Wednesday, April 6, 2011

My New Wise Traditions Article on Nonalcoholic Fatty Liver Disease

by Chris Masterjohn

I have a new article on nonalcoholic fatty liver disease appearing in the outgoing issue of Wise Traditions, and the online version just went up on the web site:

The article contains a lot of information that I've already posted on this blog, but it also contains quite a bit of additional information, and pulls everything together a little more succinctly.

In the article, I argue that fatty liver is essentially the consequence of several independent nutritional assaults.  These include 1) nutrient-poor refined foods, 2) choline deficiency, and 3) polyunsaturated oils.  Fatty liver can basically be divided into two stages, the first involving the accumulation of fat, and the second involving the progression of inflammation.  The first, I argue, results from too much caloric energy entering the liver without sufficient nutrition to process it, while the second results from any type of oxidative and inflammatory insults, with excess dietary linoleic acid making a special contribution.

I point out that none of the animal models, whether they are high in fructose, high in fat, or deficient in choline, actually look like human fatty liver until they are combined together, emphasizing that human fatty liver is likely a result of a combination of insults.

I also point out that the liver plays an enormous role in our overall health, from regulating blood sugar and blood lipids to filtering bacteria and their toxins to regulating hormones and vitamin D, and that fatty liver is a much more powerful predictor of heart disease risk even than "metabolic syndrome."

For those of you willing to support the Weston A. Price Foundation, I would highly recommend subscribing to the journal.  My articles contain a lot of sidebars, and there is really no pleasant way to arrange them online.  Reading the article in print is much more enjoyable.  Nevertheless, I believe most of you would find the information valuable, so I invite you to hop on over and read the article online.

Read more about the author, Chris Masterjohn, PhD, here.


  1. Hi Chris,
    Have you seen this article ? Researchers find link between common dietary fat, intestinal microbes and heart disease

  2. Chris, I don't want to bother you with medical questions too much, but perhaps you can give some guidance.

    I'm not fat, but I do drink. 2-3 glasses of wine a day.

    I like to schedule some "off-drinking" time and let my liver recover. Have you seen any literature on how quickly fatty liver might resolve itself?

    Personally, when I do stop drinking, I notice subtle changes in week 1 and 2, but nothing really until month 1 or 2. Hard to measure, since sleep and hydration patters really change when you stop drinking.

  3. Thanks for this excelent article on Wise Traditions. Are you aware of the study "Dietary composition and nonalcoholic fatty liver disease" that found a relative risk for inflammation of 6.5 with a higher CHO intake?

  4. Hi Chris,

    Thank you for all the time and effort you put into your blog posts, articles and your website. I think you are a great educator, and for a layman like myself your work is a fantastic resource. I gain valuable new insights with every visit.

    This NAFLD article was almost like you read my mind. Ever since I commented in the fasting insulin/calories in-out post at Peter's Hyperlipid, I tried to come up with an explanation for weight gain/obesity due to overfeeding, without 'violating' the leptin based lipostat theory. My best guess: liver impairment due to a choline deficiency, based on your "Sweet Truth About Liver and Egg Yolks" post (energy intake ↑ → choline requirement ↑). Sure enough, a few days later, your NAFLD article went online :-)

    The choline/nutrient deficiency hypothesis seems to have the potential to tie a lot of ends together: why things like refining, high palatability, chronic overeating, all can result in metabolic problems and secondary effects like weight gain.
    And what's funny: on the surface conventional wisdom appears to be right about weight, in that it's all about calories. But reality seems more nuanced: it seems all about how many nutrients (and toxins) come with the calories.


  5. Chris,
    Your blog rocks. Sorry my tweet seemed to dismiss your reasoning here.

    @John, it's not about the calories. I'm a 200lb lean, muscular guy who used to weigh 300lbs. I don't have to exercise anymore and haven't in 18 months. For 5 years time, I've been on 5,000 calories/day, 60% fat, 20% protein, 20% veg (gf butter, beef & lamb, egg yolks, coconut, MCT, avocado) diet. I am about to publish (Wiley & Sons) my book about using this diet before and during preganancy to cause epigenetic changes to make smarter babies.

    Chris, I also researched extensively the role of endotoxins and exotoxins and came up with similar conclusions to yours, along with a map of low-toxin food choices, including cooking method changes. But the worst offender by far is not bacteria in the gut. It's low grade systemic yeast infections and exogenous low level mold in food. Both of these represent hormone disruption (estrogen mimicking) but even worse, they disrupt gut bacteria, making them excrete more toxins.

    In choline-sufficient diets, methionine may even be unhealthy. I have a paper floating around here somewhere looking at how restricting methionine, cysteine, and tryptophan caused dramatic reduction of aging on par with caloric restriction.

    Finally, while phosphatidyl choline is great, I reached a point where my acetylcholine levels got too high from using choline supplements (non-gmo soy lecithin, or alpha-GPC, CDP-choline, etc.) Egg yolks don't do this. The first symptom of acetylcholine excess was jaw clenching.

    Chris - like I said, you rock. If you ever want to present at, just ask. Gary Taubes did recently. My hat goes off to you guys for doing the hard work to document and justify what I *know* works through my own experience as a biohacker.

  6. For anyone who has not seen this video, it describes in detail connections between fructose, alcohol, and fatty liver.

  7. I'm kind of proud to myself that since the year started, I've never been into any alcoholic stuff anymore. I just feel the need of having a clean living, having a sound mind as well as fit body. I find those things very lovely.

  8. Is Wise Traditions only available in northern America?

  9. Chris, I have been following your liver posts with great interest. Thank you for the series.

    I have recently been researching aspartame in an attempt to cut through the BS that is rampant on the internet. I came across some posts by a doctor that mentioned that one of the by-products of the breakdown of aspartame, methanol, breaks down into formic acid, which is then metabolized by folate (fruit and vegetable juices also breakdown into higher concentrations of methanol but natively contain some folate). He also claims that caffeine requires folate to metabolize.

    "But worse, in this case that added ‘cargo’ could well involve both folate issues and the caffeine in diet Pepsi. Caffeine generates two equivalents of formate during degradation compared to one from aspartame’s methanol. But both caffeine and aspartame require folate for detoxification, so again any issue with ‘diet Pepsi’ likely reflects personal health problems with folate or folate-related biochemistry, not the soft drink itself."

    This caught my attention, based on your recent blog posts on the liver, since folate is mentioned as preserving choline.

    I have tried to research these claims and, to my untrained eye, they appear valid. However, I am not a scientist and there is a lot of bad science out there to wade through so it is hard for me to tell if aspartame and caffeine "use up" folate in the body and can lead to a deficiency.

    In your research, have you run across anything that can back up these claims? Can consuming food and drinks containing caffeine and/or aspartame lead to folate deficiency, thus impacting the liver negatively?

  10. I also meant to ask if there were other foods and drinks that "use up" folate (it appears that alcohol and smoking does)? It may be possible to reduce the folate requirement by eliminating any non-essentials that do.

  11. A couple of things strike me:

    1. If a diet sufficiently rich in choline completely protects against fat accumulation in the liver due to fructose, ethanol or fat, does that mean that provided we have sufficient choline in our diet, we can guzzle on fructose to our heart's content? Ditto alcohol...?

    2. Those of us on low carb (high fat) diets, even though we may abstain from fructose and alcohol, because we are high in dietary fat, also need to keep up our supply of choline (so lots of eggs and liver).

    1. did you ever get an answer?

    2. Sorry, no I don't think it necessarily follows that *only* choline is important. However, I think that excess alcohol is much more likely to be harmful than excess fructose because it promotes oxidative stress. Animal studies suggest that low-PUFA, highly saturated fats are very powerfully protective against the effect of ethanol, though it hasn't been studied in humans to my knowledge.


  12. Thank you for the time and effort you put into your blog posts, articles and your website. Informative stuff.

  13. An interesting view, I think this sort of information needs to be made more publicly available for people to fully understand the harm they are doing to their bodies

  14. Luck to come across your excellent blog. Your blog brings me a useful than ever before stuff in your blog, especially its discussion.

  15. I admire the valuable information you offer in your articles. Thanks.