Our society is in a sad state that results in too many over-processed livers. When we overeat or consume processed foods, or when we get exposed to environmental pollution or stress, the liver can become overloaded. When that happens, a liver can't efficiently handle fat and toxins. Luckily there are ways to treat fatty liver disease, such as going on the keto diet. There's more on the keto diet in the Body Reboot book and how getting and staying in ketosis has positive results on the mind and body. One positive effect this low carb diet has the body is that it may treat fatty liver disease.

Since liver disease is highly prevalent in our society, how do we stop it? The best way to reverse and prevent fatty liver disease is by incorporating a diet that can control obesity, hyperlipidemia, insulin resistance, and diabetes. Ruled.me mentions that because the keto diet focuses on removing carbs, which is one of the leading causes of liver disease, it may be an excellent way to combat it:

Luckily, this diet already exists and has been found to more effective than caloric restriction and low-fat diets. This diet is called the ketogenic diet. A diet that focuses on restricting carbohydrates, removing one of the main drivers of fatty liver disease from the diet.

However, we cannot call the ketogenic diet the ideal diet for fatty liver disease yet. This is only a theory that is based on evidence for how the ketogenic diet helps people with issues related to nonalcoholic fatty liver disease. To see what works best for the disease itself, we must dig through the research.

Digging through research as Ruled.me suggested is a good idea. In fact, a manuscript study from Curr Opin Clin Nutr Metab Care discusses how the keto diet may combat nonalcoholic fatty liver disease since it can help with weight loss. Here's what they reviewed and discovered:

Purpose of review
Obesity-associated nonalcoholic fatty liver disease (NAFLD) is highly prevalent, for which weight loss is the generally recommended clinical management. Low-carbohydrate ketogenic diets have been successful in promoting weight loss, but variations in the range of metabolic responses to these diets indicate that the effects of altering macronutrient content are not completely understood. This review focuses on the most recent findings that reveal the relationship between low-carbohydrate diets and NAFLD in rodent models and humans.

Recent findings
Low-carbohydrate diets have been shown to promote weight loss, decrease intrahepatic triglyceride content, and improve metabolic parameters of patients with obesity. These ketogenic diets also provoke weight loss in rodents. However, long-term maintenance on a ketogenic diet stimulates the development of NAFLD and systemic glucose intolerance in mice. The relationship between ketogenic diets and systemic insulin resistance in both humans and rodents remains to be elucidated.

Summary
Because low-carbohydrate ketogenic diets are increasingly employed for treatment of obesity, NAFLD, and neurological diseases such as epilepsy, understanding the long-term systemic effects of low-carbohydrate diets is crucial to the development of efficacious and safe dietary interventions.

The study determined there is still much to learn about the positive effects the keto diet has on controlling liver disease, but achieving macro and micronutrient balance is vital when trying to improve one's health:

KDs are prescribed with increasing frequency for NAFLD, obesity, and neurological disease, and while they have beneficial attributes, their metabolic effects are not yet completely understood, and patient responses to these diets can be variable. Recent studies have provided insight into the contribution of macronutrient content on liver health and demonstrate the influences of shifting macronutrient class distributions. Therefore, future studies of low-carbohydrate diets in rodents and humans must take into consideration additional factors including the effects of low overall protein, choline and methionine content, plus the saturation and length of dietary fatty acids. Achieving macro- and micronutrient balance will be essential to developing efficacious diets that promote weight loss while maintaining systemic health.

The study above as well as additional studies on diabetes, obesity, cholesterol, and weight loss have shown that the ketogenic diet may have a positive impact on fighting severe health conditions. Also, Reader's Digest argues that because the keto diet may help with diabetes 2 and prediabetes that it can also improve or prevent fatty liver disease:

Fat accumulation in the liver is commonly associated with prediabetes and type 2 diabetes. In serious cases, fatty liver disease can damage the liver. Doctors test for the condition by measuring levels of liver enzymes using blood tests. “These enzymes were significantly reduced after one year in the clinical patients, indicating less risk of developing fatty liver disease,” Dr. Phinney says of the diabetes study. If you’ve been told you’re at risk for fatty liver, you may want to give this diet plan a try. Before you embark on any new eating plan, arm yourself with knowledge.

Livestrong says that ketosis does not reverse NAFLD (fatty liver disease), but that doesn't mean it won't improve it. Keto dieters tend to eat a lot of red meat, which contains choline. Choline is to have said to prevent fatty liver.

Ketosis by itself does not reverse NAFLD. It is most likely the dietary carbohydrate restriction that has the potential to reduce the synthesis of fat by the liver. One of the first studies of the ketogenic diet’s effect on NAFLD, conducted at Duke University in 2007, reported that the carbohydrate depletion seems to reverse or slow the progression of NAFLD. There might be other mechanisms at work as well. For example, some research has looked at the vitaminlike nutrient choline for its role in preventing fatty liver. Choline is abundant in meat and other animal proteins, which is the mainstay of the ketogenic diet.

Dr. Eric Westman, director of the Lifestyle Medicine Clinic at Duke University has also done countless studies on the keto diet and claims that it can help treat a variety of health conditions including fatty liver disease. According to Time, here is what Westman's research reveals:

Westman’s research suggests a ketogenic diet can help treat obesity, type-2 diabetes and fatty liver disease. But for people suffering from those conditions—as well as older adults and kids—Westman says a keto plan can have “huge impacts” on nutrient intakes and health. You’d want to try it only with a doctor or dietitian’s supervision, he says.

“But if you’re a young and healthy adult, I have no safety concerns about removing carbs,” he adds. “It’s really not a radical concept.” You may experience some short-term issues like bad breath, constipation and flu-like symptoms. (Drinking lots of water can help.) But the lasting benefits could range from reduced hunger and increased energy to weight loss.

Here's yet another study that suggests a ketogenic diet may reduce the levels of liver fat:

Researchers found that just 2 weeks of a carb-restricted diet reduced levels of liver fat and improved other markers of cardiometabolic health in a small number of individuals living with non-alcoholic fatty liver disease (NAFLD)

Study co-author Adil Mardinoglu, from the KTH Royal Institute of Technology in Sweden, and team recently published their results in the journal Cell Metabolism.

The Cell Metabolism study had positive results, and Medical News Today also discuss how increased levels of folate can improve fatty liver disease:

What is more, they found that the carb-restricted diet induced changes in gut microbiota that were associated with an increase in circulating levels of folate, which has been tied to improvements in liver fat metabolism.

Now that we know from various studies that the keto diet may improve fatty liver disease, let's learn a little bit more from ruled.me about what other conditions can cause it:

Nonalcoholic fatty liver disease affects 20-30% of adult populations in developed countries, but the mechanisms underlying its cause are incompletely understood. We can, however, take some clues from other common diseases to figure out why this happens.

In epidemiological studies including people with type 2 diabetes, 62 to 69% of them also had nonalcoholic fatty liver disease. Another study found that 50% of patients with dyslipidemia (abnormally elevated cholesterol levels) had nonalcoholic fatty liver disease.

Obesity, metabolic syndrome, and heart disease are also closely linked with nonalcoholic fatty liver disease. In fact, the most common cause of death for nonalcoholic fatty liver disease patients is heart disease.

Based on studies, to disrupt fatty liver disease, we must focus our attention on a healthy diet and exercise program. Treating the liver is similar to treating obesity which is why it's important to focus on controlling diabetes, insulin resistance, and other diseases. The keto diet can help you get and stay healthy, and along the way, it may also control harmful diseases such as fatty liver disease.

At the time of writing this post, we're currently giving away free copies of the Body Reboot book because it's our mission to increase awareness and to help people lose weight and get healthy! If you help us cover the cost of shipping, we’ll send a copy to your door FREE. Go over to this page to see if there are any copies left.

Sources: Cell Metabolism, Medical News Today, ruled.me, NCBI: Curr Opin Clin Nutr Metab Care, Livestrong, Time, Reader's Digest