Q. "I’m very overweight, my liver is fatty, and I have insulin resistance. Should I consider eliminating processed foods from my diet? Or should I reduce carbohydrates and increase protein?"
Tina Kop Simon via Facebook
A. Dr Janet Franklin (expert in obesity and metabolism; Senior Clinical Dietitian at Royal Prince Alfred Hospital, Sydney) responds:
Having a fatty liver and insulin resistance are common consequences of carrying extra weight, leading a sedentary lifestyle and eating a diet that’s high in fat or excess kilojoules.
Excess liver fat can cause both reversible and irreversible damage, depending on the severity of the organ’s condition. Fortunately, exercising regularly and improving your diet — and losing weight as a result — can help ease both conditions. In fact, exercise is one of the most important things you can do to prevent the development of diabetes. In addition, eat at least two serves of fruit and five serves of vegetables every day, swap high-glycaemic-index (GI) carbohydrates for high-fibre, low-GI varieties, reduce your consumption of saturated fat, and lower your daily kilojoule intake.
High-protein diets help you lose weight quickly at first, but they tend to be unsuccessful at helping you maintain long-term weight loss. The best way to lose weight and keep it off is to eat a sustainable, balanced diet. Studies show that if your liver is particularly fatty, a very low-energy diet (VLED) meal-replacement regimen can reduce liver fat within just two weeks. Following this program for eight weeks maximises this liver-fat loss; however, if you return to your usual way of eating after being on the VLED, the fat will also return.
To minimise fat in the liver and keep insulin resistance in check, you need to make practical, permanent changes to your lifestyle. If you decide to do this, discuss your individual approach with an Accredited Practising Dietitian or with your doctor.