Does LCHF 'clear out' pancreatic fat ?

Brunneria said:

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).

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