Cirrhosis and fish oil

The first paper in this post is just the abstract as Wiley Interscience are not particularly generous with access. There are lots of details about the diet (though not quite everything you would really want) in the second paper by the same group which is full text.

These people are using ethanol/fish oil as their model for alcoholic cirrhosis. Now I have been very rude about these models and I should be a little more consistent but, what the... While fish oil/ethanol is a bit strange as a diet the findings are exactly the same as for the corn oil/ethanol combo, nutrients which might warm the cockles of any modern cardiologist's heart.

Here is the first really impossible feat performed by the rats on booze. They can reverse both fatty liver and fibrosis of the liver. Stopping the alcohol intake does not do this UNLESS the fish oil is stopped and replaced with, you guessed, saturated fat. You can choose palm oil or coconut oil, either will do. Dextrose instead of alcohol won't hack it.

Let's pretend humans and rats are the same. Let's pretend fructose and alcohol are the same. Let's pretend fish oil and corn oil are the same. Good game. Probably true.

Let's think about human fatty liver progressing to hepatic fibrosis and inflammation, triggered by fructose and corn oil. I think this is common. Going to a low carb diet to treat fatty liver will clearly fail if all you do is stop the fructose. Something else is needed, something difficult to do in the current nutritional climate. You have also got stop the consumption of corn oil. You have got to eat saturated fat.

Now that is not so easy in a saturophobic climate. How many people with fructose induced hepatopathy, who have been told that the cause is "unknown" are willing to adopt a diet which is based on that ultra demonic, evolutionarily catastrophic monster: PALMITIC ACID? OMG it might increase your LDL. Better die of cirrhosis than increase your LDL!

Anyhoo, back to the fishoil 'n' booze nourished rats:

This paper tells us much more about reversing fish oil/alcohol induced liver damage in rats. The core finding is that you don't even need to stop the alcohol. Just get rid of the fish oil, provided you replace it with saturated fat. So theoretically you could continue to consume fructose while limiting your corn oil consumption, if it is correct that hepatic injury is core to metabolic syndrome...

From my point of view, if we are going to eat real foods which contain some PUFA and some fructose, simply limiting both to easily achievable limits seems a whole load better than the total elimination of one to allow extra consumption of the other...

As always, I have the greatest respect for Kwasniewski and I suspect the concept of liver disease being irreversible is completely specific to the context of the saturophobic modern nurtitional dogma. Waiting until your liver is a minute scrap of scarred fibrous tissue with a mass of non-functional hyperplastic nodules and is at end stage cirrhosis is a bit too late. Having a "mysterious" elevation in ALT is a good time to reach for the beef dripping.

NAFLD and NASH are candidates for reversal.

I'll kick around a few ideas about PUFA, endotoxin and cirrhosis in the next post.

Oh, and fish oil: I think some DHA is a good idea, it has lots of uses in cell membranes. Drinking it by the tablespoon is not something I would recommend! Getting 30% of your calories as fish oil is OUT. Do not do this.

Peter