The keto diet was originally developed as a medical aid for children with epilepsy, and although it is now widely used as a weight loss strategy, it still has practical applications in health care. So when it comes to the liver: are keto good for fatty liver? Can it prevent or even reverse fatty liver? Read on for the answers.
Different Types of Fatty Liver Disease
Inflammation is a key driver of disease, and excess fat in the liver can lead to inflammation in the liver. Over time, inflammation in the liver can impair function and create scarring that may lead to liver failure.
Alcoholic Fatty Liver Disease (AFLD)
You may be more familiar with alcoholic fatty liver disease (AFLD) that occurs in people who drink a lot of alcohol. Without any inflammation or other complications, the earliest stage of alcohol-related fatty liver is called simple alcoholic fatty liver. Over time, when excess fat in the liver occurs along with inflammation, it is called alcoholic fatty liver (ASH). Untreated alcoholic fatty liver can lead to liver fibrosis and liver failure.
Nonalcoholic Fatty Liver Disease (NAFLD)
Non-alcoholic fatty liver disease (NAFLD) occurs in people who do not drink heavily and affects an estimated 25 to 30 percent of people in Europe and the United States.
If you do not have a history of heavy drinking but you have excess fat in your liver, you may be diagnosed with NAFLD. If the fat buildup is accompanied by inflammation, your doctor may diagnose nonalcoholic steatohepatitis (NASH), which is a type of nonalcoholic steatohepatitis.
Acute Fatty Liver of Pregnancy (AFLP)
Acute fatty liver disease of pregnancy (AFLP) is exactly what it sounds like, involving extra fat in the liver during pregnancy. The cause of acute fatty liver of pregnancy, an uncommon but serious complication of pregnancy, is not known. Genetic factors may be associated with AFLP.
AFLP usually occurs in the third trimester of pregnancy, but returns to normal within a few weeks after delivery.
Causes Of Fatty Liver
Several things can contribute to the development of fatty liver. These include:
High Carb and Sugar Intake
Non-nutritive calories in refined sugars and highly processed carbohydrate foods contribute to fatty liver. The strict restrictions on carbohydrates required by keto directly ameliorate these two risk factors.
Overeating saturated fats also increases the likelihood of developing fatty liver. However, most studies demonstrating saturated fat as a contributor to fatty liver involve binge calorie eating on a mixed high-fat, high-carbohydrate, high-calorie diet. Keto diets that promote weight loss can improve fatty liver, even if they contain high levels of saturated fat. Thus, regardless of whether we are discussing carbohydrates or fats, the basic dietary substrate appears to have a greater impact than the macronutrients discussed.
Along with sugar, vegetable oils must bear some of the blame for the fatty liver. That’s because oils like soybean oil, corn oil and safflower oil are high in an omega-6 polyunsaturated fat called linoleic acid. When you feed animals a diet high in linoleic acid, they can develop a fatty liver. In one study, mice fed soybean oil were more likely to develop a fatty liver than mice fed coconut oil.
Not Enough Choline
Choline is a nutrient that helps your liver process fat. Specifically, your body needs choline to make very low density lipoprotein (VLDL) particles. The function of VLDL particles is to export fat out of your liver – which is essential for preventing fat buildup. While human trials on choline for NAFLD are somewhat thin on the ground, studies on animals have shown that choline supplementation can reverse fatty liver.
Unfortunately, most people don’t take enough choline. This is because the main dietary source of choline – eggs – has been demonized because of their saturated fat content. People also tend to avoid beef liver, which is another excellent source of choline. Other good sources of choline include caviar, fish such as salmon, tuna and cod, and shiitake mushrooms.
Fatty liver is associated with insulin resistance, which is why both conditions are present in up to 80% of people with type 2 diabetes. Because the ketogenic diet limits sugar intake, it helps improve insulin sensitivity in people at risk.
Can a Keto Diet Improve Fatty Liver Disease?
When it comes to diet, most health professionals and advocates agree that a balanced and nutrient-rich diet is the best choice for treating fatty liver. Many emphasize lowering refined carbohydrates, which is a given in a ketogenic diet. Keto diets have also been shown to improve blood sugar and cholesterol, which can also be beneficial for people with fatty liver.
It seems counterintuitive that a high-fat diet would improve fatty liver. But when you look at the causes of fatty liver, it makes more sense.
First, keto diets are very low in fructose. By eliminating fructose, you eliminate a major cause of fatty liver. Second, whole food keto diets do not contain vegetable oils; instead, liver-friendly fats like olive oil, coconut oil and butter are preferred. Third, study after study has shown that keto diets can reverse insulin resistance and stimulate weight loss in obese individuals. These are also risk factors for fatty liver disease.
Finally, choline is encouraged, not avoided, in the keto diet. Eggs are an ideal ketogenic food.
Other Lifestyle Changes might Help Improve Fatty Liver
It may help to drink more water and reduce or avoid trans fats, artificially processed foods and raw or undercooked shellfish.
Healthier lifestyles can improve or prevent fatty liver, including:
- Limiting or avoiding alcohol
- Taking steps to safely lose weight or maintain a healthy weight
- A nutrient-dense diet
- Avoiding supplements or medications that can be hard on the liver
- Regular exercise
Some doctors recommend detoxification and liver support. Recent studies have shown that vitamin E supplements can help reduce inflammation and excess fat in fatty liver.
It is best to discuss your questions and concerns with your doctor or healthcare practitioner before starting a new supplement, diet or natural treatment.
When fatty liver is treated in its early stages, it is possible to reverse the damage caused by fatty liver. Be aware of these symptoms and take care of your liver with a healthy lifestyle!