'Weight loss' fad diets could worsen NALFD, lead to liver cancer and cirrhosis

A fad diet is increasingly becoming popular among people looking for quick and easy weight loss. Now, a recent study published in the has found that it could worsen an increasingly common liver condition called nonalcoholic fatty liver disease (NAFLD), in which extra fat builds up in the liver. It may also lead to serious consequences such as liver cancer and cirrhosis.

Fad diet includes; ketogenic diet, Atkins diet, vegan diet, paleo diet, and south beach diet. In many cases, the diet is characterized by highly restrictive or unusual food choices, which can cause serious health problems. The diet is becoming a trend nowadays mainly due to its increasing endorsement by celebrities.

"In the clinic, I used to see mostly hepatitis C patients. Now most of the patients I see have fatty liver disease," said Hugo Rosen, a liver disease specialist and chair of medicine at the Keck School of Medicine of USC. "It's a problem that closely tracks with the emergence of obesity and diabetes throughout the world."

"It's a really important issue to be aware of NAFLD," he said. "Patients with NAFLD have at least a twofold risk of dying of a coronary event or having a stroke."

Scientists also believe the condition is linked to increased risk of liver cancer even in the absence of clear-cut cirrhosis, Rosen said. He has seen preliminary results from a Mayo Clinic study that suggest NAFLD can increase susceptibility to other forms of cancer as well.

Diet-linked liver disease often goes unnoticed until the damage is done

Many people don't know they have a fatty liver, leading to its reputation as a "silent killer." It usually causes no pain or other symptoms. It's often not until the disease has progressed to a more serious stage, like nonalcoholic steatohepatitis (NASH) or cirrhosis (serious scarring of the liver), that patients and doctors are alerted to the problem.

Poor eating habits and fad diets that boost fat intake are particularly worrisome, he said. The keto diet, which emphasizes eating lots of fats and restricting carbohydrates, can lead to NAFLD, according to research done in mouse models.

Keto is attractive to many people because "you can eat a lot of tasty stuff — butter, red meat, cheese," he said. "But you're basically consuming 80% of your caloric intake from fat. It certainly makes sense why in rodents, we're seeing that this causes NAFLD."

USC liver specialist recommends a well-balanced diet, no fast food

Don't overdo it on fats, Rosen recommends, especially from processed foods. Fructose and other sugars are a major concern as well, especially in sodas, candy, sugary cereals, sweetened juices and fast food. Those kinds of refined foods can increase cholesterol and cause inflammation in the liver.

Instead, he suggests eating a well-balanced diet that features high-fibre foods, vegetables, fruits, fish, lean meats, nuts, eggs, seeds and unrefined oils. It's a menu familiar to those following other popular diet trends: the paleo and Mediterranean diets.

"Sofad me data have shown that a paleo diet has a significant and persistent effect on lowering liver fat compared to a low-fat diet, simply because a low-fat diet isn't palatable to a lot of people," he said.

That's one problem with fad diets, Rosen said — they can be difficult to stick with, especially if they cut out tasty items entirely. Fasting is another approach that can have dramatic weight-loss effects but is hard to maintain.

"Rapid weight loss is not recommended because it's rarely sustainable," he said. "I would favour a gradual weight loss of 5% to 10%."