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From:	Chris Masterjohn (cache-dtc-ab02.proxy.aol.com)
Subject:	Re: Fatty Liver - easing into low-fat with saturated plant fats?
Date:	January 4, 2007 at 6:21 am PST

In Reply to: Fatty Liver - Afraid of fast weight loss posted by Kaylu on December 31, 2006 at 10:18 am:

There's some evidence that fatty liver requires polyunsaturated fats in the diet, and that saturated fats are protective. Perhaps you could ease into Dr. Fuhrman's program without quickly reducing your caloric intake too much (if that's what you're worried about?) first by replacing your polyunsaturated fats with saturated fats, and then reducing these over time. Coconut oil, palm oil, and cocoa butter could be used. In their unrefined states these oils are very nutritious also, especially palm oil.

In mice, alcohol can only induce fatty liver damage in the presence of polyunsaturated fatty acids (PUFA). See, for example:

You, et al., "Role of Adiponectin in the Protective Action of Dietary Saturated Fat Against Alcoholic Fatty Liver in Mice," Hepatology, 42 (2005) 568-577.

In this study rats were fed either a 40% corn oil diet (high PUFA) or a 40% cocoa butter diet (high saturated fatty acid [SFA]), and a whopping 27.5% of their calories as ALCOHOL.

In the PUFA diet, massive fatty liver damage ensued. In the SFA diet, there was NO fatty liver damage. Likewise, in the PUFA diet, liver enzymes, which are markers of liver damage, increased 4.5-fold, whereas liver enzymes did not increase at all in the SFA diet.

Although fatty liver itself hasn't been addressed in humans, there is some indication that the same phenomeonon is generally liver-protective in humans. For example, in:

Oosthuizen, et al., "Polyunsaturated fatty acid intake is adversely related to liver function in HIV-infected subjects: the THUSA study," American Journal of Clinical Nutrition, 83 (2006) 1193-8.

Liver enzyme levels, indicating liver damage, in asymptomatic HIV-positive subjects, were positively correlated with PUFA and with the PUFA:SFA ratio.

Although I would like to see Dr. Fuhrman's appraoch tested in a controlled trial, if it is as successful as he claims, perhaps part of it comes from the restriction of PUFA that is a natural corollary of the restriction of fat.

Similar to the fatty liver studies, this study:

Mozaffarian, et al., "Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women," American Journal of Clinical Nutrition, 80 (2004) 1175-84.

From lowest to highest intake of saturated fat, there was a monotonic and highly statistically significant decrease in the percent increase of arterial occlusion. In the highest quartile of saturated fat intake, atherosclerosis actually REVERSED.

So, the question becomes, was the saturated fat helpful itself, or was it displacing something that was harmful?

Consider this:

Every 5% increase in the proportion of energy intake from saturated fat was associated with a 0.16-mm lower decline in mean minimal coronary artery diameter and 5.8 fewer percentage points increase in mean percentage stenosis (and of course in the highest intake there was an actual expansion of diameter and decrease in stenosis).

By contrast, there was a 0.17-mm greater decline in mean minimal coronary artery diameter and a 5.8 percentage point increase in mean percentage stenosis for each 5% increase in polyunsaturated fat.

So, perhaps a way to ease into Dr. Fuhrman's program might be to switch your oils to coconut oil, palm oil or cocoa butter, and then gradually lower your fat intake according to Fuhrman's plan.

Chris

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