Low-Fat, High-Carb Diet for Morbidly Obese Tied to Liver Inflammation


By Peggy Peck

BOSTON (Reuters Health) Oct 27 - The high-carbohydrate, low-fat diet often recommended for morbidly obese patients with fatty liver disease is associated with increased liver inflammation, physicians at Johns Hopkins Medical Institutions report.

Conversely, high fat diets were associated with a lower risk for inflammation, according to study results presented at the 54th Annual Meeting of the American Association for the Study of Liver Diseases.

Dr. Jeanne M. Clark, assistant professor of medicine, said in an interview that the results are hypothesis-generating and point out the need for a prospective study. "But meanwhile, once again we are faced with results that suggest we need to be very cautious in our dietary recommendations," she said.

It appears, Dr. Clark said, that recommending low-fat diet in morbidly obese patients could "worsen non-alcoholic fatty liver disease."

The findings come from a study of intra-operative liver biopsies obtained from 74 consecutive morbid obesity patients undergoing bariatric surgery. All patients underwent a pre-operative dietary evaluation and a 24-hour food recall questionnaire. The biopsy samples were reviewed and scored for steatosis, inflammation and fibrosis by a pathologist blinded to clinical and dietary information.

Using the diet recall data, the Baltimore team estimated the total calories as well as carbohydrate, protein and total fat of their diets. The patients were divided into low, medium or high categories for total fat, carbohydrates and protein consumption.

The mean age of the patients was 44 years, 86% were white and 88% were female. The median BMI was 55 kg/m (range 41-97). A total of 89% of patients had at least some degree of steatosis, with 30% having moderate to severe steatosis involving more than 33% of hepatocytes. Sixty-nine percent of the patients had inflammation, and 41% had fibrosis.

Compared with patients with the lowest carbohydrate intake, a high-carbohydrate diet was associated with an odds ratio of 7.0 (p = 0.02) for liver inflammation. A high fat diet appeared to be protective, with those in the highest fat intake group having an OR of 0.17 (p = 0.009).

Dr. Clark noted that the study appears to support diets such as the Atkins Diet, but she declined to make a recommendation.


http://www.medscape.com/viewarticle/463483

It looks like a duck, waddles like a duck, quacks like a duck. But drag me kicking and screaming around the room, and I won't admit that IT'S A DUCK.




Doreen

I don't understand why it so hard for them to admit they have been wrong!!!

Thanks for info!!!

You read it thinking, they are actually going to publicly recommend a high fat diet for people with this liver problem. But in the end they cannot bring themselves to do it.

I did a bit of follow up on this Reuter's media release. Apparently, this wasn't an official study unto itself .. these observations about the diet link came out as part of larger study about treatment for non-alcoholic liver disease.

The findings were presented at the Annual Meeting of the American Association for the Study of Liver Diseases, which is underway in Boston (October 24 - 28, 2003). I can't find an actual study paper though, so no doubt these are preliminary findings only, and not yet published.

Hopefully, Dr. Clark's suggestion that further study is warranted will be heeded.


Nonetheless, this should help to silence the naysayers and nosy in-laws who feel it's their duty to remind us that lowcarbing will cause our liver to rot and fall out


Doreen

I feel we are close though. People are starting to look more closely at the low-carb, hi-carb link. Right now the scientific community is being overly cautious because it's such a huge change from the usual dogma. Notice however that there are fewer and fewer strident anti-low carb people. The ones who are most dimissive have little credibility...like that Fumento guy or that UK dietician who was suspected of being in the pocket of the industry.

I think most of the community is starting to be aware that they have been leading us down the wrong road for a long itme. It will take a few really well respected scientists to come right out and say it and the tide will turn completely