What is fatty liver (NAFLD)?
Non-alcoholic fatty liver disease means excess fat stored in liver cells — not from alcohol, but often from insulin resistance, excess fructose, and chronic calorie surplus. It is common in metabolic syndrome and type 2 diabetes.
Many people have no symptoms early on. Blood tests (ALT, AST, GGT) and imaging can detect it. This guide is educational only — diagnosis and treatment require a healthcare provider.
Why low carb comes up in conversation
The liver plays a central role in glucose and fat metabolism. When insulin is chronically elevated, the liver converts excess carbohydrate to fat (de novo lipogenesis). Reducing refined carbs and fructose lowers that signal.
Clinical research on ketogenic and low-carb diets shows improvements in liver fat markers for some patients with NAFLD — but study designs and populations vary. Dr. Westman's work at Duke focused on metabolic disease broadly, including fatty liver in obesity clinics.
Practical steps (with your doctor)
Never stop medications or ignore elevated liver enzymes without medical guidance.
- Reduce sugar, soda, juice, and refined grains first.
- Target net carbs appropriate for your plan (often 20–50g under medical supervision).
- Avoid aggressive extended fasting until liver and kidney function are evaluated.
- Retest liver enzymes after 3–6 months of consistent change.