Dr. Stephen Phinney: Does a ketogenic diet improve fatty liver disease?

This is really exciting There's a really cool paper the other day – maybe it was a few weeks ago – that came out in Cell Metabolism

And the thing that I really like about Cell Metabolism is that they they try to do the translational research between looking at mechanisms and also doing something very practical in humans So they took a group of people with fatty liver and they put them on a ketogenic diet And they found some really interesting things over time So they only did this for two weeks so very different in scale in terms of what we are doing with our trial But they brought the people and they did all of their baseline measurements on them and in just one day they saw significant reduction in fat content in the liver

And I think it was reduced by almost half after fourteen days at the end And then just to make sure that the ketogenic diet was the driver behind that change in their liver fat content After the people ended the study and they went back to consuming their typical diet they brought ten of their subjects back in one to three months later and measure their liver fat content again, and saw it returned almost back up to baseline In just that one to three months after they had completed the intervention So I think this is really interesting and it's showing a lot of promise in terms of different ways that we can use nutrition to treat fatty liver

And you know if we're not if we can cut down some of the fat content and explore some of these mechanisms I think it's going to be a really interesting research area This is a real paradox because again as I said before there is this common myth that you are what you eat And people assume well if you eat a high fat diet then all that fats going to go through your digestive system, and end up in your liver, but that's not what happens Sure The liver becomes very efficient at clearing the fat

Some of it is made into ketones maybe as much as 100g of fat is made in the ketones by the liver each day, when someone is on the well-formulated ketogenic diet So the liver is not the place where the fat goes to hide or reside, when you are keto-adapted And there's more research being done on that My co-author and scientific collaborator and very good friend Dr Jeff Volek at Ohio State University is doing some very precise imaging studies on people on the ketogenic died over a three month period of time, and that research would hopefully be published later this year

And we're looking at that more sophisticated biomarkers in our Lafayette research study and hopefully well we'll be publishing that data shortly as well Yeah this study did a really nice look at some of the underlying mechanisms to show that De Novo lipogensis was actually slowed, they showed the increased rate of ketone protection So they are showing that beta oxidation rates were going up So they did a really nice, I think elegant, job of showing some of those very early changes even before adaptation occurred potentially because they were seeing those changes and 3, 5, 7 days And stepping back a bit just up until four or five years ago there were very few people doing research

Well done research on ketogenic diets In fact, life was kind of lonely back then and we're seeing more and more really top notch research groups getting engaged in this area And I think (A) it's it's good to have more good minds looking at this and you know and again our job is not to prove we're right but you know find out where we're wrong and correct those things And it's really great to see other people coming in who, you know, aren't considered advocates in this area doing high quality research, such as this recent paper in Cell Metabolism