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.
Healthy fats are a vital component for the health of almost all body systems. They should therefore be included in the diet in ample amounts since their consumption can contribute to the natural treatment of conditions that range from depression to psoriasis and arthritis as well as lowering triglyceride levels.
while your quiting the wheat and starches , you can take a herb called milk thistle,, it helps heal the liver also.
monty wrote: «…you can take a herb called milk thistle,, it helps heal the liver also.»
Milk thistle has arisen previously on the blog, for example here:
https://drdavisinfinitehealth.com/2013/01/nutritional-supplements-in-the-wake-of-wheat-elimination/comment-page-2/#comment-27762
About 8 years ago Dr. Davis included it in a TYP Blog remark “…preparations of dubious value: milk thistle, hawthorne, ribose, hoodia, silymarin, hydroxycitric acid…”
The active ingredient in milk thistle is silymarin, so it might be sold either way. Neither is presently on the list of supplements that might have a role in a Wheat Belly lifestyle.
Consumerlab dot com was ambivalent about it. The published science is apparently unsettled (and could easily be confounded by not controlling subject diets for liver antagonists).
In any event, NAFLD (Non-Alcoholic Fatty Liver Disease) is a growing problem, and a totally optional not-really-a-disease ailment. To reverse it, absent permanent liver damage, low net carb is the answer (with very low fructose, and no alcohol, to accelerate the recovery).
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Bob, you might be interested in the work of Australian liver doctor (hepatologist) Sandra Cabot. Her protocol is very similar to Dr. Davis’s in her treatment of fatty liver disease. She’s been in practice for over 3 decades and has been very successful with employing a low carb approach as well as utilizing herbs such as milk thistle. You and Dr. Davis might be interested in checking out her website: http://www.liverdoctor.com. Her only drawback is that she does recommend some grains (usually after the liver has normalized somewhat) but otherwise I believe her medical philosophy meshes extremely well with the Wheatbelly lifestyle.
Phillis Hammond wrote: «Her protocol is very similar to Dr. Davis’s in her treatment of fatty liver disease.»
Thanks for the link. Her Fatty Liver page would be here:
https://www.liverdoctor.com/liver/fatty-liver/
That’s some generally useful information about we call NAFLD (which should really be called NAFLS, as it’s not really a disease [D] but a usually avoidable and reversible syndrome [S]).
I can’t quickly tell what her overall dietary recommendations look like, in particular net carbs. She doesn’t have specific pages for diet, metabolic syndrome or obesity.
Perhaps metsyn is called “Syndrome X” there, and there is a page for that. On it, she principally highlights liver as central to the problem, and the top solutions start with supplements. It looks like she might endorse a “low carb” diet, but also exercise, so there is yet some consensus dogma lurking.
She’s aware of the hazards of fast carbs generally, but most of the foods for which she’s advocating “restricted” need to be set to zero, permanently. On the Fatty Liver page, I do see the silymarin listed further down (and also folic acid, which is surprising in light of her awareness of the MTHFR/methylation issue).
If someone with NAFLD attends to:
• grain-free
• very low net carb (so very low sugar)
• alcohol abstinence until NAFLD remission
• increase healthy fats, esp. DHA&EPA
• low fructose
• low Omega 6 PUFA exposure
I suspect they’ll get prompt and significant results, and the supplements suggested by Dr. Cabot will only provide marginal extra contribution.
«Her only drawback is that she does recommend some grains…»
It’s apparent from her celiac page (no mention of NCGS, for example) that she’s not fully aware that the gluten-bearing grains are an acute hazard for everyone.
Modern diet is a rogue elephant. Many observers, MDs and general public, are beginning to figure out that the consensus advice is mistaken, if not upside down. Some have identified one or more parts of the elephant, but few have something close to the full picture. Despite what might appear to be a focus on wheat and grains, the Wheat Belly program has the most comprehensive picture of the whole elephant that I know of.
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From her books she recommends a fairly low carb approach. The dialogue in the books is indicative that she is very much aware of the science behind a low carb protocol in relieving fatty liver, type 2 diabetes as we as some cardiac conditions. As I indicated, she was very much a pioneer in Australia in using these methods where little to no information existed and came to her current conclusions over a span of 30 something years. I’m not sure she is aware of Dr. Davis’s approach but what she has said would mesh very well as I think she needs the information from Wheatbelly to finish out her protocols especially those concerning the detrimental effects of grains. She also has a great deal of insight into the problem of stalled weight loss and the role that the thyroid plays there. Not saying she is better than Dr. Davis (I’m a long time Wheatbelly follower) heaven forbid, but saying that she may have some additional information to help solve some of the weight stall issues that may be worth investigation.
Phillis Hammond wrote: «…she may have some additional information to help solve some of the weight stall issues that may be worth investigation.»
Agreed, and further, her real value may be insights on liver problems that don’t resolve on a remediated diet. Thanks for bringing her to my attention.
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