Does LCHF 'clear out' pancreatic fat ?

[Begonia]

I have seen people take various views on this, but then people always seem to want to promote their chosen way of eating over others.

Having just has a bit of a rummage, I found this article, which I thought was interesting
https://www.docsopinion.com/2015/12/08/low-carb-diet-to-treat-non-alcoholic-fatty-liver-disease/

This is the section that deals with NAFLD. I hope the reference links work. If not, just use the link above to go to the article where the links are live.

Low-Carb Diet to Treat Non-Alcoholic Fatty Liver Disease – Does It Make Sense?

Low-carb diets have been in and out of fashion for more than a century. The basis of such a diet is that sugar and carbohydrates should be restricted. The approach usually involves more consumption of fats than is usually recommended.

Most patients with NAFLD are already insulin resistant. This implies that carbohydrate metabolism is already abnormal, a situation that has been described as carbohydrate intolerance.

The insulin released after a high carbohydrate meal is necessary to both inhibit glucose output from the liver and to promote glucose uptake by skeletal muscle. The failure of insulin to perform these tasks, as occurs in patients with insulin resistance, will lead to elevated blood sugar.

If the liver glycogen stores are full, further excess dietary glucose is likely to increase triglyceride accumulation in the liver as liver cells will convert glucose to free fatty acids. Conversely, restricting carbohydrate intake may offload an already broken system, reduce blood sugar spikes and triglyceride accumulation in the liver.

The Scientific Data

Most studies addressing the role of dietary intervention for NAFLD have studied the effects of different diets on weight loss, liver biochemistry (transaminases), liver fat content, and insulin resistance.

Few studies have directly compared different diets for the treatment of NAFLD. Some of them show similar results with calorie restricted low-carb and low-fat diets while other suggest that low-carb diets are more effective.

One randomized trial, with 170 overweight adults showed equal reductions in liver fat, liver transaminases, visceral fat, body weight and insulin resistance after 6 months of calorie restricted, low-fat or low-carbohydrate diets respectively (20). Another 3-month study found that low-carbohydrate and low-fat diets reduced liver transaminases and insulin resistance to a similar degree (21).

A small study showed that calorie restricted low-carb and low-fat diets both decreased body weight by approximately 7%. The low-carb diet decreased liver fat significantly more after 48 hours, but the diets led to equal decreases in liver fat after 11 weeks and both diets similarly reduced insulin resistance following weight loss (22).

A prospective study of patients with insulin resistance showed that a hypocaloric low-carb diet improved liver biochemistry more than a hypocaloric low-fat diet (23).

Another prospective study followed three groups of patients with type 2 diabetes over 12 months, on one of three diets: American Diabetes Association (60% carbohydrate, 20% fat); low glycemic index (50–55% carbohydrates, 30% fat); or modified Mediterranean diet (35% carbohydrates, 45% high monounsaturated fat). Liver transaminases decreased in all three groups, with the greatest decrease in those on the low-carbohydrate modified Mediterranean diet (24).

A recently published study showed that implementing a low-carb diet in the primary health care setting led to significant weight loss and improved liver biochemistry and glucose metabolism in patients with metabolic syndrome and abnormal glucose metabolism or raised liver transaminases. Interestingly, improvements in liver biochemistry did not correlate with weight loss. The authors suggest that the improvement in liver biochemistry occurs parallel to weight loss and not necessarily because of it (25).

Thanks @Brunneria
I haven't read all the links yet but it looks like the scientific data is not conclusive.

 

[kokhongw]

Thanks for all your responses. Just to clarify further what I'm getting at. Suppose an experiment were done in which four cohorts of comparable subjects all lost 15kg of weight but by different diets:

1. Newcastle diet with shakes
2. Michael Mosley blood sugar diet (low calorie with real food)
3. Low Carb High Fat
4. Intermittent Fasting as well as LCHF

Would they all be likely to lose the same amount of fat from the pancreas ?

Just wonder whether there is any science that says one or other diet is more effective at clearing pancreatic fat or is it just a question of the weight loss ?

Currently only the Newcastle diet successfully restored the first phase insulin response. That means those who achieve remission on ND are able to resume and handle "normal" carbs load...until they accumulate sufficient pancreatic/liver fats again.

All the others are able to restore good glucose/insulin levels, not much data on restoring the first phase insulin response.

 

[bulkbiker]

That means those who achieve remission on ND are able to resume and handle "normal" carbs load...until they accumulate sufficient pancreatic/liver fats again.

Great point..

 

[AdamJames]

Having just has a bit of a rummage, I found this article, which I thought was interesting
https://www.docsopinion.com/2015/12/08/low-carb-diet-to-treat-non-alcoholic-fatty-liver-disease/

Thank you very much for that.

Thanks for all your responses. Just to clarify further what I'm getting at. Suppose an experiment were done in which four cohorts of comparable subjects all lost 15kg of weight but by different diets:

1. Newcastle diet with shakes
2. Michael Mosley blood sugar diet (low calorie with real food)
3. Low Carb High Fat
4. Intermittent Fasting as well as LCHF

Would they all be likely to lose the same amount of fat from the pancreas ?

Just wonder whether there is any science that says one or other diet is more effective at clearing pancreatic fat or is it just a question of the weight loss ?

This is the question that fascinates me most at the moment, as well.

Although the general scientific consensus seems to be that you can't target where your body chooses to use up fat, you just lose fat and hope for the best, I find it impossible to believe that all diets are the same even if the calories are the same.

An obvious example is that we know that some types of sugar will very specifically result in liver fat increasing.

So imagine if, in the first Newcastle experiment, the main source of carbs in Optifast had been fructose. Could we expect the same results?

Also re the Michael Mosley blood sugar diet, one person doing it can be on a very different diet to another person doing it. I have the book, and the recipe book. For breakfast you can be eating 48 grams of carbs, or zero carbs, such is the difference between the recommended recipes! I found this frustrating as I wanted to know: How many people have tried it for 8 weeks, and for how many people did it "work"? But there is no definition of "it".

And interesting feature of the first "Newcastle Diet", I think, is that it's not "high" anything, but relative to itself, its an extremely high carb, extremely low fat diet. So 3 times a day, participants will have been making a significant demand of their pancreas, and that may be an important factor in its success. Conversely, the results may have been even better had it been low carb, given the pancreas a rest for 8 weeks, then afterwards the carbs were slowly re-introduced.

 

[ickihun]

Currently only the Newcastle diet successfully restored the first phase insulin response. That means those who achieve remission on ND are able to resume and handle "normal" carbs load...until they accumulate sufficient pancreatic/liver fats again.

All the others are able to restore good glucose/insulin levels, not much data on restoring the first phase insulin response.

I think that's not true of bariatric surgery thou. My consultant envisages me still needing basal and metformin. So I wouldn't need fast acting insulin and that is what I need currently due to no 1st phase.
Obviously I want to use less of that, no insulin would be my idea of a success, for me.
I was way-out of the criteria for the ND subjects.