Wheat Belly Blog reader, Denise, posted this question:

“My doctor has prescribed a low fat diet due to a barrage of tests that ended up showing I have a very fatty liver. I am overweight, have high blood pressure, IBS and acid reflux. In all the reading I have done on here, I keep seeing to add fats . . . healthy ones . . . to your daily eating. How do I eat these and also stick to a low fat diet to please my doctor? I am 59, female, and really need to try to get healthier.”

Sorry, Denise, but it’s not your job to please your doctor. It’s your job to do what’s right for your health. Sadly, your doctor is doing more harm than good.

A low-fat diet CAUSES fatty liver because cutting fat increases carbohydrate intake which, in turn, increases liver de novo lipogenesis, the conversion of carbohydrates to fats that are then deposited in the liver.

In other words, feeding your liver more carbohydrates and less fat encourages the formation of triglycerides, some of which are released into the bloodstream as VLDL (very low-density lipoproteins), the rest of which remain in the liver. Triglycerides are fats, fats are triglycerides. As you eat more “healthy whole grains” and other foods that fit into a low-fat diet, your liver makes more triglycerides, your liver––along with your intestinal tract, pancreas, kidneys, and heart (pericardial fat)––accumulates fat, gets larger, increases markers of liver damage like AST and ALT. Over many years, this can lead to cirrhosis, identical to the disease generated by excessive alcohol consumption (alcoholic cirrhosis).

If dietary fat is made of triglycerides, doesn’t this also cause fatty liver? No, because your liver’s capacity to manufacture fats outweighs your ability to consume fat. Fats in the diet do indeed increase triglyceride levels in the blood . . . a little bit. But carbohydrates in the diet increase triglycerides . . . a lot (though the effect is delayed for several hours).

This is the overly-simplistic thinking of most doctors: If there is fat being deposited in the liver, it must be from eating fat. Your doctor prescribed a diet that is not only ineffective, but actually causes the problem it was meant to treat. This is like telling a smoker that he’s short of breath because he doesn’t smoke enough. Or telling an alcoholic that she’s woozy and uncoordinated because she’s not drinking enough bourbon. Your liver is fat because you eat too much fat? Wow.

And the “overweight, high blood pressure, IBS and acid reflux” you’re experiencing are highly likely to be a consequence of our favorite carbohydrates to bash: wheat and grains. Lose the wheat/grains, lose the weight, lose the hypertension, lose the IBS, lose the acid reflux, lose the fatty liver. Fish oil helps, too, as EPA and DHA (not linolenic acid) helps clear triglycerides.