LIVER HEALTH
LOW-FAT HIGH-CARBOHYDRATE DIET & YOUR LIVER HEALTH
The high-carbohydrate, low-fat diet often recommended for morbidly obese
patients with fatty liver 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 Problems
(2003).
It appears that recommending low-fat diet in morbidly obese patients could
worsen non-alcoholic fatty liver.
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).
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