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300 lbs, fatty liver, diabetic, no gallbladder, eating tons of fruit. Please advise my friend . . .

Answered on September 12, 2014
Created February 12, 2013 at 5:25 PM

As the title suggests, my friend is 300 pounds, has diabetes, fatty liver, no gallbladder , and has a major sweet tooth. He joined OA and is 2 weeks into not eating sugar, but he's still woofing down the fruit. He's addicted to diet soda and has a major sweet tooth.

He's experiencing pain in what he thinks is his liver, and is blaming the pot roast he had 2 days ago, and not the quart of fruit he had last night.

He's 49 and at this rate, I'm not sure he'll make it to 50.

I tried to explain that fructose is only metabolized in the liver and he really needs to cut back on the carbs, and fruit in particular. Aside from the fact that he's diabetic, and lots of fruit will obviously cause all kinds of diabetic related problems.

He pointed me to this article for dietary advice (I'm not impressed):

http://ezinearticles.com/?What-To-Eat-To-Improve-A-Fatty-Liver---Eat-This,-Dont-Eat-That,-What-Every-FLD-Patient-Should-Know&id=5011160

Since he's not listening to me, please chime in and give him some advice and any inspirational paleo success stories.

Thanks, Mike

3491e51730101b18724dc57c86601173

(8395)

on February 12, 2013
at 07:25 PM

He probably IS following his doctor's advice on how to lose weight, which is why he is in such terrible shape in the first place. That said, if the adage "you can lead a horse to water . . ." applies anywhere, dietary advice from well-meaning friends and strangers is where it applies the most. Nothing we can say is going to magically turn around this guy's thinking and help him, sorry to say.

7fc82eebafd44badc73c520f44660150

(3275)

on February 12, 2013
at 07:05 PM

it's probably just as good a place as any since he's obviously not following his doctor's advice to lose weight.

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3 Answers

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3
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on February 12, 2013
at 05:44 PM

Well, he can either trust D.J. Atterson, a self proclaimed "Diamond Level Expert Author" or he can trust sound science conducted by actual resarch doctors:

http://www.utsouthwestern.edu/newsroom/news-releases/year-2009/low-carbohydrate-diet-burns-more-excess-liver-fat-than-low-calorie-diet-study-finds.html

???Instead of looking at drugs to combat obesity and the diseases that stem from it, maybe optimizing diet can not only manage and treat these diseases, but also prevent them,??? said Dr. Browning, the study???s lead author. Although the study was not designed to determine which diet was more effective for losing weight, the average weight loss for the low-calorie dieters was about 5 pounds after two weeks, while the low-carbohydrate dieters lost about 9?? pounds on average.

More from Dr. Browning:

http://www.ncbi.nlm.nih.gov/pubmed?term=21367948

"Liver triglycerides decreased significantly with weight loss (P less than 0.001) but decreased significantly more (P = 0.008) in carbohydrate-restricted subjects (-55 ?? 14%) than in calorie-restricted subjects (-28 ?? 23%)."

http://www.ncbi.nlm.nih.gov/pubmed?term=18925642

"Carbohydrate restriction modifies hepatic GNG by increasing reliance on substrates like lactate or amino acids but not glycerol. This modification is associated with a reorganization of hepatic energy metabolism suggestive of enhanced hepatic beta-oxidation."

http://onlinelibrary.wiley.com/doi/10.1002/hep.21264/pdf

Patients with NAFLD are at increased risk for cardiovascular disease and endothelial dysfunction.7 Some concern has been expressed that the increased dietary fat intake as a result of a low-carbohydrate diet may be deleterious to the cardiovascular risk profile in such patients. However, two recent studies have shown that the longterm use of a low-carbohydrate diet (6-14 months) has a favorable effect on serum cholesterol, lipoprotein subfractions, and high-sensitivity C-reactive protein despite the increased intake of dietary fat.

1
32652cb696b75182cb121009ee4edea3

(5802)

on February 12, 2013
at 06:31 PM

That's a hard one, because I don't think you're going to convince anyone still eating SAD that fruit is problematic. Even people who convert to paleo can take a while to understand the fruit issues.

However, as someone who has had liver and digestive problems (and my gallbladder removed) I can tell you that I found a LOT of relief for abdominal pain following a low FODMAPs diet. Here is a good place to start:

http://www.eat-real-food-paleodietitian.com/paleo-diet-and-fodmap.html

-3
6d3ca716e659e6664f3e2264d5ebbeda

(45)

on February 12, 2013
at 06:58 PM

An internet forum is not the place to seek medical advice for somebody in this critical of a condition.

3491e51730101b18724dc57c86601173

(8395)

on February 12, 2013
at 07:25 PM

He probably IS following his doctor's advice on how to lose weight, which is why he is in such terrible shape in the first place. That said, if the adage "you can lead a horse to water . . ." applies anywhere, dietary advice from well-meaning friends and strangers is where it applies the most. Nothing we can say is going to magically turn around this guy's thinking and help him, sorry to say.

7fc82eebafd44badc73c520f44660150

(3275)

on February 12, 2013
at 07:05 PM

it's probably just as good a place as any since he's obviously not following his doctor's advice to lose weight.

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