Sunday, June 28, 2009

Another Fatty Liver Reversal

Just to show it wasn't a fluke, reader "Steve" replicates the experiment:
I had a similar problem as what Sam described, and it just happened to coincide with my discovery of and commitment to a new eating plan (based on low/good carb, high in good fat and omega 3, and good protein--basically a mix of paleo, primal, low carb, whatever they call it). I consider myself lucky to have had great fortune in my timing of finding out about my fatty liver.

My ALT and AST [markers of liver damage] had been at 124 and 43 respectively, and then still at 80 and 30 in a follow up a few months later. I weighed in at about 205 (I'm 6'1.5" on a slimmish frame), which was my heaviest. I had been on a basic American (bad) diet. The whole thing shocked me, especially after a CT with contrast showed the fatty deposits on my liver (and prior to that, when the muddy ultrasound revealed a fatty liver and a possible pancreatic mass, later ruled out by the CT). Like Sam, though I was surely overweight, I was not fat or heavy. (Most people have noticed I look leaner, but are shocked when I disclose how much weight I have lost since they say "I cannot believe you had that much to lose.")

At about the same time I found out about my liver issue, I had been getting into reading about diet and health (something I had done once when I read the Zone stuff from Sears many years ago). I practically dove through Taubes, Eades, Cordain, and a bunch of blogs (including yours), and I made a commitment to fix my problem.

I started a pretty severe regimen at first, which included only protein and good fats with a minimal amount of non-starchy fruits and vegetables. Almost immediately, I started losing weight and body fat (as measured by an electrical impedance scale). I have always supplemented with fish oil, but I added krill oil and I also started eating grass-fed beef and pastured eggs and pastured pork as much as possible. I have added some coconut oil and pastured butter to my diet as well. I have dropped almost 40 pounds, I am down to about 10-11% body fat (from 24%), and my ALT/AST on my last test was 24/14 [normal]. I am getting another test soon, and I expect similar results.
And a later comment:
I can add to the story that I first found out about the fatty liver on a routine new patient blood screening when I moved to a new town. I can also add that it took a bit of initiative on my part to get to the right diagnosis. The first doctor suspected hepatitis, but when blood work ruled that out, he ordered the imagining tests. Once I was referred to a GI specialist, it was a quick diagnosis. Still, I had to undertake myself to figure out the best diet. The GI recommended eliminating white bread, rice, pasta, starches, etc. but also recommended lowering fat intake. Having done some of my reading on diet and health, I knew to follow the former advice and to modify the latter to be "get plenty of fat, but make sure its the right kind."
Steve took the initiative and fixed his damaged liver. He modified his GI doctor's advice based on what he had read about nutrition, with excellent results. I suspect his doctor will be all ears next time Steve comes into his office.

The liver is a remarkable organ. Besides being your "metabolic grand central station", it's the only organ in the human body that can regenerate almost completely. It can be 75% obliterated, and it will grow back over time. Fatty liver and NASH are largely reversible.

16 comments:

Anna said...

"Another Fatty Liver Reversal"

Just to show it wasn't a fluke...

I thought this was very funny. Was the pun intentional? ;-)

derek said...

I was never diagnosed but im a lab tech and ran several lab test over a period of time. My lipid and liver panels have been high for the past 3 years. Three months ago I had alt of 92 chol 275 ldl 175 hdl 30 trig 177. Now they are alt 30 chol 180 ldl 100 hdl 45 chol 170. I always ate healthy and exercised 3-5 days a week doing crossfit. I ate nothing but whole grains, veggies, fish (beef once a week)for the past 8 years. But i still had severe discomfort in my right quadrant. Did liver cleanses with huge cholesterol stones coming out all the time. A doc in ER said most likely fatty liver. Then i read an article in passing about patte and how they are force fed grain. Wasnt sure if our metabolism correlates with avian, but was willing to cut out my grains in favor of upping my good fats and meats and going all out on vegetables. The results are the above labs, 15 lbs weight loss, loss of that puffy weight lifter look to a more cut look, no loss in strength, and no right quad pain.

Mark said...

http://www.eurekalert.org/pub_releases/2009-06/sfeb-mrf062409.php

Anybody catch this article about Omega-6 improving the running speed of mice? I'm confused - is Omega 6 bad in itself or is it bad because we humans tend to consume it once it's been heated to a high temperature (french fries, potato chips)? Thoughts?

Stephan Guyenet said...

Anna,

Pun not intended!

Derek,

Thanks for posting your story.

Mark,

Their comparison group was rats eating a diet high in flax oil, which is not exactly ideal either. And the differences in running speed were very small.

There was another study showing that rats had a reduced cardiac output when they were raised on a diet high in n-6, compared with normal rat chow. Their hearts also showed abnormal inflammation and oxidative damage:

http://www.ncbi.nlm.nih.gov/pubmed/17023268

P said...

Hi Stephan,

Just trying to figure out the optimal diet for me. I have read conflicting opinions about canola oil. Is it a do or a don't?

Robert Andrew Brown said...

Mark.

It would have been more interesting if they had compared with saturated fats as well.

Energy density in fats drops with each additional double bond.

But in general terms animal activity correlates with levels of long chain Omega 3 DHA in the mitochondrial membrane.


In general terms long chain Omega 3 is associated with increased metabolism and Omega 6 with reductions in metabolism.

I first saw reference to this in Susan Allport's book The Queen of the Fats.



Author Omega Six The Devils Fat
www.omegasixthedevilsfat.com

Stephan Guyenet said...

P,

My opinion is that you're better off avoiding canola oil. I do recognize that it was used in the Lyon trial. But I think you can get the same effect but better by using traditional fats.

Regular off-the-shelf refined canola oil is several percent trans fat, and it contains dihydro-vitamin K, which is an unnatural vitamin K analog that I've written about before. Canola oil increases the stroke risk of spontaneously hypertensive rats for reasons that aren't clear but may involve the dihydro-vitamin K.

Neither trans fats nor dihydro-vitamin K occur in unrefined (virgin) canola oil, but that oil cannot be heated and should be stored in the refrigerator because it's high in omega-3 fatty acids. It may be OK if used sparingly.

Mark said...

Thanks, Robert. A question for you:

If Omega-6 reduces metabolism, does this mean that the mice may have moved faster because a mouse fed Omega-3 would have burned up his energy sources more quickly?

I have read several of Stephan's interesting articles on Omega-6 and thyroid signaling disruption, so I'm curious as to why the mouse would run faster on Omega-6. I do a lot of running myself and I have always felt that the more Omega-6 I eat, the slower I run!

Best,

Mark

Robert Andrew Brown said...
This comment has been removed by the author.
Robert Andrew Brown said...

Mark

I am only guessing as I have not seen the full trial, and just dont know.

Maybe because Omega 3 ALA is oxidised in preference to LA,it would be used first, and because it has a lower energy density the Omega 6 LA mice ran faster.

I presume their calories intake was controlled.

I am intrigued too.

Thanks

Robert

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P said...

Thanks Stephan. I guess I still balk at the actual cholesterol content of the traditional fats and think about other options. I guess the "traditional" thoughts about cholesterol in fats like ghee still have some place in my psyche. But I am getting over them. Yesterday I made "sarson ka saag" ( mustard and spinach) with ghee and it turned out to be finger lickin good. And healthy.

Rick said...

This isn't a central point in the post, but I'm curious about the reference to "pastured" butter. I've also seen "fermented" butter, which seems to be way more expensive than simple "butter". If you know anything about butter, could you perhaps post sometime about the various kinds and what they mean?

Ed said...

Stephan,

Between these posts and Peter's about liver dysfunction being a key component of a number of problems, I am very curious to hear your thoughts about using the liver ALT/AST lab values as useful markers for health. Perhaps these are more predictive than other markers, eg cholesterol.

Michael said...

Hi Stephan,
I am just finding your site and reading the wealth of information on it. I also was told I have a fatty liver. I have lots of other bad stuff too, but the liver articles are my biggest concern these days. I lost over 50 pounds and have my diabetes under control. Just curious if you have any plans to do a liver cirrohosis article? I have been recently told by my doctor (in the last 3 years now) that I have hepatitus C, and probably had it over 30 years unknowingly. I now am trying to learn all I can and your site is very helpful. Thank you.

Steve Bergman said...

Stephan Guyenet said...

"""
Regular off-the-shelf refined canola oil is several percent trans fat...
"""

This is quite false. Check the USDA Nutrient Database. Canola oil has < 0.4% naturally occurring trans fats. A tablespoon contains ~0.055 gm trans.

The AHA guideline for trans is very restrictive at, IIRC, 1%. Or 2.2g for a 2000 calorie diet.

If you were to eat a diet of 2000 calories of canola oil and nothing else, you would get < 0.9g of trans, or well under half the guideline. (40%)

If you get 30% of your calories from canola oil, it works out to just 12% of the guideline.

In addition, I've know I've seen, from credible sources, statements to the effect that naturally occurring trans-fats are not bad like those which are created during partial hydrogenation. I'm not sure if they were talking about a difference between trans-monoenoic and trans-polyenoic fats or what. But I won't pursue that since I don't have a reference.

But considering the tiny amounts of trans we're talking about, it's a moot point.

-Steve Bergman