Low-Carb Diet and Non-Alcoholic Fatty Liver Disease (NAFLD)

Fatty liver disease is a growing health crisis affecting over 4 billion people worldwide. Also known as non-alcoholic fatty liver disease (NAFLD), it is characterized by an accumulation of fat in the liver that is not caused by alcohol. NAFLD can lead to inflammation and liver damage, and is a major risk factor for other serious conditions like heart disease and diabetes.

While fatty liver disease was previously thought to only affect adults, rates in children have skyrocketed in recent years. Today, 40% of obese children have NAFLD, making it the most common chronic liver disease in this age group. However, the standard advice of “eat less, exercise more” rarely works to reverse fatty liver disease long-term.

Fortunately, a groundbreaking new study from the University of Alabama provides clear evidence that a low-carb diet is highly effective at reversing fatty liver in children. This article will summarize the methods and key findings of this research, and explain how the results can help adults reverse NAFLD as well.

Study Design and Methods

The University of Alabama study aimed to compare the effects of a low-carb diet versus a low-fat diet on fatty liver disease in children. The study included 32 overweight or obese children between the ages of 9 and 17 who had been diagnosed with NAFLD.

The children were randomly split into two groups:

• Low-carb group: This group was instructed to eat a diet composed of 25% carbs, 25% protein, and 50% fat.
• Low-fat group: This group was instructed to eat a diet of 55% carbs, 25% protein, and 20% fat.

Importantly, both groups were told to avoid junk food and eat whole, unprocessed foods. This removed the variable of food quality and isolated the effect of carbohydrate restriction.

The study duration was 8 weeks total. For the first 2 weeks, the researchers provided all the groceries to the participants. For the remaining 6 weeks, the children and their families purchased their own groceries, but still received guidance from dieticians on sticking to their assigned diets.

At the beginning and end of the study, the researchers assessed the following measures in both diet groups:

• MRI of liver fat
• Body composition (DEXA scan)
• Fasting glucose and insulin
• Lipid panel
• Inflammation (CRP)
• Insulin resistance (HOMA-IR)
• Resting energy expenditure

Importantly, calories were not restricted in either group. Participants were given enough calories to maintain their weight throughout the study.

Results: Low-Carb Diet Superior for Reversing Fatty Liver

The results of the study clearly demonstrate the superiority of low-carb diets for treating fatty liver in children:

• The low-carb group lost 32% of liver fat. The low-fat group lost only 1%.
• The low-carb group lost 2.4% total body fat. The low-fat group lost only 0.4%.
• Lean muscle mass was unchanged in both groups.
• Liver enzymes (ALT/AST) improved more in the low-carb group.
• Insulin resistance improved more in the low-carb group.
• Inflammation (CRP) was unchanged in both groups.
• Lipids were unchanged in both groups.

This proves that a low-carb approach can rapidly reverse fatty liver, even without calorie restriction. Fatty liver reversal was far greater in the low-carb group, despite an equal calorie intake.

Additional Benefits of Low-Carb Diets

Beyond the direct effects on liver fat, low-carb diets provide numerous other benefits:

1. Appetite control. Low-carb diets are known to have a regulating effect on appetite hormones like leptin and ghrelin. This leads to less hunger and better long-term compliance.

2. Insulin control. Carb restriction lowers insulin levels and reduces insulin resistance. This has benefits for PCOS, metabolic syndrome, and diabetes risk.

3. Inflammation. High insulin levels directly contribute to systemic inflammation. Lowering carbs reduces inflammation linked to fatty liver disease.

4. Blood sugar stability. The fewer carbs you eat, the more stable your blood sugar levels will be throughout the day. This provides better energy and protects against fatigue.

5. Mental clarity. Low-carb diets have been shown to improve various markers of cognitive function like memory and concentration.

Implementing A Low-Carb Diet

Based on the impressive results of this study, adopting a low-carb diet appears to be the most effective nutritional approach for reversing fatty liver in both children and adults. Here are some tips for getting started:

• Gradually reduce overall carb intake, aiming for less than 50 grams of net carbs per day. Focus on nutrient-dense sources of protein, fat, and low-carb vegetables.
• Remove all sugary drinks, desserts, and processed snack foods from your diet. Read ingredient labels carefully.
• Increase healthy fats from sources like olive oil, avocados, nuts, seeds, and fatty fish. Do not fear fat – it is essential on a low-carb diet.
• Stay well hydrated with water and herbal teas. Avoid sweetened beverages.
• Plan out weekly menus and grocery lists. Having low-carb foods on hand helps avoid temptation.
• Consider supplements like fish oil, vitamin D, magnesium, and probiotics which may provide additional benefits.
• Get support. Consult a healthcare practitioner familiar with low-carb/ketogenic diets. Join online groups to connect with others following this way of eating.

Conclusion: Low-Carb Diets Are Highly Effective at Reversing Fatty Liver

In summary, this groundbreaking study from the University of Alabama provides the first concrete evidence that low-carb diets are highly effective at reversing fatty liver disease in children, without requiring calorie restriction.

Participants following a low-carb diet lost dramatically more liver fat compared to the low-fat diet group, despite eating an equal number of calories. Low-carb diets also appear to confer additional benefits related to appetite control, hormones, inflammation, and mental clarity.

Adopting a low-carb diet presents a proven, effective approach for both children and adults seeking to reverse their fatty liver disease and improve their metabolic health. This should be considered the first-line nutritional recommendation rather than ineffective advice to simply “eat less and exercise more.”