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Low-Fat High-Carb Diet for Obese Patients Linked to Liver Problems
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Low-Fat High-Carb Diet Linked to Liver Problems

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Low-Fat, High-Carb Diet Linked to Liver Inflammation

The high-carbohydrate, low-fat diet often recommended for morbidly obese patients with fatty liver disease 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 Diseases (2003).

It appears that recommending low-fat diet in morbidly obese patients could worsen non-alcoholic fatty liver disease.

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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