Fatty liver despite decent diet and healthy bmi

[INeedNewShoes]

I'm just wondering if anyone else is in the same boat.

Ultrasound scan showed fatty liver. I've read the NHS advice and I already naturally follow most of it re fruit and veg, wholegrains, lean meat and fish. All meals I eat are cooked from scratch. I eat no UPFs. I drink very little alcohol. Daily drinks are coffee and water.

Where I could be going wrong is that I eat full fat dairy and I probably roast/fry foods more than is ideal. I also enjoy eating cake and biscuits. Having said that, my BMI is 23 and I've actually been concerned that I've been losing weight for no apparent reason lately.

I generally walk 3 miles a day, spend very little time sitting and also go on bike rides and do Pilates. When I read the info on fatty liver I feel like I don't fit, yet here I am.

I'm not sure how concerned to be and I'm most definitely feeling a bit indignant about it 😅

I think it’s it’s fairly well established that the “saturated fat is bad for you” vibe is unfounded and unsupported by evidence. Saturated fats are stable - they can be heated to high temperatures without oxidising. Cooking with saturated fat dies not cause heart disease.

Oxidised PUFA ( the ones in so-called heart healthy oils like sunflower) are hugely damaging, causing inflammation and insulin resistance. PUFA’s oxidise readily, both during storage and when heated.

The healthiest fats for cooking are natural ones such as lard, butter, ghee, coconut oil, avocado. Avocado and extra virgin olive oil are great for drizzling.

Where is this information from?

Did you have a blood test to see what your liver levels were on? Mine has came back slightly realised I am worried I have fatty liver now too and curious what your levels were on.

@PuzzledObserveri didnt talk about saturated fat. That said, I take your point but I still think that more many people , if they’re eating butter by they probably have a reasonable amount. See this discussion

This worries me a bit as I'm on sirolimus. I've had some recent upper abdominal discomfort. I know about 10 years ago I had a couple of liver spots.

Overall had a moderate diet, I did some keto a while back and my visceral fat was low, no concerns on bloods.

But, my diet has been really bad this last year. Gained about 3 stone (through overeating). Struggling to switch it up.

When I did the keto, I gave up butter and full fat yoghurt. Instead use avocado as 'butter' or a dash of extr virgin olive oil. I have zero fat yoghurt but add nuts for healthy fat. It's quite an easy switch to make.

Anyway this year I'm going to have to sort it out.

The thing with butter and other full fat dairy products is that they are good sources of Vitamin K and calcium, both of which I need in my diet. I can't take Vit K as a supplement as it's derived from foods I'm allergic to. I also need to do my best for my bone density so I am reluctant to reduce dairy much.

I’ve seen it in multiple places, e.g.

Books: The Big Fat Surprise (Nina Teicholz), The Great Cholesterol Myth (Jonny Bowden and Stephen Sinatra) and many more.

YouTube:

Plenty of people sharing this information. Ben Bikman, Robert Lustig, Zoe Harcombe… I could go on.

And behind these public-facing offerings, studies by scientists and doctors, and review articles demonstrating that the lipid-heart hypothesis is not supported by evidence and never was. You can look up the references if you are so inclined.

Back in the 1950’s, Ancel Keys cherry-picked the data of his 7 Countries Study to “prove” his hypothesis that saturated fat in the diet caused heart disease. He actually collected data from 22 countries - and when you look at all of it, his hypothesis falls apart. But he shouted loud and long, and managed to influence the dietary guidelines, launching the low fat diet craze. And the modern obesity epidemic started right about then, with the type 2 diabetes numbers following about 10 years behind.

Yeah populist books… and people selling you things. Ok.

Here’s the relevant section from my post:

“And behind these public-facing offerings, studies by scientists and doctors, and review articles demonstrating that the lipid-heart hypothesis is not supported by evidence and never was. You can look up the references if you are so inclined.”

There ARE peer reviewed scientific studies, journal articles, reviews and so forth. In reputable scientific journals. The references are in the back of the books. You can look them up if you’re so inclined.

But the mills of public health messaging and NICE guidelines grind exceeding slow. Especially when there are multi billion pound industries whose future depends on us continuing to buy their products.

Now, to be fair, if the advice were to change from reduce fat to reduce sugar to extremely low levels, they would probably reformulate their products to meet the new demand. However, the simplest and most effective message would be this: eat food as close to its natural state as possible.To put it another way - if it couldn’t be made before the Industrial Revolution, don’t eat it.

But there’s no profit in that, so the companies would fight it tooth and nail.

I think there is a connection between fatty liver and thyroid so if that hasn't been checked recently it might be worth testing

I have MASLD (non-alcoholic fatty liver disease) and have been told I have early stage cirrhosis. I think mine is because I gained a lot of weight. My hepatologist just says to avoid UPFs and obviously alcohol. I have lost 2.5 stone, but still need to lose another 2.5. There are some good FB groups you might want to join.

I have nafld. My alt is usually around 90. Mine is not from diet but from Conns disease. Maybe worth asking for some blood tests to look at other levels seem as you seem to have a healthy diet and exercise , it’s not always our fault x

@INeedNewShoes have you had bloods done for a liver profile ?

Is that LFT?

A month ago everything was in normal range apart from alkaline phosphatase was 26 which is below normal range. ALT was 12 which is the very lowest end of normal range and doesn't really seem to tally with the fatty liver.

Thanks. Well done on the weight loss.

My diet already has no UPFs due to allergies and I drink very little so it's hard for me to find things to change. I'm going to try upping exercise though.

Do you eat loads of cakes and biscuits with high fructose corn syrup?

Then why didn’t you share those peer reviewed journal sources instead of books and YouTube videos? Or are you just believing them when they say there are journal sources? Have you checked who funded any studies or whether they are meta sources or have drawbacks?

And PHE/NHS advice IS to eat whole foods, reduce free sugars as much as possible, reduce fats and eat less than 30g saturated fat a day, eat whole foods, whole grains and little to no UPF and processed meats. Under 70g red meat a day.

No. The only sweet things I eat are cakes and puddings I've baked myself which do contain butter and sugar. I can't even buy a chocolate bar in a supermarket as they all contain things I'm allergic to so everything sweet I eat has been made by me. I don't eat any weird ingredients.

@HarvestMouseandGoldenCups

I have glanced over some of the journal sources - enough to convince me that the interpretation being presented by the books and YouTubers is correct. Especially since one of the things several of them point out is that the source of funding of a study is correlated with the outcome of the study. Not so much the results, but the way they are interpreted. The reason I didn’t link to the studies directly is because I don’t have a ready-made list of them to copy and paste.

And yes, the NHS advice includes limiting sugar and UPF’s, eating whole foods. But it also suggests reducing fat and places a limit on saturated fat - and that has no relevance to the development of fatty liver. It says to eat whole grains - and while whole grains are better than processed grains, they are still providing a lot of carbs, which depending on the individual’s metabolism could be problematic.

For sure, someone who changes from a diet which involves a lot of processed food to those recommendation, will improve fatty liver, and lots of other things besides. But the reduce fat, limit saturated fat part of the advice would not be why. It’s a hangover from Ancel Keys and the intuitive but wrong diet-heart hypothesis. The flavour, and satiety, are carried in the fat. When you limit fat, food becomes much less luscious.

My first contribution to this thread came because the OP said she would use less oil in cooking, and less butter as well. I came on to point out that fatty liver is caused by excess carbohydrate, not excess fat. And I stand by that, 100%.

@PuzzledObserversaturated fats are said to affect the heart because they are straight in structure with no kinks which provide fluidity like PUFAs and MUFAs (which kink at the site of the carbon dehydration reaction) This causes them to build up in the arteries (atherosclerosis) as they form plaque with other cellular waste and don’t move through vessels as fluidly.

How is that ‘intuitive but wrong’? I wouldn’t say it’s intuitive at all…

@HarvestMouseandGoldenCups the "intuitive" bit refers to Ancel Keys' original hypothesis: heart attacks are caused by plaques in the arteries, especially little bits breaking off and causing blockages. The plaques are made up largely of cholesterol.

His hypothesis was a) the plaque are there because cholesterol levels in the blood are too high. Whereas, once the actual mechanism of plaque formation is investigated, it has been found that the plaques are formed as part of the body's attempts to heal damage caused to the linings of the blood vessels by substances such as glycated haemoglobin, small dense LDL particles and other things which are associated with metabolic syndrome.

b) That fat in the diet increases the level of cholesterol. This is not necessarily true, but even in those people for whom it IS true, the fractions which increase are large, fluffy LDL particles (neutral for cardiac health) and HDL (protective).

The small, dense LDL particles which cause the damage are a result of excess carbohydrate in the diet.

Most weight loss comes from diet, so I use the WeightWatchers app which works really well for me. Exercise is definitely good for overall health. I am physically disabled (mobility issues), so increasing my exercise isn't as easy as it would be for an able-bodied person. A couple of days ago I tried doing a bit more walking and completely wiped myself out!

Sorry, I've only just seen this. It all settled down and he hasn't had any issues for years.

Back in the 1950’s, Ancel Keys cherry-picked the data of his 7 Countries Study to “prove” his hypothesis that saturated fat in the diet caused heart disease. He actually collected data from 22 countries - and when you look at all of it, his hypothesis falls apart. But he shouted loud and long, and managed to influence the dietary guidelines, launching the low fat diet craze.

That really is outrageous bollocks. Ancel Keys was a proponent of the Mediterranean-style diet - high in olive oil. He did not launch or suggest "the low-fact diet craze".