Originally Posted by SabreCat50
I posted this originally in the "Cholesterol/Heart" forum:
My wife and I got the same diagnosis today from our doctor. We both have fatty livers and high (total & LDL) cholesterol.
We both had good total/HDL ratios so the doctor was willing to let that slide with regards to heart health. (Whew! I didn't have to argue with her on the issue of statins.)
But she said that high (total & LDL) cholesterol can increase the infiltration of fat into the liver. Since our liver enzymes were normal and we are otherwise healthy, she didn't have any specific recommendations except to eat fewer carbs .
But here's the thing -- we have been on low carb for almost six years!
Does anyone have any insight into this?
I was questioned - rightly so - if we are truly low carb. I would have to say yes. No sugar or grains. Yes on nut flours/sugar alcohols / dark chocolate, but no on high-carb veggies.
In any case, while I am heartened by the research mentioned by the OP, I am at a loss for why my wife and I both came down with fatty livers.
Personally, I believe dietary fat fixes fatty liver. In a mouse experiment, it was found that dietary fat activates the PPAR-alpha pathway, which in turn clears fat deposits from the liver: https://www.ncbi.nlm.nih.gov/pubmed/16054078
I can't say if it's also true in humans, but I choose to believe that anyway. As far as I'm aware, there's only two things that cause fatty liver - alcohol and fructose. I mean, maybe there's other things, but dietary fat ain't one of them.
The thing about "cholesterol increasing infiltration of fat into the liver", first time I hear something like that. Ima say it's total complete BS. A quick search reveals it's about NAFLD, which is caused by fructose, not dietary fat or cholesterol or anything else. The language used is "factors" and such, which means there's no experimental data. So, basically, somebody (some pharma rep most likely) told the doc something, the doc drew a conclusion in his mind, then he told you that conclusion but without a iota of evidence to support any of it, except of course his doctorate and status that comes with it. I love docs, they spew crap out their mouths and we take it seriously.
About the question whether you actually eat low-carb. It's quite simple. Either you follow as best you can some popular diet book like Atkins or Protein Power for example, or you follow your own plan which you devised from experience and/or from one of those low-carb diet books. For example, Atkins advises to eat less than 20g/day for induction, then go up the carb ladder to find out what your carb threshold is, get back down a bit to lose fat at a constant pace, then keep it there once you reach goal for on-going maintenance. I don't know what your carb threshold is, but you should know it if that's what you're doing. Anyways, if it's 50g/day for example, then the doc tells you to eat less than that (but he doesn't know how much carbs you eat in the first place), I'm pretty sure it's already low enough. Ima say ignore the doc on that one. After 6 years doing LC, you probably know a whole lot more than he does about diet and especially low-carb.
I'm wondering how the doc diagnosed fatty liver? If all is normal, how did he find that the liver was not normal? For high cholesterol, I would personally ignore that diagnosis, but if I'm not mistaken high cholesterol used to be a marker for low thyroid function so if you're worried about that it's a simple test and an equally simple fix - just eat more iodine. On the other hand low-carb will cause cholesterol to rise somewhat. It's important to keep in mind that when we talk about cholesterol, we don't talk about cholesterol, instead we talk about lipoproteins. It's also important to know which type of test the doc used to measure it. There's the actual, then there's the estimated/calculated. If it's the estimated/calculated, ignore it, low-carb makes that test lie. Finally, when it comes to lipoproteins, what matters most is particle size, not particle quantity. The bigger the lipoproteins, the better. Low-carb just happens to make these bigger, which is one reason it makes the estimated/calculated test lie. The thing about particle size is that smaller lipoproteins are more easily oxidized and that's a bad thing, or at least that's how I understand it.
Anyways, if the article is correct about low-carb, B vitamins and folic acid to fix fatty liver, I wouldn't worry about a thing if you're been doing LC for the past 6 years. Which means either the doc misdiagnosed fatty liver, or there's something else going on and you should figure out what it is and then fix that.