Nonalcoholic fatty liver disease (NAFLD) — a condition in which excess fat accumulates in the liver of people who drink little or no alcohol — has become one of the most common liver diseases in the U.S. It's estimated that the disorder affects up to 20 percent of American adults. Researchers believe this is associated with rising rates of obesity. While some studies have shown a benefit from vitamin E and the prescription medication pioglitazone, the focus is generally on treating the risk factors.
Forty three patients with hepatic steatosis seen in the liver clinic at Princess Alexandra Hospital between 1999 and 2000 were invited to participate in the study. Informed consent was obtained from each patient and the study protocol was approved by the hospital research ethics committee. Criteria for entry into the study were liver biopsy demonstrating ⩾grade 1 steatosis, overweight or obese (BMI ⩾25 kg/m2 in Caucasians and ⩾23 kg/m2 in Asians) or weight gain of >10% of usual body weight within 12 months, and alcohol consumption <10 g/day.
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Increased insulin levels don't just add pounds to your stomach; they put fat cells all over your body into calorie-storage overdrive, says endocrinologist David Ludwig, MD, a professor of nutrition at the Harvard T.H. Chan School of Public Health, and coauthor of Always Delicious. "I call insulin the Miracle-Gro for your fat cells. It's just not the sort of miracle you want happening in your body." Replacing refined carbs and sugary foods in your diet with healthy fats helps keep your insulin stable, he says, so fewer calories get stored as fat. As a result, "hunger decreases, metabolism speeds up, and you can lose weight with less struggle."
The buildup of fat in the liver can result in inflammation and scarring (fibrosis). This more serious form of NAFLD — called nonalcoholic steatohepatitis, or NASH — can cause severe liver damage and eventually lead to liver failure or liver cancer in a small percentage of people. Although rare, the scarring can also harden the liver and impair its ability to function properly — a condition known as cirrhosis.
There are several predictors of how fast or slow a person’s metabolic rate will be. These include the amount of lean muscle and fat tissue in the body, age, and genetics. Women tend to burn fewer calories than men. Having a higher metabolic rate means your body uses food for fuel (instead of storing it as fat) more quickly. But you can still gain weight if you consume more calories than your body needs. Counterintuitively, heavier people generally have higher metabolic rates than skinny folks to meet the fuel demands of their larger bodies.
Being in optimal ketosis for a prolonged period of time (say, a month) will ensure that you experience the maximal hormonal effect from eating a low-carb diet. If this doesn’t result in noticeable weight loss, you can be certain that too many carbs are NOT part of your weight issue and not the obstacle to your weight loss. There are, in fact, other causes of obesity and being overweight. The next three tips in this series might help you.
The most expensive but highly regarded test is the direct calorimetry test. A direct calorimeter is a large insulated, air-tight chamber. During a test you spend at least an hour inside the chamber with minimal movement. During that time your released body heat (including expired carbon dioxide and vapors) is measured. Based on these measurements, a resting metabolic rate is calculated. In most situations, this test is not practical due to the expensive equipment needed and the time you need to spend laying in the chamber.
When you arrive at the testing facility, you'll be allowed to rest quietly for a short period of time. Then you'll sit or lay in a relaxed position and a mask or mouthpiece will be given to you to breathe into. You'll continue to rest while breathing into the mouthpiece for 10-20 minutes. During this time the amount of carbon dioxide that you exhale is measured.
Until there is more definitive information on the necessary blood levels and the differing proportions of BOHB an AcAc to optimize cellular and organ functions, it will be difficult to specify the dosing and duration of supplemental ketones. However for fuel use, and very likely for exercise performance as well, sustained blood levels of BOHB in the range of 0.5 mM to 1.0 mM are likely to be required. This is achieved physiologically by an estimated ketone production of 50-100 grams per day in a keto-adapted human.
Cirrhosis of the liver will develop progressive symptoms as the liver fails. Some symptoms are directly related to the inability of the liver to metabolize the body's waste products. Others reflect the failure of the liver to manufacture proteins required for body function and may affect blood clotting function, secondary sex characteristics and brain function.

Here’s the bottom line: There are a lot of companies that claim to have the new magic pill. Weight-loss supplements are popular because they don’t require work. The truth is there is no magic pill. To lose weight and stay healthy, it’s best to eat a well-rounded diet, and you can rely on fat-burning foods that have been consumed by humans for thousands of years.
This one seems pretty obvious – no kidding, weight loss reduces your body mass. That’s the whole point. But body size is one of the biggest factors driving your overall metabolism. It takes calories to maintain all those extra pounds of fat tissue – fat might burn fewer calories than muscle, but it absolutely does burn some calories just by existing. If you have 50 or 100 pounds of extra fat, they’re burning a lot of calories every day just by being there, not to mention the extra calories you burn carrying them around from place to place.
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Meanwhile, the liver begins to burn fatty acids as an alternative energy source, resulting in the accumulation of extremely high levels of ketones in the blood.10 These ketone levels (> 20 mmol/L) can exceed normal fasting levels more than 200 to 300 times.1 Since ketones are mildly acidic, this deluge of ketones causes the blood to become excessively acidic (metabolic acidosis), increasing the risk of coma and death if not timely treated.
This might be hard to hear, but coffee and donuts are not a match made in heaven. Apparently, the caffeine in your coffee can inhibit your body's ability to process the sugar in your glazed breakfast. In one study published in the American Journal of Clinical Nutrition, Canadian researchers found that when men consumed one to two cups of regular coffee an hour before a sugary meal, their blood sugar shot up 16 percent more than if they had one to two cups of decaffeinated coffee before the meal. The researchers suggest that caffeine causes your body's cells to be less responsive to insulin, causing short-term insulin resistance, says Fear.
Until there is more definitive information on the necessary blood levels and the differing proportions of BOHB an AcAc to optimize cellular and organ functions, it will be difficult to specify the dosing and duration of supplemental ketones. However for fuel use, and very likely for exercise performance as well, sustained blood levels of BOHB in the range of 0.5 mM to 1.0 mM are likely to be required. This is achieved physiologically by an estimated ketone production of 50-100 grams per day in a keto-adapted human.
Healthy weight is so important for overall heart health, in fact, that the American Heart Association and American College of Cardiology released a new report calling for physicians to create customized weight loss plans and recommend counseling with a dietitian or certified weight loss professional for at least six months. Doctors should also offer bariatric surgery as a potential option for some patients with high body mass index, the report said.
Hipskind, P., Glass, C., Charlton, D., Nowak, D., & Dasarathy, S. (2011). Do Hand-held Calorimeters Have a Role in Assessment of Nutrition Needs in Hospitalized Patients? A Systematic Review of Literature. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 26(4), 426–433. doi: 10.1177/0884533611411272
As if weight gain and cavities weren't enough, high sugar intake has also been linked to diabetes, heart disease, and breast cancer-it's enough to scare anyone into taking a closer look at their diet. I consider myself a healthy eater. I know to add protein or fiber to every meal, avoid processed foods, and eat my fruits and veggies. I don't have a candy or two-a-day soda addiction to kick to the curb, but a big part of my diet is flavored yogurts, pre-made sauces and dressings, and grains. Spoiler alert: Those all contain sugar. So after reading about the USDA's new rules, I decided to challenge myself to go 10 days without sugar-including limiting my intake of honey, pure maple syrup, and other natural sweeteners. (Check out these 8 Healthy Foods with Crazy-High Sugar Counts.)
If you doubt that this advice could be wrong, just look around. We have tripled our obesity rates since 1960, and in the last decade, cases of type 2 diabetes in children have increased by over 30 percent. In 1980, there were no children with type 2 diabetes (formerly known as adult onset diabetes), and now, there are over 50,000. Seven out of ten Americans are overweight. The advice is not working. Could it be the wrong advice?
Currently, a liver biopsy is the only way to make a definitive diagnosis of fatty liver or NASH. Liver biopsies involve inserting a long needle into the right side of the abdomen and extracting a small piece of liver tissue that can be examined under a microscope. Liver biopsies are an invasive procedure, so they aren't entirely free of risk and complications, but they're also fairly routine these days and can be done on an outpatient basis.
Spicy foods have natural chemicals that can kick your metabolism into a higher gear. Cooking foods with a tablespoon of chopped red or green chili pepper can boost your metabolic rate. The effect is probably temporary, but if you eat spicy foods often, the benefits may add up. For a quick boost, spice up pasta dishes, chili, and stews with red pepper flakes.

TIP: Try replacing cow's milk with almond milk and choose grass-fed products. Instead of meat, use legumes like black beans or chickpeas as well as root vegetables like carrots and beets. Mushrooms are a great meat substitute since they can have a similar consistency, and they're both flavorful and filling. Instead of eating meals where meat is the main dish, make soups or stews or chili. With these dishes it is easy to cut back on some meat and throw in more vegetables instead.
I realized that, despite my sweet tooth and my nightly bowl (okay, okay, scoops straight from the carton) of ice cream, I eat well and don’t have much to “cut out.” Sure, if I wanted to shed ten pounds and get to some elusive race weight, I could probably do it. But I’d have seriously sacrifice by cutting out all sweets and dialing back my caloric intake, which during marathon season, may not be as high as it should be anyway. So, chalk one up for me, for eating a pretty balanced diet and performing pretty well on the road.
In a keto-adapted individual where ketone metabolism is brisk with up to 100 grams or more being oxidized (i.e., ‘burned for energy’) daily, the small amount lost in breath and urine as acetone is minor. But because this breakdown occurs spontaneously without needing the help of enzymes, it also happens to AcAc in a stored beverage or food (even in an air-tight container), making the shelf-life of AcAc-containing products problematic. Thus all current ketone supplements consist of BOHB in some form rather than the naturally occurring mix of BOHB and AcAc produced by the liver.
“I always tell clients to balance their carb and sugar intake with protein, fiber, and [or] healthy fats,” says Fear. All three of these nutrients slow the absorption of sugar into your bloodstream, which decreases the spike and crash in your blood sugar and your energy levels, she says. That means you won't feel weak, shaky, or hangry 30 minutes after you eat.
Blood, urine, plasma, and breath ketone concentrations following mole-matched ketone ester or isocaloric dextrose drinks in fed and fasted subjects (n = 16) at rest. Data from both of the two study visits in each condition (fed and fasted) completed by an individual are included in the analysis. Values are means ± SEM. (A) Blood d-βHB. (B) AUC of blood d-βHB. (C) Urine d-βHB excretion. (D) Plasma acetoacetate (AcAc). (E) Measured breath acetone (ppm = parts per million). (F,G) Mean d-βHB Cmax and difference between βHB Cmax over two visits when subjects separately consumed two ketone ester drinks in both the fed (F) and fasted (G) state. X axis = mean d-βHB Cmax of the 2 visits (mM), Y axis = difference between d-βHB Cmax in each visit. 95% confidence limits are shown as dotted lines. Significance denoted by: *p < 0.05 fed vs. fasted.
There are enticing anecdotes of supplemental ketones being used to boost human physical performance in competitive events, notably among elite cyclists. Given that BOHB can deliver more energy per unit of oxygen consumed than either glucose or fatty acids (Sato 1995, Cox 2016, Murray 2016), this makes sense. But what we do not know is if there is any required period of adaptation to the use of exogenous ketones, and thus how to employ them in training. It is clear that exogenous ketones decrease adipose tissue lipolysis and availability of fatty acids, the exact opposite to what happens on a well formulated ketogenic diet. This distinction between exogenous ketones and ketogenic diets on adipose tissue physiology and human energy balance underscores an important reason why these two ketone-boosting strategies should not be conflated.
There’s also the issue of supplement safety in general. All supplements—whether you’re talking about vitamins, minerals, herbs, or other nutritional mixes—are only loosely regulated. “We know that there is contamination of supplements here in the U.S., often from products that are manufactured abroad,” Palumbo says. In that case, “the same concerns apply to this as for any other supplement.”
It is a tendancy that body builders and althletes use high protein diets to add muscle. but muscle is denser than body fat, so this tends to put on weight, not lose it. This type of diet suits active people who can burn off the excess, but for more sedentary people it is better (IMO) to either calorie or carb restrict for weight loss, since it is possible to overdose on the proteins, leading to potential kidney damage. The RDA for protein is around 0.8g for every kg of body weight per day.

Some people will also counter that since all carbohydrates, excluding fiber, turn into sugar in the body, low-carbohydrate diets will produce superior fat loss and health compared to higher-carbohydrate diets. However, a study performed at the University of Arizona compared an isocaloric low-carbohydrate diet to a moderate-carbohydrate diet equal in protein.


As it turns out, how the sweet stuff affects your weight has a lot to do with what sugar-laden foods you eat, when you eat them, and what you pair them with, says dietician Georgie Fear, R.D., author of Lean Habits for Lifelong Weight Loss. So instead of forcing yourself through sugar withdrawals, adopt these sane, totally doable strategies to eat the sweet stuff and actually lose weight at the same time.
Yes, you can actually boost your metabolism, but—no surprise here—there is no silver bullet. Despite what Instagram influencers or clever advertisements will lead you to believe, the methods of boosting your metabolism are the same habits of a healthy and active lifestyle: strength training, eating well with a focus on high-quality foods, sleeping enough, and staying hydrated. Do these things, and you’ll not only stoke your metabolism, but you’ll also run stronger and avoid injury.
Skimping on snooze time doesn’t just leave you feeling crummy the next day. It could mess with your calorie burn. Though the relationship between sleep and weight loss is complex, research shows that sleep deprivation sets off a cascade of hormonal changes that can put the brakes on calorie burning. The lesson? Aim to get 7 to 8 hours of shuteye per night.
Serial drinks or a continuous NG infusion of KE effectively kept blood ketone concentrations >1 mM for 9 h (Figure ​(Figure6).6). With drinks every 3 h, blood d-βHB rose and then fell, but had not returned to baseline (~ 0.1 mM) when the next drink was consumed. There was no significant difference in d-βHB Cmax between drinks 2 and 3 (3.4 ± 0.2 mM vs. 3.8 ± 0.2 mM p = 0.3), as the rate of d-βHB appearance fell slightly with successive drinks (0.07 ± 0.01 mmol.min−1 and 0.06 ± 0.01 mmol.min−1 p = 0.6). d-βHB elimination was the same after each bolus (142 ± 37 mmol.min, 127 ± 45 mmol.min; and 122 ± 54 mmol.min). When KE was given via a nasogastric tube, the initial bolus raised blood d-βHB to 2.9 ± 0.5 mM after 1 h, thereafter continuous infusion maintained blood d-βHB between 2–3 mM. Total d-βHB appearance in the blood was identical for both methods of administration (Serial drinks AUC: 1,394 ± 64 mmol.min; NG infusion AUC: 1,305 ± 143 mmol.min. p = 0.6).
I have more than a professional interest in liver health because for more than 30 years, I’ve had hepatitis C. I’ve never had a symptom, never missed a day of work and never had fatigue, flagging energy or jaundice typical of this disease (which can sometimes end very badly, with sclerosis, liver cancer or even death). Some of my good fortune may be due to luck, but I credit most of it to rigorously following some very innovative liver-health protocols designed by Burt Berkson, MD, PhD, who I talked about in my book, The Most Effective Natural Cures on Earth (Fair Winds Press, 2008).
You know you’re supposed to eat less sugar. After all, the sweet stuff has been linked to obesity, type 2 diabetes, heart disease, and more chronic diseases. And it’s not just in soda and candy; sugar is hidden in some of your favorite grocery store staples like pasta sauce and wheat bread. Cutting back on sugar will help you drop those unwanted pounds, but sometimes it’s easier said than done.
I realized that, despite my sweet tooth and my nightly bowl (okay, okay, scoops straight from the carton) of ice cream, I eat well and don’t have much to “cut out.” Sure, if I wanted to shed ten pounds and get to some elusive race weight, I could probably do it. But I’d have seriously sacrifice by cutting out all sweets and dialing back my caloric intake, which during marathon season, may not be as high as it should be anyway. So, chalk one up for me, for eating a pretty balanced diet and performing pretty well on the road.
For most people, natural sugars found in whole foods aren’t something to worry about. Dairy products contain lactose, a natural sugar, but you also get essential nutrients like calcium, vitamin D (when added), potassium, and magnesium. Likewise, fruit is loaded with vitamins, minerals, polyphenols, and phytonutrients and are high in fiber and water, which promotes satiety, keeps you feeling fuller longer, and helping prevent weight gain. “If it’s naturally occurring, you shouldn’t stress about the natural sugars that are included it in, because you’re getting other nutrition with it,” Lemond says.

7. Exercise the same way you take your prescription medicine: consistently and every day. Aim for at least a half hour, though more can be better, and be sure you're doing intervals, which will help melt fat. A review published in the Journal of Hepatology found that a combination of diet and exercise was best to reduce body weight and therefore improve liver health.
There are several predictors of how fast or slow a person’s metabolic rate will be. These include the amount of lean muscle and fat tissue in the body, age, and genetics. Women tend to burn fewer calories than men. Having a higher metabolic rate means your body uses food for fuel (instead of storing it as fat) more quickly. But you can still gain weight if you consume more calories than your body needs. Counterintuitively, heavier people generally have higher metabolic rates than skinny folks to meet the fuel demands of their larger bodies.
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