reading, but I have not cataloged them. And finding that information again is proving arduous.

I am reaching out to this forum for information specific to fatty liver (podcast episodes are best for her 3 hours of commuting) I could send her way.

Thanks!
Kathleen


(Jane- Old Inky Crone) #2

I’m watching this post as I, too, have fatty liver. I’m currently trying to cure it with a ketogenic diet, but would love to hear some more information on the process. Thanks for your kind caring of your friend, she’s lucky to have you!


#3

Does she also have blood sugar problems? Or has no one checked for that? I’ll go dig through podcasts for something liver related, but I just wrote a post about the underlying mechanisms too.


('Jackie P') #4

Dr Ken Berry has a few good, short and accessible YouTube videos about fatty liver and fatty pancreas. Great intro.
:slightly_smiling_face:


(Bacon is a many-splendoured thing) #5

In his lecture, “Sugar: The Bitter Truth,” Dr. Lustig describes an experiment with some of the kids in his pediatric obesity clinic, in which they greatly reduced the amount of fructose by replacing it with glucose from starches. That alone was enough to show a significant improvement in the kids’ liver numbers, after only a week or ten days. So my question would be, what’s your friend’s sugar intake like? Would that be a place to start, perhaps?

P.S.–That lecture hit me at the right time and scared me so much that I cut out sweets on the spot. It was easier than I expected—guess I was finally ready! But the point is I felt so good without sugar that a couple of weeks of that, and I went full-bore keto. Perhaps that could be a workable path for your friend?


#6

I’m also having a hard time finding specific podcasts dealing with fatty liver. It’s usually mentioned as part of another topic. Or a YouTube, which isn’t the best while driving. :wink:

Another article from Virta Health: https://www.dietdoctor.com/new-research-keto-improves-liver-health-markers


(Linda) #7

I had a liver biopsy at the beginning of the year in conjunction with being relieved of my gallbladder. I had been doing lazy keto (or Atkins if you prefer) for about three years. I still had mild fatty liver (less than 10 percent), which surprised me a bit. I haven’t had a drink in at least seven years. I wondered if that was related to my gallbladder disease and if it might be better now. No way to know, though. Whatever, I don’t think I need to go out shopping for my urn just yet.


(Kathleen Newcombe) #8

I will take a look. Thanks!


(Kathleen Newcombe) #9

Going to find this tonight. Thank you, Paul.


(Kathleen Newcombe) #10

Excellent, thank you!


#11

Oh, and if you have any influence with your friend see if they can get their insulin tested. That may show elevated levels even before they would notice abnormal glucose readings.

https://www.ketogenicforums.com/t/blood-sugar-level-test-are-to-late/86034/


(Carl Keller) #12

Dietary fat often takes the blame for many modern diseases when it’s actually sugar or hydrogenated oils that are causing the problems. Here’s an article that talks about a study that showed remarkable liver improvement when participants cut sugar and starch from their diet. The study is small but the results were profound:

The study, which was published in Cell Metabolism, included only ten people and is small, but it’s a very interesting piece to dig into as a biochemist like yours truly. It’s an extremely detailed map showing what happens when a person cuts down on sugar and starch in their diet. The liver metabolism changed almost immediately. Instead of creating fat, it started burning it and already in the first day you could see a significant reduction in liver fat.


#13

Kathleen, I would also take a look on here for “fatty liver” and “NAFLD” because I’m pretty sure that I’ve seen posts from folks who have seen improvement from keto and there might be some good info in those threads.

One thing that can help as you talk with your friend: don’t use the word keto, and don’t suggest eating lots of fat. The crucial point for fatty liver (from what I understand) is keeping sugar, and fructose in particular, very low. No doctor will fight her on eliminating sugar. Eventually she can take a look at other things that raise her blood sugar level, and she may end up basically eating keto without realizing it.


(Todd Allen) #14

Here are a couple papers suggesting deficiency of choline and its metabolite betaine play a role in some cases of NAFLD, especially severe cases that lead to cirrhosis.

Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes

Betaine and Choline Improve Lipid Homeostasis in Obesity by Participation in Mitochondrial Oxidative Demethylation

Both are available in supplements though it is commonly advised to get nutrients from food when possible. There are excellent keto options, eggs and liver are great sources of choline and most poultry, fish and other meats are good sources. Spinach is high in betaine.


('Jackie P') #15

Thank you that was very interesting.


(a student of the health benefits of fasting, keto and low carb) #16

I would recommend the audiobook of The Diabetes Code by Jason Fung. I think it’s his best book, very well written narrative format, and it is read by Jason Fung, which is a big plus. From the title, you might not expect it to mention fatty liver, but it comes up frequently. It also gives a very compelling illustration of the cumulative effect of consuming more sugars than the body can process. It’s rather shocking.

The sugar threshold is very interesting. Jason Fung mentions how it’s not necessarily a matter of being visibly obese, obesity can be a manifestation of the body trying to protect itself from the over abundance of sugars. Some people aren’t as able to put on weight as others but that excess sugar still has to go somewhere and winds up getting deposited on the organs like the liver and pancreas and these people wind up with diabetes sooner.

Something that the book spends some time on is how fructose and alcohol toxicity manifest in the same way on the liver. (I think alcohol is worse than fructose in any number of ways, but I’m just talking about fat accumulation in the organs here.)

Alcohol may not be one of the factors for your friend but should be mentioned. People sometimes talk about keto approved alcohol, referring to spirits that have no carbs, therefore, keto. Maybe that’s true in the sense of spirits not spiking insulin like beer or wine, but what startled me about the fructose chapter in Jason Fung’s Diabetes Code is that fructose doesn’t spike insulin either. And like alcohol, fructose can only be metabolized by the liver. Because of this limitation, having more come through than the liver can process at once can lead to fatty liver. With the introduction of high fructose corn syrup into the food supply, combined with dietary recommendations to cut back on fat which led to people filling in the gap with more carbohydrates that breaks down into sugars, more and more people are getting a condition that had been mainly associated with high alcohol consumption. So given that, being on a higher carb diet and being a regular drinker of alcohol is a particularly toxic combination and everyone has their own threshold as to how much they can consume before bad things happen. Some people have lower threshold due to genetics, gender, size, etc.

I recommend The Diabetes Code because it is better written than Jason Fung’s previous two books (in my opinion) and good for listening to on a commute or on walks. It does not mention keto so avoids the “fad diet” tag. It addresses an alarming health epidemic that affects everyone even if your friend thinks diabetes is not her personal concern, and offers hope of being able to turn this worldwide trend around.

A ketogenic diet combined with fasting to burn off the fatty accumulation on the organs so that the body can work better and start to heal would help your friend, but since she is scared to go against her doctor’s recommendation to go on a low fat diet, I think this is a good audiobook to recommend that’s written by another doctor and goes into detail about how the entire body is affected by excess sugars/carbs.

Your friend cannot be blamed for being afraid of your suggestion that she’s better off eating MORE fat when she’d just had this diagnosis come down. It’s counterintuitive advice. It goes against the recommendation of her doctor. It goes against everything we’ve all been hearing for years and years about the dangers of fat, and unfortunately, the name fatty liver sounds like a problem of fat, not sugar. So it’s a huge mental shift that needs to take place. But it shouldn’t be too hard for her to be convinced that low carb is the right course. So I think, start with The Diabetes Code. I think she will find it very reasonable and logical delivery.

A good followup audiobook is “The Big Fat Surprise” by Nina Teicholz, read by Nina Teicholz. It’s not written by a doctor, but by the time I was about half way through, I was already feeling, “okay, okay, you’ve convinced me, we’ve been told the wrong things about fat!” but she just kept going on an on. I don’t mean that in a bad way necessarily, it’s just kind of relentless how much information she’s gathered. I found the information somewhat upsetting.

Recently, I listened to “Why We Get Fat and What to Do About it” by Gary Taubes and the narrator Mike Chamberlain is good. It’s another good book about science and what happens when people fall into trap of seeing what they want to see, so it’s interesting.

Best wishes to you and your friend. Sorry for such a long post.


(Bunny) #17

High or low carb Choline matters, why eggs are so magical!

image

The Sweet Truth About Liver and Egg Yolks — Choline Matters More to Fatty Liver Than Sugar, Alcohol, or Fat:

”…Physiologists first identified the role of insulin deficiency in type 1 diabetes by studying the disease in dogs. In 1889 they produced diabetes by simply taking out the whole pancreas from these dogs and, after scrambling for a couple decades to identify the active component, they cured the diabetes with insulin in the early 1920s (6). As cured as their diabetes was, the insulin-treated dogs nevertheless developed severe fatty liver degeneration and ultimately died of liver failure. Adding raw pancreas to their diet, which was composed of lean meat and sucrose, cured the problem. As researchers attempted to discover what it was in raw pancreas that cured the disease, they found in the early 1930s that egg yolk lecithin, which is abundant in choline, could cure it (7). And then they found that choline alone could cure it (8). …” …More

BTW: I eat them (eggs) raw sometimes! :wink:

Related:

[1] “…Eggs, liver, and peanuts, are especially rich in choline (27). Major contributors to choline in the American diet are meat, poultry, fish, dairy foods, pasta, rice, and egg-based dishes (77). Spinach, beets, wheat, and shellfish are also good sources of the choline metabolite, betaine (78). …More

[2] STOP These 5 Things to Reverse Fatty Liver (Update 2019) - Dr. Berry

[3] Critical Tips to Reverse a Fatty Liver - Dr. Berg

[4] Methionine- and choline-deficient diet induces hepatic changes characteristic of non-alcoholic steatohepatitis.


(Marianne) #18

You’re right; I find it heartbreaking, too. It’s something I had to let go of for my own sanity. Now I never talk about keto unless I am specifically asked.


(a student of the health benefits of fasting, keto and low carb) #19

"gingersmommy wrote: I find it heartbreaking, too. It’s something I had to let go of for my own sanity. Now I never talk about keto unless I am specifically asked”

This is such a good point and something I ignored when I offered audiobook suggestions. If the friend isn’t trying to be convinced that her doctor is wrong, telling them to read this and that may not be a good idea. How would any of us react if someone asked us to read a book about the downsides of keto because that someone was trying to save us going down a dangerous path?

If we had a true scientific bent, we’d read it with an open mind, but the more comfortable choice would be to ignore the well meaning person’s book recommendation.

I know a lot of people who are on meds for blood sugar, but I don’t give them food advice. The only person I talk to about this is my cousin who expressed to me her concern over her labs and was afraid that she’s doomed to become diabetic. She asked me for advice so I made some suggestions. She was amazing. Bought a glucose meter the next day and made note of what was happening when she ate a certain thing, compared that to her husband who agreed to get poked for the sake of study. Ate less of the certain thing to decide whether to have it in moderation or just eliminate it. I read and listened to The Diabetes Code many times because I want to be able to paraphrase it for her as English is not her first language.

But I wouldn’t be considered an authority on this or any other way of eating by anyone else unless I have exemplary labs to prove it and since I avoid going to the doctor, I have no idea what my blood work looks like. So please take my previous book recommendations with a grain of salt. I am still learning.

I’ll also take this opportunity to say that I love this forum. Great posts every day. Thank you.


(Brian) #20

In the initial post… the word that stood out to me was, “dabbling”.

The keto diet is not something that you can “dabble” with and expect good things. Either do it or don’t do it but riding the fence usually ends up with high-fat AND high-carb, aka, the “standard American diet” or the “sad American diet”.

I know of several people who have “dabbled” that have not done well. There are two ladies that work with my wife. #1 does little but bitch that she doesn’t like meat and that she can’t afford the food. She announced today that she quit, though I suspect she’s never really even started real ketogenic eating… she’s been “dabbling”. #2, along with her husband, came over to our house a few weeks ago to try out some sous vide chuck that I had started 3 days earlier, along with more keto good eats. It was awesome and they loved it. She’s gung-ho, losing a good bit of weight and doing very well. She’s also accused us of being “lazy keto” because she’s quite strict. And good for her!

I’m thrilled for my wife’s friend #2 but both #1 friend and #2 friend both completely own where they are. All we did was share some good keto food. We’ve share with numerous others, a few of which turned out to be “dabblers”. One of those has even revisited the “dabbling” a time or two since. But some people just can’t seem to get settled into a way of eating and bounce from one diet to another diet to another diet, sometimes back to ones they’ve been to before, and continue the rinse-repeat cycle of insanity. I feel bad for them. But it’s their way of eating to own, not mine. I make my decisions. And they make theirs.

Sorry for rambling.

Point of the post: Don’t Dabble In Keto! Do it or don’t do it.