The combination of the ketogenic diet and exercise makes a great treatment for fatty liver disease, but they aren’t the only important things that can help reverse the disease. Physical activity alone improves insulin sensitivity and reduces fat in the liver. ... she became intrigued by the ketogenic diet—an extremely low-carb approach that forces the … These inflammatory cytokines increase inflammation levels and cause reactive oxygen species to accumulate (oxidative stress). It took years of work to damage it. It will also help us meet our omega-3 fatty acid needs for the day so that we can experience their benefits to the fullest. As a result of the low carbohydrate diet, these levels decreased, but not enough to be statistically significant. The key to disrupting the vicious cycle of fatty liver disease before it damages the liver is exercise and diet. Once glycogen reserves are full, sugar is not needed for energy, so it is stored inside the liver and results in fatty infiltration. (Keep this in mind for when we go over the ideal fatty liver diet later.). As poor lifestyle choices continue, so much fat builds up in the liver that it leads to lipotoxicity (accumulation of fat in non-fat cells). For example, the PNPLA3 I148M gene variant will only lead to disease progression in combination with alcohol abuse, unhealthy diet, high levels of fructose consumption, inactivity, or viral infection. The mild dietary ketosis, such as that which is experienced during the Weight Loss phase of the Lean for Life program, is not harmful to individuals with a normal, healthy, functioning liver. If allowed to progress from simple fatty liver, it can sometimes lead to more serious liver disease. You can also add these five scientifically-proven liver healing foods to your diet to help reverse fatty liver disease: Two or more servings of oily fish per week can have a beneficial effect on blood lipids and may reduce liver fat. These factors are an unhealthy lifestyle, genetics, and gut health issues (an obesity and inflammation causing microbiome). Higher protein intake has been found to reduce liver fat in people with NAFLD, as well as those with type 2 diabetes.28 Use our target protein ranges chart to figure out how much you need. The medication is called: a strict low carb or keto diet. In studies that combine caloric restriction with exercise, the results are even more promising. Although no alcohol consumption is best for reversing nonalcoholic fatty liver disease, some alcohol consumption may be beneficial as well. To see what works best for the disease itself, we must dig through the research. And to help optimize health, consider the following: Keto diets eliminate major sources of glyphosate and reverse fatty liver, says Dr. Berry. A diet that focuses on restricting carbohydrates, removing one of the main drivers of fatty liver disease from the diet. One genetic variant, in particular, that is called  PNPLA3 I148M is associated with the development of nonalcoholic fatty liver disease without the presence of obesity, diabetes, dyslipidemia, or insulin resistance. By interacting with this site, you agree to our disclaimer. Phytotherapy Research 2019: Does turmeric/curcumin supplementation improve serum alanine aminotransferase and aspartate aminotransferase levels in patients with nonalcoholic fatty liver disease? This increases the risk of many common diseases like heart disease, diabetes, and nonalcoholic fatty liver disease.Women, on the other hand, tend to accumulate fat in their hips and thighs, which is much less inflammatory. Walnuts, in particular, have been found to be one of the healthiest nuts for your liver. Eat less and move more, and you can reverse fatty liver disease. Fatty liver disease is so intimately associated with type 2 diabetes, obesity, hyperlipidemia, metabolic syndrome, and heart disease that it is believed to be caused by the same factors. Coffee is associated with reduced fibrosis severity in nonalcoholic fatty liver disease. Like many common diseases, nonalcoholic fatty liver disease is polygenic. It is probably best to go for brisk walks throughout the day and do resistance training at least 3 times a week. Journal of Investigative Medicine 2017: Influence of dietary macronutrients on liver fat accumulation and metabolism [overview article; ungraded] ↩ American Journal of Clinical Nutrition 2003: Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high-fat, low-carbohydrate and low-fat, high-carbohydrate isoenergetic diets [nonrandomized study, weak evidence] ↩ The American Journal of Clinical Nutrition 2012: Effect of short-term carbohydrate overfeeding and long-term weight loss on liver fat in overweight humans [non-controlled study; weak evidence] ↩ In one trial, overweight people were randomly assigned to consume 1 liter (about 32 ounces) of either sugar-sweetened beverages, milk, diet soda, or water every day for six months. The combination of vegetables and carbohydrate restriction is what makes an ideal fatty liver diet. Fatty liver is considered a chronic disease, but researchers at the University of Gothenburg have now proven that it is possible to get rid of the liver fat in just two weeks. Sugar seems to be one of the biggest drivers of NAFLD. In fact, many scientific papers agree that the treatment of nonalcoholic fatty liver disease should be focused on controlling diabetes, obesity, insulin resistance, and hyperlipidemia. Simply enter your info, goals, and preferences, and it will provide you with a personalized long-term meal plan. Any exercise is better than no exercise for all aspects of health. This can develop if you follow the diet for a long time. The measurements they looked at to determine liver function were the liver enzymes (AST, ALT, and GGT) that are usually elevated in patients with nonalcoholic fatty liver disease. The only problem with the drug is that patients relapse when they aren’t on it. In blood tests, in addition to high triglycerides and insulin levels, certain liver enzymes are elevated, especially GGT and ALT. Seafood is also a great source of protein for keto dieters. In a meta-analysis on the effects of probiotics on nonalcoholic fatty liver disease, researchers found that probiotic therapy can help improve liver function and reduce inflammation. Scientists postulate that this is due to the difference in hormones and fat distribution between men and women. The good news is the liver is the liver. By the end of the trial, liver fat had increased significantly more in the sugar-sweetened beverages group compared to the other groups: Some people were born with a set of genetic variants that make it harder for them to adapt to the low carbohydrate diet, which may lead to a minimal improvement of liver function. This is why many dieticians and doctors recommend eating two or more servings of fatty fish, like sardines and salmon, every week. GuideAre you ready to lose weight while eating delicious, nourishing food that keeps you satisfied for hours? Diet, a sedentary lifestyle and low levels of exercise are something that fatty liver patients have in common. Lifestyle and diet strategies to pr… The healthiest way to get more fiber is by consuming low-carbohydrate vegetables. I am not talking about your genes. Why the difference? Nonalcoholic fatty liver disease affects 20-30% of adult populations in developed countries, but the mechanisms underlying its cause are incompletely understood. Another study found that 50% of patients with dyslipidemia (abnormally elevated cholesterol levels) had nonalcoholic fatty liver disease. Diabetologia 2019: A carbohydrate-reduced high-protein diet improves HbA1c and liver fat content in weight stable participants with type 2 diabetes: a randomised controlled trial. A drug called thiazolidinedione, however, has been shown to be effective for improving diabetes, liver function, and fibrosis of the liver. There are rare instances of metabolic complications with weight loss, but it makes no difference if you do it with keto or through a normal diet. Meanwhile, in the gut, the fatty liver disease promoting lifestyle changes the microbiome. Although older studies found that women were at greater risk for fatty liver disease, current studies found that it is more prevalent in men. In a 2016 meta-analysis and systematic review on the effects of low carbohydrate diets on liver function tests in nonalcoholic fatty liver disease patients, the researchers’ conclusions were not as promising. It has all the tools, information, and recipes needed for you to succeed. This provides preliminary evidence that the ketogenic diet can reverse fatty liver disease and nonalcoholic steatohepatitis. Recently, keto eating has been shown to improve NAFLD in a number of ways. This is hands-down my favorite keto liver recipe. Updated Sep 30th, 2020 – Written by Craig Clarke, Medical review by Dr. Pamela Lyon, MD, FACEP. These include: Excess energy intake: Eating more calories than needed may lead to excess fat accumulation in the liver — and research... Too many refined carbs: Consuming more carbohydrates than your body is able to handle can drive liver fat storage via a... Too much sugar: When it … Imagine what happens to you when the majority of your time is spent sitting and the majority of your meals consist of an overwhelming amount of carbohydrates and fat. Anything more than may cause fat to build up in the liver. This diet maintains a healthy gut microbiome and limits fructose and carbohydrate (the two dietary components that cause fat to build up in the liver), which makes it the ideal fatty liver diet. Scientists believe that the same is true for nonalcoholic fatty liver disease as well. After six months of this dietary intervention, the researchers concluded that “severely obese subjects with a high prevalence of diabetes and the metabolic syndrome lost more weight in a six-month period on a carbohydrate-restricted diet than on a fat- and calorie-restricted diet.”. Each patient underwent a liver biopsy, and four of the five patients showed a reduction in liver fat, inflammation, and fibrosis. Once she found out about keto, however, everything changed. I got to give some props going back, Paul Jaminet made the case, gosh, ten years ago that the standard ketogenic diet recommendations are too low in protein, for the most part. By Dr. Eric Berg. You shouldn't drink at all if your fatty liver disease results from heavy drinking. Gastroenterology 2017: Isocaloric diets high in animal or plant protein reduce liver fat and inflammation in individuals with type 2 diabetes [randomized controlled trial; moderate evidence] ↩ Journal of Hepatology 2017: Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: A systematic review [systematic review of randomized trials; strong evidence] ↩ Gastroenterology Research and Practice 2016: Effects of omega-3 fatty acid in nonalcoholic fatty liver disease: A meta-analysis [systematic review of randomized trials; strong evidence] ↩ Integrative Medicine Research 2019: Efficacy of curcumin/turmeric on liver enzymes in patients with non-alcoholic fatty liver disease: A systematic review of randomized controlled trials [systematic review of randomized trials; strong evidence]. When you search the internet for liver supplements, you are inundated by supplements that seem promising, yet have no shred of evidence that backs of their claims. Unfortunately, many people aren’t aware they have NAFLD because symptoms like abdominal swelling, loss of appetite, and jaundice usually don’t develop until the disease is well advanced. The ketogenic diet has also been proven in multiple studies to be more effective than a calorie-restricted diet at reversing type 2 diabetes, obesity, heart disease, and hyperlipidemia. The full Diet Doctor experience also includes exclusive videos, support, programs and more. This ratio of Bacteroidetes to Firmicutes led to an increase in lipopolysaccharide absorption. A urine test can check glyphosate levels while an ultrasound can diagnose fatty liver. Lactobacillus GG, Lactobacillus bulgaricus, and Streptococcus thermophilus were helpful in reversing nonalcholic fatty liver disease as well. So I came here and began research on NASH/NAFLD. This increases inflammation, oxidative stress, and lipopolysaccharide absorption, which causes more liver damage. When it comes to exercise, many different forms of activity from walking to lifting weights can help reverse fatty liver disease. The best way to supplement with betaine is by eating raw beets (not keto-friendly) or taking a TMG supplement. Here are some examples of high-fiber ketogenic salads that you can try : Or you can pair your favorite meal with a low-carbohydrate vegetable side dish like one of these: For more on what vegetables to eat on the ketogenic diet, check out our vegetable guide for ketogenic dieters. It’s that simple. In fact, many studies conclude that caloric restriction is inferior to a low-carbohydrate, ketogenic diet when it comes to weight loss. Plus, keto will help reverse the buildup of fat in the liver caused by the herbicide glyphosate, the primary ingredient in Roundup, asserts Dr. Gundry. The calorie restricted diet was based on a daily calorie intake of the patient’s ideal weight in kilograms multiplied by 25 calories, and the exercise program is described as “walking or jogging”. Click for more info. This is because they can all be caused by a combination of lifestyle, genetics, and gut health issues. But don’t get caught up in finding the perfect workout plan. TMG stands for Trimethylglycine, and it is the form of betaine that is found in beets. The Journal of Clinical and Translational Hepatology 2020: American Journal of Clinical Nutrition 2003: The American Journal of Clinical Nutrition 2012: The Journal of Clinical Endocrinology & Metabolism 2015: Hepatobiliary Surgery and Nutrition 2015: Nature Reviews Gastroenterology & Hepatology 2019: The American Journal of Clinical Nutrition 2011: Proceedings of the National Academy of Sciences of the United States of America 2020: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2019: Gastroenterology Research and Practice 2016: Critical Reviews in Food Science & Nutrition 2018: Suppress appetite, promote weight loss, and improve heart health markers, Provide a healthy, satisfying way of eating that can be maintained long term. This is mainly because avocados have a substantial amount of monounsaturated fat, fiber, and antioxidants. Men tend to store more fat near their organs, which is a type of fat that is more inflammatory. The keto diet reduces sugar, insulin, and triglycerides and lowers fat stored inside the liver. Plus, there is even better news —   type 2 diabetes, obesity, heart disease, and fatty liver disease can all be reversed with the same lifestyle changes. April 21, 2015. So feeding even more fat – 3 times more than the regular person should – doesn’t sound like a good idea. Exercise (or lack of it) also plays a big role in NAFLD. For example, one study took twenty-five obese patients with fatty liver and put fifteen of them on a calorie restricted diet and exercise program for 3 months. The healthiest way to get more fiber is by consuming low-carbohydrate vegetables. This leaves us with five conditions that are commonly associated with nonalcoholic fatty liver disease: type 2 diabetes, obesity, heart disease, dyslipidemia, and metabolic syndrome. On the other hand, patients who made no lifestyle changes had gotten worse after discontinuing the drug. A handful of nuts per day improves liver function tests. Having a sedentary lifestyle will also make your cells less sensitive to insulin. This is why many researchers agree that improving insulin sensitivity is a key strategy in the treatment of nonalcoholic fatty liver disease. Our popular meal plans are customizable and include shopping lists and nutritional information. What are lipopolysaccharides? Throughout the body, insulin resistance causes fatty acids to be released from fat cells and sugar to build up in the blood. “The manufacturer of glyphosate has assured us that it’s safe for humans. However, we do know what is better — doing the exercise that you will actually do. However, just because you have the gene does not mean you will have the disease. Milk thistle contains a compound called silybin. The ketogenic diet is a good diet for reversing fatty liver disease, but you can make it the best fatty liver diet by following these guidelines: 1. Journal of Applied Physiology 2011: Does physical inactivity cause nonalcoholic fatty liver disease? Change your diet to invoke ketosis and possibly reverse fatty liver disease. ... A ketogenic diet may benefit some people, such as those with obesity or type 2 diabetes and children with epilepsy. If youre having concerns about the health of your liver, it might be time to kick your nasty sugar habit to the curb. When we look more closely at the studies in the meta-analysis, they either found no effect on liver enzyme levels or a significant effect. The Best Fatty Liver Diet. There are two main types of fatty liver disease: Both types of fatty liver disease are diagnosed when fat makes up at least 10% of the liver, but the cause of the fat build up is different for each type. Similar low-carb diets such as keto may similarly increase a person’s risk for heart disease. However, when the cause of that fat build up gets worse, it can lead to nonalcoholic steatohepatitis. It’s time to move on to the genes in your microbiome. The American Journal of Clinical Nutrition 2011: Short-term weight loss and hepatic triglyceride reduction: Evidence of a metabolic advantage with dietary carbohydrate restriction [non-controlled study; weak evidence] Instead, you eat whole foods including natural proteins, fats and vegetables. Can Keto Diet Cause Fatty Liver? The good news is that a low-carb or keto diet can lead to a dramatic loss of liver fat and may potentially reverse the disease. This is because, like type 2 diabetes, obesity, and heart disease, fatty liver disease is reversible. A dose of 4.5 grams (about a teaspoon) per day of spirulina has been shown to help reverse fatty liver disease. Keto Diet For Beginners Ketogenic Diet Plan Keto References Ketosis Approved Foods Ketogenic Recipes Ketogenic Before & After Successes Keto & IF Mini-Courses Keto Coach Certification Keto Health Summit 2018 ... How To Reverse A Fatty Liver. Start by doing what you enjoy doing. The kind of exercise that is best for reversing fatty liver disease is not yet known, but almost any type of exercise will help. Although genetics can’t be changed, almost everyone can prevent and reverse fatty liver disease with the right diet and exercise program. Cell Metabolism 2018: An integrated understanding of the rapid metabolic benefits of a carbohydrate-restricted diet on hepatic steatosis in humans [non-controlled study; weak evidence] ↩ PLoS One 2015: Dietary intervention for overweight and obese adults: Comparison of low-carbohydrate and low-fat diets. Sign up for Diet Doctor Plus today to make your low-carb journey even more simple, fun and delicious. Fixing a fatty liver really depends on 3 things: 1. Does The Keto Diet Get Rid Of Cellulite How Many Grams Of Sugar In A Keto Diet. The American Journal of Clinical Nutrition 2011: Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction [non-controlled study; weak evidence] However, there is a small subset of people who can get nonalcoholic fatty liver disease without showing any signs of insulin resistance. The American Journal of Clinical Nutrition 2012: Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: A 6-mo randomized intervention study [randomized trial; moderate evidence] In epidemiological studies including people with type 2 diabetes, 62 to 69% of them also had nonalcoholic fatty liver disease. Research suggests that the right diet is a low carbohydrate and high fiber diet. Talk to a Dr. Berg Keto Consultant today and get the help you need on your journey. Journal of Medicinal Food 2011: The effect of the Spanish Ketogenic Mediterranean diet on nonalcoholic fatty liver disease: A pilot study [non-controlled study; weak evidence] A meta-analysis [strong evidence] The build-up of fat in the liver is harmless at first, but it can lead to nonalcoholic steatohepatitis (inflammation and liver damage). But glyphosate paralyzes key liver enzymes and disrupts slimming.” … I know I should eat more liver, so over the years, I have experimented with numerous ways to prepare beef liver. For more on how to restrict your carbohydrates and follow the ketogenic diet properly, look through our comprehensive beginner’s guide to the ketogenic diet. Several things can contribute to the development of NAFLD. The best way to achieve this weight loss, however, is not with caloric restriction. It … As such, poor eating can aggravate the situation. Do some form of activity every day for best results. After just over a year of keto eating, her results are astonishing: Believe it or not, this is only a brief snippet of what she shared with us in her success story — and all she did was switch to the keto diet. However, this isn’t the worst of it. Here is some information about ketosis that may help you to understand its role in weight loss: That’s right — Treating obesity of the liver is similar to treating obesity of the body. Dr. Berg's Keto & IF Booklet: Dr. Berg's Webinar on Healthy Ketosis and Intermittent Fasting: Take Dr. Berg's Free Keto Mini-Course: or go here: In this video, Dr. Berg talks about how long will it take to fix a fatty liver. Silybin can reduce fat build up in the liver, and it may even reverse liver damage. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2019: Diet, diabetes status, and personal experiences of individuals with type 2 diabetes who self-selected and followed a low carbohydrate high fat diet [non-controlled study; weak evidence] ↩ Nutrición Hospitalaria 2014: Hypocaloric high-protein diet improves clinical and biochemical markers in patients with nonalcoholic fatty liver disease (NAFLD) [non-controlled study; weak evidence] Besides eating low carb, a few other changes might also be helpful: Note: If you take blood thinners, do not take curcumin or turmeric before speaking with your doctor or pharmacist. 4 Main Causes of Fatty Liver Disease #1: Diet and Fatty Liver Disease. After one-year Keto, the results were an “unremarkable” liver ultrasound compared to the previous one which indicated “fatty infiltration”! The result will be an obesity-causing microbiota profile that favors the development of obesity and fatty liver disease. Having some extra fat in the liver isn’t going to cause any problems for 70-80% of people with fatty liver disease. This causes the pancreas to secrete even more insulin to keep blood sugar stable. We can, however, take some clues from other common diseases to figure out why this happens. Dr. Mark Hyman explains the dangers of fatty liver, and how sugar, rather than fat, may indeed be the primary culprit. This leads to more lipopolysaccharides being absorbed and more inflammation in the body and the liver. Please note: This sample fatty liver diet plan is not one-size-fits-all. This is why it is of the utmost importance to develop healthy lifestyle habits if your parents and grandparents struggled with nonalcoholic fatty liver disease. What Type Of Bread Can You Eat On A Keto Diet Is Vitamins Good On A Keto Diet ★ Does Keto Diet Give You Fatty Liver. Diabetes Care 2018: Nonalcoholic fatty liver disease and risk of incident type 2 diabetes: A meta-analysis [systematic review of observational studies with HR >2; weak evidence] ↩ Medicine 2016: Nonalcoholic fatty liver disease is associated with excessive calorie intake rather than a distinctive dietary pattern [observational cohort very weak evidence]. Cell Metabolism 2018: An integrated understanding of the rapid metabolic benefits of a carbohydrate-restricted diet on hepatic steatosis in humans [non-controlled study; weak evidence] A systematic review and meta-analysis [strong evidence] ↩ Hepatology Research 2018: Comparison of efficacy of low-carbohydrate and low-fat diet education programs in non-alcoholic fatty liver disease: A randomized controlled study [randomized trial; moderate evidence] The perfect example of this is the ketogenic diet. This form of fatty liver disease affects 20-30% of patients with nonalcoholic fatty liver disease, and it occurs when the build up of fat in the liver leads to inflammation that can result in liver cell damage. More specifically, a high-sugar, high-fat diet. ↩ Frontiers in Pharmacology 2019: The effects of curcumin on weight loss among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials [strong evidence] Avocado consumption is associated with weight loss and improved liver tests. To give you a better idea of what this diet would look like, here is a menu of low carb recipes featuring liver-healthy foods: Here is a quick and simple example of what each meal would look like while implementing the information found throughout this article: Breakfast: 1-2 servings of Salmon Benny Breakfast Bombs, Lunch: 1-2 servings of  Keto Chicken, Bacon, and Avocado Salad, Dinner: 1 serving of Low Carb Walnut Crusted Salmon with a side of 1-2 servings of Lemon Roasted Spicy Broccoli, Dessert (optional): 1 Keto Avocado Brownie, Breakfast: 1 serving of the Keto Meal Replacement Shake, Dinner: 1-2  servings of Zucchini Ribbons & Avocado Walnut Pesto, Dessert (optional): 1 serving of Luscious Caramel Pecan Pie, Lunch: 1 serving of Grilled Tuna Salad with Garlic Dressing, Dinner: 1-2 servings of Nacho Steak Skillet, Dessert (optional): 1 serving of Chocolate Chunk Avocado Ice Cream. Keep in mind that this recipe is also great for Primal, Paleo, Whole 30, and any whole food nutrition dense diet. This response contributes directly to insulin resistance in the liver and obesity. The information we provide at DietDoctor.com is not intended to replace consultation with a qualified medical professional. Another important thing to mention is the effect that other genes have on the development of fatty liver disease. It will reduce the insulin resistance causing the fatty liver. JavaScript must be enabled in your browser to log in! To optimize your diet to reverse disease, especially fatty liver disease, it is imperative to have low-carbohydrate vegetables with every meal. Keto diet promotes weight-loss, but it is also fat-laden. The amount of alcohol it takes to cause fatty build up in the liver, however, is not so obvious. Fatty liver. Betaine is a compound that is naturally found in beets and spinach. Many factors determine whether fatty liver will lead to liver damage, including: To simplify these complex terms, fatty liver disease goes from bad to worse when the lifestyle and microbiome that caused the build up of fat in the liver continue. The answer is — an obesity producing diet. Other genetic factors like your gender and ethnicity impact your likelihood of developing fatty liver disease as well. Fat oxidation is a process in which the body breaks down fatty acids. It can … In a review of studies on nonalcoholic fatty liver disease treatments, the researchers found that weight loss leads to a substantial improvement in the disease. I heard lose weight or things like that from Dr's over the years but never so blunt. Insulin resistance is a common side effect of eating too much and exercising too little, and it is one of the main reasons why fat builds up in the liver. [overview article; ungraded] ↩ Nutrients 2017: Nonalcoholic fatty liver disease and insulin resistance: New insights and potential new treatments [overview article; ungraded] ↩ World Journal of Gastroenterology 2015: Central obesity and nonalcoholic fatty liver disease risk after adjusting for body mass index[pooled obervational studies with OR >2; weak evidence] ↩ Nature Reviews Gastroenterology & Hepatology 2019: Genetic contributions to NAFLD: Leveraging shared genetics to uncover systems biology [overview article; ungraded] ↩ World Journal of Gastroenterology 2016: Fatty liver index vs waist circumference for predicting non-alcoholic fatty liver disease [observational study; very weak evidence] ↩ In fact, in one intervention trial, a low-fat diet performed worse than a low-carb or Mediterranean diet for treating NAFLD: Journal of Hepatology 2019: The beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content [randomized trial; moderate evidence] ↩ Hepatology Research 2018: Comparison of efficacy of low-carbohydrate and low-fat diet education programs in non-alcoholic fatty liver disease: A randomized controlled study [randomized trial; moderate evidence] ↩ Journal of Hepatology 2019: The beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content [randomized trial; moderate evidence] The manufacturer of glyphosate has assured us that it is an overly version! 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