The ketogenic diet, a high-fat, moderate-protein, low-carbohydrate diet, can induce weight loss and improve glycemic control but also poses risks of hyperlipidemia, elevation of liver enzymes, and the onset of fatty liver disease. A keto diet may lead to elevated AST and ALT levels, indicating liver damage or inflammation. Rapid weight loss, high fat intake, and nutrient deficiencies can contribute to increased AST.
A ketogenic diet may keep the liver healthy and even possibly prevent or reverse certain liver conditions. However, it is important to note that a ketogenic diet can cause fatty liver or hepatic steatosis, which can lead to liver dysfunction and elevated enzyme levels. Studies have shown that feeding a high-fat ketogenic diet may trigger severe steatohepatitis and promote liver fibrosis progression.
In addition to reducing insulin levels, a low-carb diet can reduce insulin levels and alter hepatic mitochondrial fluxes and redox state during ketogenic diet-induced reversal of NAFLD in humans. In some cases, a ketogenic diet has resulted in severe elevation in transaminases and an abnormal lipid panel.
In conclusion, the ketogenic diet has the potential to increase blood cholesterol levels and elevate liver enzymes leading to non-alcoholic fatty liver disease. However, it is crucial to be aware of these potential risks and to consult with a healthcare professional before starting a ketogenic diet.
| Article | Description | Site |
|---|---|---|
| Are There Negative Effects of Keto Diet? Does It Do More … | The keto diet has been associated with the development of non-alcoholic fatty liver disease (NAFLD) and an elevation in liver enzyme levels in animal studies. Nevertheless, other studies have yielded different results. | www.medicinenet.com |
| Keto and Fatty Liver – The Surprising Benefits of This Diet | Such inflammation and irritation have been demonstrated to result in liver dysfunction and elevated liver enzymes. In addition to reducing insulin levels, a low-carbohydrate diet also has the effect of… | ezra.com |
| Effect of a ketogenic diet on hepatic steatosis and … | By PK Luukkonen · 2020 · Cited by 212 — The present study presents evidence that hepatic mitochondrial fluxes and redox state are markedly altered during ketogenic diet-induced reversal of non-alcoholic fatty liver disease (NAFLD) in humans. | www.pnas.org |
📹 Can a Ketogenic Diet Cause Fatty Liver Disease? – Dr.Berg
Can a ketogenic diet cause fatty liver disease? Watch this video to find out.. Take Dr. Berg’s Advanced Evaluation Quiz: …
What raises liver enzyme levels?
Common causes for elevated liver enzymes include:Certain medications, such as cholesterol-lowering drugs (statins) and acetaminophen. Fatty liver disease, including alcohol-related and non-alcohol-related conditions. Hemochromatosis. Hepatitis A, hepatitis B, hepatitis C, alcoholic hepatitis and autoimmune hepatitis.
What does it mean to have elevated liver enzymes?. If you have high levels of liver enzymes in your blood, you have elevated liver enzymes. High liver enzyme levels may be temporary, or they may be a sign of a medical condition like hepatitis or liver disease. Certain medications can also cause elevated liver enzymes.
What are liver enzymes?. Liver enzymes are proteins that speed up chemical reactions in your body. These chemical reactions include producing bile and substances that help your blood clot, breaking down food and toxins, and fighting infection. Common liver enzymes include:
- Alkaline phosphatase (ALP).
- Alanine transaminase (ALT).
- Aspartate transaminase (AST).
- Gamma-glutamyl transferase (GGT).
What is the #1 food that causes liver disease?
Stay Away From Fatty Foods French fries and burgers are a poor choice to keep your liver healthy. Eat too many foods that are high in saturated fat and it can make it harder for your liver to do its job. Over time it may lead to inflammation, which in turn could cause scarring of the liver that’s known as cirrhosis.
Food with lots of fiber can help your liver work at its best. Want one that’s a great way to start your day? Try oatmeal. Research shows it can help you shed some extra pounds and belly fat, which is a good way to keep away liver disease.
French fries and burgers are a poor choice to keep your liver healthy. Eat too many foods that are high in saturated fat and it can make it harder for your liver to do its job. Over time it may lead to inflammation, which in turn could cause scarring of the liver that’s known as cirrhosis. So next time you’re in the drive-thru line, think about ordering a healthier option.
Add lots of veggies to your diet if you want to keep your liver healthy. Broccoli can be part of this strategy. Some studies suggest this crunchy food can help protect you from nonalcoholic fatty liver disease. If steamed broccoli sounds a little too blah, shred it into a slaw and toss it with sliced almonds, dried cranberries, and a tangy vinaigrette. It’s also delicious roasted with garlic and a splash of balsamic vinegar.
Can keto cause elevated liver enzymes?
If you have existing liver problems, the keto diet can make them worse. Your liver breaks down fat and converts it to energy and cholesterol. A high-fat diet like the keto diet can cause fat to build up in your liver and lead to fatty liver disease.
Animal studies suggest the keto diet can cause non-alcoholic fatty liver disease, or NAFLD, and raise liver enzyme levels. However, other studies suggest that the keto diet can improve NAFLD and lower liver fat content.
These are early animal or human studies that show early results, though. More research is needed to understand how or if the keto diet produces long-term results.
Experts generally don’t recommend the keto diet because it’s extreme and hard to follow. It may be beneficial for brain conditions like epilepsy and seizures that don’t respond to medications and might help you lose weight quickly. However, it’s not clear that results last.
What should I avoid if I have high liver enzymes?
What to avoid: Don’t eat foods high in fat, sugar and salt. Stay away from a lot of fried foods including fast food restaurant meals. Raw or undercooked shellfish such as oysters and clams are a definite no-no.
A Healthy Diet, a Healthier Liver, a Healthier You. So, what should you eat to ensure that your liver can function normally?
If you’re a liver patient, your diet is adjusted to meet your individual needs. Talk to your doctor about what’s best for you. Still, here are some general food tips for a healthy or healthier liver:
- What to avoid : Don’t eat foods high in fat, sugar and salt. Stay away from a lot of fried foods including fast food restaurant meals. Raw or undercooked shellfish such as oysters and clams are a definite no-no.
- Talk to your doctor about alcohol and your liver health : Depending on the state of your liver, you should avoid alcohol. If you’re allowed alcohol, limit it to no more than one drink a day if you’re a woman and two drinks a day if you’re a man.
- Eat a balanced diet : Select foods from all food groups: Grains, fruits, vegetables, meat and beans, milk, and oil.
- Eat food with fiber : Fiber helps your liver work at an optimal level. Fruits, vegetables, whole grain breads, rice and cereals can take care of your body’s fiber needs.
- Drink lots of water : It prevents dehydration and it helps your liver to function better.
What is the most common cause of high liver enzymes?
There are many causes of mildly elevated ALT and AST levels. The most common causes are nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease. In NAFLD, the liver has more fatty tissue in it than normal. Regular or heavy alcohol use can also hurt the liver and increase liver enzymes. Other medical conditions can increase liver enzymes, like hepatitis B or C and a condition that runs in families called hemochromatosis. Using certain medicines and over-the-counter supplements can also increase liver enzymes.
People with mild elevations in liver enzymes usually do not have symptoms.
Your doctor will ask you questions and examine you to try and find out why your liver enzymes are elevated. He or she may also do blood tests. A scan of your liver, called an ultrasound, might help your doctor find a cause.
What is the most likely cause of elevated liver enzymes?
There are many causes of mildly elevated ALT and AST levels. The most common causes are nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease. In NAFLD, the liver has more fatty tissue in it than normal. Regular or heavy alcohol use can also hurt the liver and increase liver enzymes. Other medical conditions can increase liver enzymes, like hepatitis B or C and a condition that runs in families called hemochromatosis. Using certain medicines and over-the-counter supplements can also increase liver enzymes.
People with mild elevations in liver enzymes usually do not have symptoms.
Your doctor will ask you questions and examine you to try and find out why your liver enzymes are elevated. He or she may also do blood tests. A scan of your liver, called an ultrasound, might help your doctor find a cause.
Is slightly elevated liver enzymes serious?
Elevated liver enzymes might be found during routine blood testing. In most cases, liver enzymes are only mildly raised for a short time. This usually doesn’t signal a chronic, serious liver problem.
What is an alarming ALT level?
An ALT test result of >100 IU/l is a clear indicator of serious liver disease, but a mildly elevated ALT result (30–100 IU/l) is often ascribed to the use of medication (for example statins) or alcohol, obesity, or, for lower ALT levels (<50 IU/l), considered as part of the normal distribution of test results.
Background. Hepatitis C (HCV) and hepatitis B (HBV) virus infection can lead to serious complications if left untreated, but often remain undetected in primary care. Mild alanine aminotransferase (ALT) elevations (30–100 IU/l) are commonly found and could be associated with viral hepatitis; unfortunately, these findings frequently remain without follow-up.
Aim. To determine if and how mild ALT elevation can be used to identify hidden HCV and HBV infection in primary care.
Design and setting. Primary care patients referred for liver enzyme testing were selected by a large primary care Diagnostic Centre (Saltro).
What can falsely elevate liver enzymes?
Common causes of elevated liver enzymes include: Nonprescription pain medicines, particularly acetaminophen (Tylenol, others). Certain prescription medicines, including statins, which are used to control cholesterol. Drinking alcohol.
Can high sugar intake cause elevated liver enzymes?
The study found that among healthy women, higher levels of sugar-sweetened beverages (SSB), added sugar, and total fructose consumption were significantly associated with increased serum liver enzyme concentrations. This suggests that habitual consumption of even moderate added sugar levels may elicit hepatic lipogenesis. The consumption of added sugars is decreasing in the United States, but their intake can still impact cardiovascular health. Dietary fructose and glucose differentially affect lipid and glucose homeostasis, and dietary fructose is a key player in the development of fatty liver disease.
Fructose consumption is also linked to nonalcoholic fatty liver disease, as demonstrated by the BioCycle study, which designed a longitudinal study of the oxidative stress and hormone variation during the menstrual cycle. The study also found that fructose-rich beverages and the risk of gout in women are linked to fructose-rich beverages. The University of Minnesota Nutrition Data System for Research, Nutrition Coordinating System, and other studies have also shown that adherence to a Mediterranean diet and plasma concentrations of lipid peroxidation in premenopausal women may be associated with increased lipid peroxidation.
In conclusion, the study highlights the importance of maintaining a nutrient database in a changing marketplace to keep pace with changing food products. Consuming high levels of added sugars, including SSB, added sugar, and total fructose, can lead to increased serum liver enzyme concentrations, suggesting that habitual consumption of even moderate added sugar levels may elicit hepatic lipogenesis.
The article discusses various studies on the role of diet and nutritional management in non-alcoholic fatty liver disease (NAFLD). It highlights the importance of consuming a balanced diet, including avoiding sugary drinks, reducing saturated fat consumption, and limiting saturated fat intake. The article also discusses the role of fructose in the metabolic syndrome, which is associated with increased fibrosis severity in patients with NAFLD.
The article also discusses the consumption of added sugars among U. S. adults from 2005 to 2010, and the unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome. The article also discusses the effects of short-term overfeeding with fructose, fat, and fructose plus fat on plasma and hepatic lipids in healthy men.
The article also discusses the use of intake bio-markers to evaluate the extent of dietary misreporting in a large sample of adults. The article also discusses the relationship between serum transaminase activities and fatty liver in children with simple obesity.
The article concludes by discussing the clinical aspects of fatty liver disease and the use of intake bio-markers to evaluate the extent of dietary misreporting in a large sample of adults.
In conclusion, the article provides a comprehensive overview of the role of diet and nutritional management in the development and progression of NAFLD. It highlights the importance of a balanced diet, avoiding sugary drinks, and limiting saturated fat consumption to improve overall health and well-being.
What diet causes elevated liver enzymes?
Eating certain kinds of food can increase the risk of developing NAFLD. Foods that are high in sugar, fat, and salt put extra stress on the liver. Fast food, packaged foods, and processed foods tend to contain a lot of these elements.
📹 Dr. Phinney and Dr. Hallberg on how ketogenic diets affect the liver
Dr. Sarah Hallberg is a physician, board-certified lipidologist, Medical Director at Virta Health, Medical Director at the Indiana …
I use apple cider vinegar and lemon to prevent fatty liver… I love the keto diet and have lost tons of weight using it.. I can’t eat that many cups of vegetables or it will kick me out of ketosis. The key to the keto diet, is to be in ketosis, intermittent fast and exercise.. So I usually eat about 3 cups of vegetables a day.. I’m doing just fine.
My wife and I have been perusal Dr Berg since March 2018 and have been doing exactly what he says. Everything is great my wife is a diabetic and her sugars are down she’s lost 20 pounds. One thing has been bothering her is a pain right where her liver is. If anyone can give us their thoughts would be greatly appreciated. My guess is her liver is losing fat and the switch to burning fat instead of sugar made it do some reconstruction to work differently. Thank you to anyone that takes time to answer. Dr. Berg we love you!
Thank you for this article. I think it is very important to point out what can very unhealthy if you do a ketogenic diet incorrectly. Another point of discussion may be the aspect of overeating on a ketogenic diet. Yes, I know that it is claimed that overeating is unlikely on a ketogenic diet since you do not have intense cravings due to the absence of insulin peaks. But please consider that people may start eating because of other reasons as well (Keyword: stress-eating ). Thus, I would be very happy about articles on the effects of overeating or other mistakes on a ketogenic and its effects on the human body. Thank you very much and best regards
This will help anyone on keto: 100g kale (steamed/baked as kale chips) ~4 net Carbs 100g cauliflower ~2 net Carbs 100g brocolli ~4 net carbs 100g spinach ~1.5 net carbs 100g avocado ~2 net carbs 100g lettuce ~1 net carbs 1 large stalk of celery (~70g) ~1 net carb 100g asparagus ~2 net carbs 100g zucchini ~2 net carbs —————————————————————– Total = 19.5g net carbs and you just ate pretty much most of your required nutrients and TONSSSSSS of potassium (I think around 3000+ mg which is great since required is around 4500mg) as well as a lot of fiber (I believe it comes to around 25g+ of fiber) . I would say keep 5-10 g of carbs from outside sources, I recommend buying keto strips and test yourself, if one day you ate 30g carbs mostly from veggies and a little bit from trace carbs in other foods and you still in ketosis, then you are good, if not, then bring those trace carbs down. I usually stay around 25g, with 20 from veggies as I explained above. 100g of cauliflower, brocolli, zucchini, & avocado is not that much when you weigh them out (weigh before steaming), but they are packed with potassium and nutrients. Make a shopping list and go buy these, whether frozen or fresh (I prefer fresh) and cook them on a daily basis. You could alter the amount depending on your size. The key is variety and nutrient-rich meals.
“Dr.” Eric Berg you have misrepresented the text you quoted entirely. The section of text with which you refer to in this article is within the scope of a discussion concerning the total removal of the pancreas. In the still frame photo at 0:28 the text immediately preceding your ‘supporting evidence’ is as follows: “Figure 78-5 illustrates the effect of insulin lack on the plasma concentrations on free fatty acids, glucose, and acetoacetic acid. Note that Immediaty after removal of the pancreas the free fatty acid concentration in the plasma begins to rise, rising considerably more rapidly even than the concentration of glucose.” Would you like to clarify why you have changed the clinical definition of ‘lack’ of insulin in the case of pancreas removal to your deffinition of ‘low insulin’ in a ketogenic scope?
He is a little right and mostly wrong as most “experts” are, that really don’t know what a keto diet is. Keto is not low carb. It’s low NET carbs which is carbs – fiber. So yes, eat lots of green leafy veggies. Spinach, kale, brussels sprouts, celery, cucumbers, cabbage, etc. Stay away from grains. Bread, alcohol, pasta, etc
I think it should be clearly specified that Dr. Berg is referring to Cruciferous vegetables ONLY and not starchy or high GI veggies like potatoes, corn or carrots. There are supplements (Dr. Berg sells some…) that help with fatty liver, but I personally like Rose Hips Solid Extract along with Milk Thistle. I do Keto and my triglycerides are LOW… but you have to make sure you’re getting plenty of vegetable FIBER and the supplements mentioned above help too.
I have done keto for 9 months and never consume 7-10 cups of vegetables. 3-5 at best. I do consume about three tbsp apple cider vinegar with lemon juice daily. Liver is awesomely clean according to all tests from my complete work up. Triglycerides 48, balance. A1C 5.0, BP 116/72, particle B 394. Lost a total of 61 pounds to date. So i’m not too sure about that fatty liver claim.
I had fatty liver, my dr told me when I went for a physical. He said its “no big deal” lol. So I do what Dr Berg suggests, lemon water in the morning first. And I bought a good blender that I use every day and fill it up to the top wIth GREEN STUFF that has leaves: whatever you can find at grocery stuff, such as… spinach, kale, swiss chard, bok choy, cabbage, (always add avocado btw) I can not find beet tops here from some reason? parsley. Add water, blend it and DRINK it everyday. I bring it to work and drink it in the afternoon. In a huge smoothie cup. It looks kid of gross, I sometimes add crystal light, which is not so healthy but it makes it taste good. But Dr Berg suggest stevia which is better, you can add some brazil nuts or almonds too if you like, chia, or handful of blueberries etc. Not a big deal, I do not like eating some veggies (but I love spinach salad) so drinking your veggies is EASY and fast. _cant just eat fat we need to detox the liver as well it is important for electrolytes and potassium magnesium etc
Interesting. I wonder how long term fasting affects the same thing. I routinely do 5-7 day complete fasts where I only consume water with lemon juice and a little stevia drops along with unsweetended green tea. I also continue to maintain my daily routine of fish oil, potassium, vitamic C, a probiotic etc.
I don’t understand why so many want to put a label on a diet Paleo, Keto, Atkins, vegetarian, vegan, etc. Why not go somewhere in between just eat natural nature foods the best you can? Eat the fats, fruit, vegetables, meat, no sugar and let nature take care of our body. Of course eat only until your are satisfied not seconds, thirds etc. Make healthy treats like ie fat bombs to stop the craving for candy bars. I am trying to follow the keto diet until January when my next blood work is done because my triglycerides are way way high. I will see the results I hope. After that I will stay away from sugar still and just eat natural with no label of my diet lifestyle.
This is a good article and touches on the point that sooooo many keto-type websites and bloggers forget: it’s not about the fat/carb/protein, it’s the quality of the thing! Eating a bunch of broccoli might have the same amount of carbs as X slices of bread but it’s buffered by the other nutrients, fibre and stuff and your body treats it differently than it would a straight sugar–which is why he is totally right in saying not to count veges in your macros. Starchy root veges are different, and shld prob be included, but what you don’t realize is that there are low amounts of carbs in HEAPS of foods, and it adds up and that’s what the 20g limit is for.
If you pause the article and look at the paragraph directly above the one he reads from it talks about REMOVING the pancreas, and Figure 78-5 is a chart showing levels of Insulin in a CONTROL animal, in this case they used rats, and on the right a DEPANCREATIZED rat. “Dr.” Berg apparently knows how to read, but is not very observant and does not COMPREHEND what he’s reading and can not deduce and place what he’s reading into the proper CONTEXT. So what Berg asserts about a Ketogenic Diet causing fatty liver is completely wrong, incorrect, extremely disingenuous and is even a lie.
The best food – is freshly sprouted seeds – seeds and anything made with them have phytic acid in it, which inhibits the uptake of vitamins and minerals into our system- once sprouted the phytic acid is used up and the vitamins within the sprout explode to over 20 times the dormant seed levels – add this to intermittent fasting – the amount of food required will be a much less than 8 cups of vegetables.
I’ve been using ketosis to control my narcolepsy symptoms on and off for years, and strictly now as its freed me from needing all medications aka drugs. in my day I eat dark chocolate, a veggie meal shake, avacado, lots of green leafy vegetables. salmon/fish, eggs, nuts, seeds, healthy oils, raw pumpkin, olives. some cheese. I snack on cucumbers and brocolli. I stay in my net carbs of 20 to 30. fat adaption, which takes a few weeks or months to achieve (your brain accepting fat as fuel) has given me energy I’ve never had and my symptoms of narcolepsy are extremely manageable. I exercise daily, which I couldn’t do on the drugs without my heart near exploding, so this is a natural and healthy way for me to live. I rarely eat bacon and slop food, most people tend to think keto means bacon and burgers all day. I have a family member who used vegan keto to shrink a tumor and control endometriosis. it has benefits with veggies ;).
Huh? Who ever said that vegetables weren’t part of the KG diet? “Let’s talk about the KG diet without vegetables.” Ok, and let’s talk about baseball without the outfielders. A Ketogenic Diet with plenty of LOW CARB, Low Calorie vegetables would NEVER cause a fatty liver. That’s patently absurd. Any method of doing anything won’t be successful if it’s done only partially. This article should be titled “A Ketogenic Diet Done Incorrectly or Partially Can Cause a Fatty Liver” – Duh
My understanding is that non alcoholic fatty liver is primarily caused by the liver storing excess blood sugar, especially fructose. If this is true then I believe that low insulin levels naturally corresponding to low sugar levels such as from a keto diet, would not be a problem. Low insulin levels paired with elevated blood sugars would be a culprit, which usually won’t happen on a keto diet.
Hello Dr Berg, I’ve lost about 17 lbs in 2 months doing the intermittent diet. Very happy! But now I am addicted to your fat bomb recipe. You know, the one with coconut oil, peanut butter, butter and cocoa powder and stevia. I’m eating about 7 boys a day after a meal. It’s soooo delicious! And to add on that I’m NOT eating that much greens. Is this a problem? Should I stop with the fat bombs? I’m afraid to get a fatty liver. Ah! I also love your recipe for bread. I eat that too 😬 please answer me and let me know. Ah I’m not trying to loose weight for now as I’ve reached my goal, but I want to be healthy. Than you!
correct me if i am wrong, but eating red meat is supposed to have a high insulin effect yes? Also eating a balanced meal in general will elevate your insulin levels, just not spike it like a simple sugar. Fructose sugars and turned into fat in the liver- not sure how a diet devoid of simple sugars would cause a fatty liver- especially when the body would be fueled by ketones from fat.
If you want to get lean and fit then you need to do this: cut back on all processed foods and sugars (except for fruits), eliminate refined carbs, keep your Carbs from wheat and rice low, proteins high and fats moderate. And then add two types of exercises-aerobic like jogging, running etc first thing in the morning and anaerobic like weight training in the evening. Believe you me, you will get ripped and fit in no time!
This explains in part why for 2 years I had fatty liver while on a high protein diet to lose weight- nobody could tell me why. Various factors brought them unexpectedly down but I’m putting on weight again- so annoying. Underactive thyroid and goitre runs in the family but doctors always say it’s fine while hair falls out in clumps, my skin has become as dry as a desert for the first time ever my face is red peeling and swollen along with my hands, I could sleep 16 hours a day and I’m chronically cold along with frequent bouts of anemia despite even getting iron infusions at the hospital. I don’t eat a lot of food- mostly when hungry and never as soon as I wake- usually I don’t eat til 11am or so and am a slow eater, so 7-10 cups of ANYTHING- even ice-cream or cake would kill me.
This is exactly how I do my diet. 95% of my foods come from meats and protein. No dairy, no sugar, no sugar substitute, & for sure no carbohydrates. The other percent is vegetables and some fruit. Don’t know what kind of diet this is but all I wanted was to get rid of fatty liver, bring my weight down and be healthy.
I do this, eating many vegetables each day, spinach, asparagus, zucchini, cucumbers, tomatoes and many other nonstarchy vegetables while eating ketogenic to control my diabetes. I don’t eat steak but I do eat tofu. I’m not interested in Keto sis but controlling my sugar levels and A1C. It’s worked when the diabetic diet did not. I’m very carb sensitive. Wheat, potatoes and rice need to be out of my picture.
The problem I am finding with this is that, if low insulin is the problem, high fiber, low starch/sugar vegetables is not going to fix it, as it causes little to no insulin response. Protein will cause more response, and only produces glucose as necessary. In keto the can be such a fear of protein and gluconeogenesis. So I will suggest either that the problem or the solution had been misidentified. Yes, increased acid improves liver function, although I’m not convinced human consumption of fiber is necessary or beneficial. If we can’t digest it and it’s consumption can be a contributing factor to a host of intestinal disease and general distress, why are we so concerned with getting enough. Perhaps fatty liver is more a result of low stomach acid, which would certainly be exacerbated by sugars and starch, but aided by lemon juice and vinegar. Stomach acid is also optimally designed to digest animal proteins, whereas fibrous foods can easily pass through and remain recognizable, unless well-cooked (in only some cases, certainly not including corn or beans, although those are not the plant category in question). If it comes through and we can tell what it is, there is a very small chance that we reaped any benefit from it nutritionally. I am not providing links because this ia a body of knowledge I find easy to find articles in support or opposition of fiber. Questions I think we need to be asking ourselves would be: “If fecal matter is largely dead bacteria and indigestible material, do I really need to be eating fibrous food for the sake of seeing more bowel movements?
I break my fast every day by eating anywhere from 10 – 15 cups of salad. It’s manageable if I chop the hell out of all the greens to where it looks like coleslaw. Sometimes it can take me 30 minutes to 1 hour to eat it all but I don’t mind because previously I tended to “inhale” my food – lol, whereas now I actually acknowledge and enjoy it more (because it makes me). My biggest struggle is not forcing myself to eat more afterwards, if I’m full, simply because I’m afraid I’ll miss something nutritionally or I don’t want to only have salad. Work in progress.😉
I want to make two points here in response to the above article. one is, i wonder if somebody HAS to eat 20 to 50 grams of carbs per day. what i mean is, can we eat no carbs whatsoever, other than the salad vegetables, and be healthy? and my other question that i have which i cannot seem to get an answer to, is what constitutes 7-10 cups of vegetables not by volume, but by weight, since it is weight that measure my vegetables. i have been told that means 7-10 ounces of vegetables by weight, but that seems way too small of an amount. i typically eat three 12-ounce packages of cruciferous vegetables per day. i wonder if that is enough. if it is more than enough, i wonder how much i can reduce that and still prevent a fatty liver
I always get kicked out of ketosis if I eat too many green vegetables (I will literally go from 2 ml Ketones down to .02ml). I feel like to actually be in ketosis you must count vegetables as carbs as well. You can still eat like keto, but you will not be in ketosis if total cars exceed 20 to 30 grams including fiber (in my experience). What are your thoughts?
If I eat unlimited veggies, it WILL kick me out of ketosis. Obviously everyone is different but, to people saying “oh well, veggies don’t make you fat.” That’s great and all, but your’e missing the point that being kicked out of ketosis means you are NOT burning fat as your fuel source, so yes, being kicked out of ketosis is a big deal and will not help with the high fat you are consuming. If you are trying to lose weight, keep your veggies under 20 net carbs!
Hi Dr. Please clarify… If youre not counting the carbs of vegetables then your total will likely be over 20g net and therefore will likely not be in ketosis. This would not be a ketogenic diet. You cant get halfway pregnant, you either support a keto diet as it is designed or you do not. What youre essentially saying is that a keto diet causes fatty liver. Do you then not support a keto diet?
So, Dr. Berg — unlimited veggies, but do you mean only GREEN veggies? I imagine corn would not be an unlimited veggie….but even cabbage and broccoli, which I LOVE, have some carbs? Can I eat as much of these as I like? (I usually steam the broccoli and roast the cabbage with a bit of EVOO and butter — its yummy)
I have hyperinsulinemia and fatty liver from the excess insulin. The state where a lack of insulin causes fatty liver is where a diabetic type 1 consumes the same things that lead to a fatty liver for anyone. A glucose tolerance test with insulin labs will prove exactly what I am saying. Those with high insulin will have fatty liver.
Any suggestions for those of us who are post sleeve gastrectomy who want to stay in ketosis and do intermittent fasting? We already have limited stomach capacity and limited time to get in the required amounts of protein. Intermittent fasting will limit the time even more, and there is no room for 7 cups or even 1 cup of vegetables. All I can do now at 9 weeks post is water, protein, and a little fat to help it go down but I know the sleeve is only a tool, and I need an eating plan to go with it. Of course my bariatric program suggests low fat, high protein, and healthy carbs. What would you do in my position?
Can fresh veggie juice be calculated as veggies? I mean, I love me some salad, but 7-10 cups is overwhelming. I get about 4-5 cups a day of fresh salad greens, but can I also juice veggies and have the same effect? Also, I am scared about an overdose of Vitamin A with all those veggies? Should that be a concern?
Interesting article. Which I had see the first, i thought on keto diet you had to limit your vegetables. No wonder why i was feeling sick too much fat was hard on my digestive system. I think keto is a great diet but after two weeks of feeling sick with no energy I’m going back to a regular low carb diet, with fruits and bo salt
I have to ask because I have yet to see anywhere anything about dehydrating one’s kale/spinach/chard/etc. I bought four beautiful bunches of kale from the Farmer’s Market the other day and dehydrated and pulverized it into 1 cup of green powder. After perusal a article on dehydrating kale, the lady demonstrated that by doing so 2 tsp of dried kale (not powdered) was equal to 1 cup of kale. Powdered kale in a smoothie or even added to a salad aids in the ability to eat ones required veggies…yes?? Or am I missing something. If so, I’d really be interested in your thoughts.
I believe that it is not enaugh just reading or quoating a text book to state a fact. This affirmation is way contradictory based on the fact that fartty liver is a chronic ailment that generate insuline reisistance. Free fat due to gluconeogenesis is fat avaiable for burning not to store. Besides, youserlf tought us that the only way to create fatty liver is using the metabollic insuline pathways. If insulne and glucose are low, how is it supposed to store fat in the liver?
KenDBerryMD there are some cases put in the text books as a theory or a suggestion or it may be happened if …- do you get what I say- as water intoxication by searching it will happen if you consumed more than 24 litres of water/day, and who can consume that amount ?!, so don’t worry and relax, you have never seen this case, and you will never see it, as body poisoning by consuming too much fibers, these cases will not happen ever, I think this.
So I was wrong all this while for counting the carb in veggies toward my 20gms of carb? But regardless it works. I did a very strict diet under a dietitian scientist who developed this diet of no fat no, carbs only from 20 gms form selected veggies, and it was way before this Keto diet was a fad. I list 11 kilos in less then 2 months and I never put it on after I stopped. I was on no carb diet after that but had my Sat and Sunday as my cheat days. Let’s do everything in moderation even the veggies and Focus on Eating less. Eating less is the key believe me
Heres an awesome tip on getting your vegetables in quickly and easy. I hate salad and veggies and there is NO WAY im going to eat 7 cups of it everyday, but i dont 😝 I drink it instead, heres my recipe: take a shitload of kale throw it in ur blender, and a table spoon of peanut butter powder, add a table spoon or two of instant chocolate kale shake ( bergs product ) and FINALLY add as MUCH stevia as u like ( better stevia brand is my preferred one ) Add some ice to it, blend that bitch up and drink up. ( mix for a good 2 minutes ) After 2-3 weeks of doing it you will notice that ur stomach can handle the kale shake better and u wont have so much green nasty diarrhea all the time ( trust me its not that bad )
Fatty liver disease is a DISRUPTION in fatty acid metabolism, which can definitely be caused by removing the pancreas because 98 percent of the structure and function of the pancreas is devoted to production of enzymes to metabolise FATS and protein. In contrast, a Ketogenic Diet CORRECTS and normalizes not only the body’s fatty acid metabolism but also virtually all of the body’s processes back to a normal level and condition of Homeostasis. So the “Lack of Insulin” paragraph Berg reads from is in reference to the PRECEEDING paragraph and means an ABSOLUTE PHYSIOLOGICAL ABSENCE and complete lack of insulin causing fatty liver due to the COMPLETE ABSENCE and removal of the Pancreas but IS NOT due to a Ketogenic Diet.
Considering fatty liver is caused by insulin(insulin resistance) and both carbs and proteins induce an insulin spike as opposed to fats and fiber its pretty clear Keto is anti fatty liver. Show me someone with a fatty liver than can process carbs. Aint gonna happen. Hell, some get so bad they can’t even process proteins without a huge insulin spike. Their glucose system is so broken they can’t fuel their body and Keto offers them not only another fuel source that isn’t subject to their broken metabolism but one that also tells their body to use their own fats for fuel such as the ones in their liver. The studies on high fat fish, nuts, olive oil, and avocados show marked improvements in NALFD. Even studies on eskimo tribes shows their huge amount of fat consumption lowered their risks significantly for heart, liver, and metabolic disorders. Fasting is using your own fat for fuel, so using the logic that fasting is good but keto is bad for your liver makes no sense since its the same mechanism, ketosis. Either way your eating fats as your primary fuel source. I won’t even get into how certain fats put you into ketosis quicker. So much research on this, even stuff going back to the 60’s.
Hey Doctor.. Just i wonna know Why the carbs of the vegetables are not counted ?! Will not they digested and realising glucose molecules?! .. What about vegetables that are super high in carbs like green pea, beetroot, …?!! And i saw in an other article of u that u spoke about deleting fibers frome the total carbs ( but there is digestible fibers i think it can be used as feul ?! )
Thanks Dr Berg, as always. Ok, here’s where I get a bit confused… I don’t honestly know how to accurately measure a cup of any leafy vegetable. Is it chopped? I love weight measurements, because I can get very accurate readings from a kitchen scale, but I honestly struggle with cups of this or that.
Am I able to do a ketogenic diet with veggies if I already have a fatty liver? (Im not diabetic or overweight but could lose about 10-12lbs & do not have high blood pressure or cholesterol) I’m not sure how I even got it but it showed up on an ultrasound & I’d like to reverse it but really enjoy the keto diet. I’m not sure if losing weight on ketosis will make it worse. Thoughts?
Im in the induction phase first 14 day . My sgpt sgot both 120 and 150. Freaks me out. Induction phase only can eat 20gr in total carbs. I always count the carbs in my veggie too. When you dont count the carbs in veggie . Did you still have weight loss? . I want to eat more veggie . But afraid that it could stalled weight loss. Because like radish. 100gram contains 6.24 carb if you eat one whole radish . It will be 12-13carb. Isnt it easy to pass the daily limit of total 20gr carb
Dr. Berg provides lots of excellent information but this article is really not good regarding the ketogenic diet. You definitely should eat lots of vegetables on the Ketogenic Diet but they need to be very low glycemic, low carb vegetables like leafy greens, onions, radishes, broccoli etc. If you eat too many carbohydrates and too much protein you will not reach nutritional ketosis. The ketogenic diet should not be implemented by everyone. You should be screened by a health professional. If you are taking medications like blood pressure and diabetes medications, you should regularly be monitored by your doctor because your medications will need to be adjusted. Thank you – Dr. Danielle Heard, DCN, MS, MS, CNS, LDN, INHC
Hi doc! I’m following your articles since about a year and have become your fan I should say. All your topics are very very informative. Regarding this article, I have a doubt. Generally ketogenic diet refers to high fat, moderate protein and very less carbs, right? As your diet includes lot of veggies, can’t this be called as LCHF diet(low carb high fat)? My doctor advices the same diet like yours and he mentions it as LCHF only. Hence this doubt.
So, I have a question…. If I’m supposed to eat only 2 or more ideally 1 meal per day to reach Ketosis, and a I have to consume a lot of greens and basically become a Rabbit! Where do I have enough room for other things like fat and protein and the small amount of carbs? There wouldn’t be enough room in the belly for all that salad plus the other stuff?? Please expound and give a detailed explanation as to how to structure my meals I have been doing Keto for about 2 to 3 months and I’ve noticed yellow in the whites of my eyes which has me kinda freakin out, I just saw this article so I think I’ve been doing something wrong! Please help!
Typical MD giving diet advice. I haven’t eaten any carbs for 4 years and I’m in better health than this guy will ever be. I eat one pound of raw beef, two raw eggs and one stick of butter … daily .. one meal OMAD. Takes me about 5 minutes to eat my breakfast … then I water fast for the remaining 24 hours. I’ve been in ketosis for 4 years and my liver is in great shape.
Ketogenic diet can cause fatty liver only if trans-fats are the source of fat or if the ketogenic diet is way too high in calories for the needs of the organism. Another possibility is if someone is eating too much protein but then ketosis is probably not happening as the excess of protein is converted into glucose preventing ketone bodies to be produced. If ketosis were causing fatty liver, TRADITIONAL isolated tribes like the Inuit, Masai etc would have diet by the age of 4. They are in ketosis almost since birth.
I’m a fan of yours doctor but this might be the worst information you’ve put out there.. you can’t eat unlimited vegetables and stay in ketosis.. on the keto diet you must stay in ketosis in order to lose weight with intermittent fasting and exercise.. 7 – 10 cups of vegetables is just too much. I do use your kale Shake, twice a week.. I eat 3 cups of vegetables a day and I stay in ketosis.. it’s funny ketosis gets a bad rap but it does not cause a fatty liver. people do the keto diet for life and they are just fine. it’s a matter of balance.
God created plants then created man.this is because we need the plants for our healthy survival.plants are what man is meant to feed on.plants has nutrients chemicals blablabla 😊😊 that the human body runs best with.they balance out things in our bodies for our well being.they give u what u need and eliminate what you dont.this is just if u r wondering why Dr Berg enphasises on eating greens always.just my personal opinion.
I already have a fatty liver and can’t absorb fats at all.. they go straight to the TOILET. and WORST Diarhea ever if I eat fat.. Sorry but taking my DOCs advice and staying on my LOW FAT, LOW SUGAR diet. I also have dysautonomia and severe digestion problems.the diet my doc has me on is even more strict then this one.. but losing weight.
All this is confusing because it’s not scientific; it’s basically a guessing game; a trial and error recipe. Most of the scientific literature points to a whole-food plant-based diet as the best for human consumption except in the case of diabetes, for some people, and a few other diseases. Thus, a whole-food plant-based ketogenic diet may be the answer, but studies are presently scarce. However, plain logic suggests that a sensible whole-food plant-based diet would be best for everyone. Sorry carnivores but our digestive system resembles that of a herbivore, not that of a meat-eating animal.
I went on the keto diet about 2 months ago…was taking in anout 80-100 grams or protein powder and quest bars a day…food i did eat like chicken steak vegs but my calories like 800-1000 a day … and keepin carbs at about 50 day …well past 2 weeks i been very sick and having this pain that comes agos at my liver and radiates entire abdominal area and low back…. like somethin is being stressed…even splean area a bit of pain ..had an ultra sound urine work and blood and xray everything came back fine …i did have some constipation though. .i was in and out of doc office losing my mind and patience…..i jus couldnt take this pain and could only think maybe its my diet this keto crap…..so i drove to dairy queen and got a triple patty burger i scarfed it..it was weird my pain went to a ten hurt so bad then all of a sudden down to like a 2 like something passed in the liver area…still have a a very little pain but no where near what it was…like a sharp cramp or stabbing…… I need carbs ..im done with this keto thing it had to have been it…..i dont care about a summer body lol
Many thanks. I’ve been looking for “fatty liver disease cause” for a while now, and I think this has helped. Ever heard of – Fackenzieron Fatigue Filtration – (Have a quick look on google cant remember the place now)? I’ve heard some pretty good things about it and my buddy got excellent results with it.