Author: Janice Man
Editors: Sarah Armes & Jenneffer Tibaes
Contributors: Sumantra Ray & Matheus Abrantes
Acknowledgements: NNEdPro Global Institute for Food, Nutrition and Health, International Academy of Nutrition Educators (IANE), BMJ Nutrition, Prevention & Health, Francis W. B. Sanders, Animesh Acharjee, Celia Walker, Luke Marney, Lee D. Roberts, Fumiaki Imamura, Benjamin Jenkins, Jack Case, Sumantra Ray, Samuel Virtue, Antonio Vidal-Puig, Diana Kuh, Rebecca Hardy, Michael Allison, Nita Forouhi, Andrew J. Murray, Nick Wareham, Michele Vacca, Albert Koulman, and Julian L. Griffin
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is becoming an increasingly common health concern worldwide, affecting millions of people across various age groups. Often linked with obesity and metabolic syndrome, MASLD is characterised by the abnormal accumulation of fat in the liver, which can progress to more severe liver conditions if left untreated. While excessive fat intake has long been blamed for this condition, recent research reveals that the story is far more complex. This study investigates the link between carbohydrate consumption and hepatic steatosis, with a specific focus on de novo lipogenesis (DNL) — the process by which the liver converts excess carbohydrates into fatty acids. The researchers hypothesise that increased DNL following carbohydrate intake contributes to developing and exacerbating hepatic steatosis, thus identifying a metabolic pathway that may influence the risk of fatty liver disease. Understanding this mechanism is crucial in determining dietary strategies to mitigate MASLD progression.
Key Findings:
Elevated De Novo Lipogenesis (DNL) Following Carbohydrate Consumption: The study found that individuals with hepatic steatosis exhibited significantly elevated DNL activity after consuming carbohydrate-rich meals. This suggests that carbohydrates, particularly refined sugars, fuel lipid synthesis in the liver, leading to fat accumulation.
Insulin Resistance and Lipogenesis: Insulin resistance was positively correlated with increased DNL. Insulin resistance, common in metabolic syndromes, impairs the body's ability to regulate DNL, resulting in more fat being synthesised and stored in the liver.
Dietary Carbohydrate Composition Matters: The composition of carbohydrates in the diet plays a crucial role in modulating DNL. Simple sugars, such as fructose, were more potent in stimulating DNL than complex carbohydrates. This indicates that not all carbohydrates pose the same risk for hepatic steatosis. While simple sugars rapidly increase blood glucose and insulin levels, contributing to fat synthesis, complex carbohydrates are metabolised more slowly, posing a lower risk.
Protective Role of Dietary Fat Substitution: Substituting certain dietary fats for carbohydrates was shown to reduce DNL and, consequently, hepatic fat content. However, the type of fat substituted matters—monounsaturated and polyunsaturated fats (found in foods like olive oil, nuts, and fish) are generally more protective against MASLD compared to saturated fats. This suggests that a low-carbohydrate, high-fat diet may be protective against hepatic steatosis in some individuals.
Impact on Weight Loss and Liver Health: The results indicated that reducing carbohydrate intake, particularly sugars, decreased DNL and helped reduce overall liver fat content. This highlights the potential of carbohydrate restriction in managing MASLD alongside other lifestyle modifications such as exercise and weight loss.
The study's findings have significant implications for managing and preventing hepatic steatosis and MASLD. By identifying the direct link between carbohydrate consumption, DNL, and hepatic fat accumulation, the research suggests that dietary interventions focusing on reducing refined sugars and limiting carbohydrate intake could be crucial in preventing and treating MASLD. This is especially relevant for individuals with insulin resistance, where managing carbohydrate intake may help reduce the liver's tendency to synthesise excess fat. These insights contribute to developing more targeted nutritional guidelines and therapeutic approaches for managing fatty liver disease.
If you are interested in reading more about this study, click here.
10th International Summit on Food, Nutrition and Health, Democratising & Decolonising Food & Nutrition: From Science to Society
The NNEdPro Global Institute for Food, Nutrition and Health, in partnership with the International Academy of Nutrition Educators (IANE) and BMJ Nutrition, Prevention & Health, is hosting an upcoming Summit, "Democratising and Decolonising Food and Nutrition: From Science to Society" from December 17th to 20th in Kolkata, India.
This event promotes global collaboration by incorporating various perspectives into food and nutrition research, education, practice, and policy. The Summit will emphasise the importance of inclusive dialogue, focusing on contributions from historically marginalised communities, and will explore strategies to connect traditional knowledge with modern scientific approaches.
Learn more about the Summit and register here. If you have any questions, please contact us at learning@nnedpro.org.uk
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