If you’re looking to shed a few pounds, you might be tempted to try out popular new approaches like the keto diet or fasting. But you might be unwittingly worsening a problem you don’t even know you have: a fatty liver. Doctors are worried about an increasingly common condition called nonalcoholic fatty liver disease, or NAFLD, in which extra fat builds up in the liver. It may lead to serious consequences like cirrhosis and liver cancer —just like liver problems caused by drinking too much alcohol. A quarter of the global population is estimated to have NAFLD—which doctors pronounce as “nah-fold” or “naffle-dee. The liver disease affects about 35 percent of Americans. Scientists also believe the condition is linked to increased risk of liver cancer even in the absence of clear-cut cirrhosis, Rosen said. He has seen preliminary results from a Mayo Clinic study that suggest NAFLD can increase susceptibility to other forms of cancer as well. Many people don’t know they have a fatty liver, leading to its reputation as a “silent killer.
Abdominal ultrasound showed a mildly heterogenous and echogenic liver, without focal lesions, suggestive of non-alcoholic fatty liver disease. The only significant change from previous consultation four months prior was introduction of a ketogenic diet consisting of eggs, cheese, butter, oil, nuts, leafy green vegetables and milk almond and coconut. The patient reported a reduction in hunger on this diet. Immediate discontinuation of the diet resulted in modest reduction of low-density lipoprotein cholesterol LDL-C and liver enzymes two weeks later. This case report discusses the rationale, benefits and risks of a ketogenic diet and encourages increased vigilance and monitoring of patients on such a diet. The ketogenic diet was originally developed for implementation under medical supervision to treat refractory epilepsy in infants and children [ 1 ]. It is a high-fat, low-carb, moderate-protein diet that produces metabolic changes similar to those seen in a state of starvation. These changes include increased levels of free fatty acids and serum ketones acetoacetate, acetone and beta-hydroxybutyrate and decreased levels of insulin, glucose and glucagon [ 2 ]. The theory is that ketone bodies are anti-convulsant when they cross the blood-brain barrier [ 3 ].
As a family doctor with a low-carb clinic, I see ultrasound reports of non-alcoholic fatty livers on an almost daily basis. Those are the two most important risk factors in non-alcoholic fatty liver disease. Yes, I know. Eating low fat is what got your liver in trouble in the first place My friend Dr. When she does an ultrasound for a fatty liver follow up, she always asks her patients what did their family doctor say about them having a fatty liver. I ask my low-carb patient to get an abdominal ultrasound at the beginning of their low-carb journey, and six months later, at the end of our program.