Skip to main content
Top
Published in: Surgical Endoscopy 8/2007

01-08-2007

The effect of a low-carbohydrate diet on the nonalcoholic fatty liver in morbidly obese patients before bariatric surgery

Authors: O. Benjaminov, N. Beglaibter, L. Gindy, H. Spivak, P. Singer, M. Wienberg, A. Stark, M. Rubin

Published in: Surgical Endoscopy | Issue 8/2007

Login to get access

Abstract

Background

Bariatric surgery may be complicated by enlargement of the liver, especially of the left lobe, caused by nonalcoholic fatty liver disease often present with morbid obesity.

Methods

The effect of a very low carbohydrate diet for 4 weeks before surgery on liver density and volume was assessed in 14 candidates for bariatric surgery. Computed tomography (CT) scans were performed before and at termination of the diet period.

Results

The CT scans clearly showed a significant increase in mean liver density (p = 0.06) and a decrease in mean liver volume (p = 0.01). The increased mean density of the left lobe was markedly greater than that of the right lobe.

Conclusions

The findings show that 4 weeks of a very low carbohydrate diet reduces liver fat content and liver size, particularly of the left lobe. This approach may render bariatric surgery or any foregut operations less difficult in morbidly obese patients and may be a useful treatment for nonalcoholic fatty liver disease.
Literature
1.
go back to reference Adams LA, Lymp JF, St Sauveur J, Sanderson SO, Lindor KD, Feldstein A, Angulo P (2005) The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology 129: 113–121PubMedCrossRef Adams LA, Lymp JF, St Sauveur J, Sanderson SO, Lindor KD, Feldstein A, Angulo P (2005) The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology 129: 113–121PubMedCrossRef
2.
go back to reference Alfalah H, Phillipe B, Ghazal F, Jany T, Arnalsteen L, Romon M, Pattou F (2006) Intragastric balloon for preoperative weight reduction in candidates for laparoscopic gastric bypass with massive obesity. Obes Surg 16: 147–150PubMedCrossRef Alfalah H, Phillipe B, Ghazal F, Jany T, Arnalsteen L, Romon M, Pattou F (2006) Intragastric balloon for preoperative weight reduction in candidates for laparoscopic gastric bypass with massive obesity. Obes Surg 16: 147–150PubMedCrossRef
3.
go back to reference Beymer C, Kowdley KV, Larson A, Edmonson P, Dellinger EP, Flum DR (2003) Prevalence and predictors of asymptomatic liver disease in patients undergoing gastric bypass surgery. Arch Surg 138: 1240–1244PubMedCrossRef Beymer C, Kowdley KV, Larson A, Edmonson P, Dellinger EP, Flum DR (2003) Prevalence and predictors of asymptomatic liver disease in patients undergoing gastric bypass surgery. Arch Surg 138: 1240–1244PubMedCrossRef
4.
go back to reference Eriksson S, Eriksson KF, Bondesson L (1986) Nonalcoholic steatohepatitis in obesity: a reversible condition. Acta Med Scand 220: 83–88PubMedCrossRef Eriksson S, Eriksson KF, Bondesson L (1986) Nonalcoholic steatohepatitis in obesity: a reversible condition. Acta Med Scand 220: 83–88PubMedCrossRef
5.
go back to reference Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S (2003) A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 348: 2082–2090PubMedCrossRef Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S (2003) A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 348: 2082–2090PubMedCrossRef
6.
7.
go back to reference Gill HK, Wu GY (2006) Nonalcoholic fatty liver disease and the metabolic syndrome: effects of weight loss and a review of popular diets: are low-carbohydrate diets the answer? World J Gastroenterol 12: 345–353PubMed Gill HK, Wu GY (2006) Nonalcoholic fatty liver disease and the metabolic syndrome: effects of weight loss and a review of popular diets: are low-carbohydrate diets the answer? World J Gastroenterol 12: 345–353PubMed
8.
go back to reference Hwang S, Lee SG, Jang SJ, Cho SH, Kim KH, Ahn CS, Moon DB, Ha TY (2004) The effect of donor weight reduction on hepatic steatosis for living donor liver transplantation. Liver Transpl 10: 721–725PubMedCrossRef Hwang S, Lee SG, Jang SJ, Cho SH, Kim KH, Ahn CS, Moon DB, Ha TY (2004) The effect of donor weight reduction on hepatic steatosis for living donor liver transplantation. Liver Transpl 10: 721–725PubMedCrossRef
9.
go back to reference Lewis MC, Phillips ML, Slavotinek JP, Kow L, Thompson CH, Toouli J (2006) Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg 16: 697–701PubMedCrossRef Lewis MC, Phillips ML, Slavotinek JP, Kow L, Thompson CH, Toouli J (2006) Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg 16: 697–701PubMedCrossRef
10.
go back to reference Luyckx FH, Desaive C, Thiry A, Dewe W, Scheen AJ, Gielen JE, Lefebvre PJ (1998) Liver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty. Int J Obes Relat Metab Disord 22: 222–226PubMedCrossRef Luyckx FH, Desaive C, Thiry A, Dewe W, Scheen AJ, Gielen JE, Lefebvre PJ (1998) Liver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty. Int J Obes Relat Metab Disord 22: 222–226PubMedCrossRef
11.
go back to reference Mattar SG, Velcu LM, Rabinovitz M, Demetris AJ, Krasinskas AM, Barinas EM, Eid GM, Ramanathan R, Taylor DS, Schauer PR (2005) Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann Surg 242: 610–620PubMed Mattar SG, Velcu LM, Rabinovitz M, Demetris AJ, Krasinskas AM, Barinas EM, Eid GM, Ramanathan R, Taylor DS, Schauer PR (2005) Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Ann Surg 242: 610–620PubMed
12.
go back to reference Nakamuta M, Morizono S, Soejima Y, Yoshizumi T, Aishima S, Takasugi S, Yoshimitsu K, Enjoji M, Kotoh K, Taketomi A, Uchiyama H, Shimada M, Nawata H, Maehara Y (2005) Short-term intensive treatment for donors with hepatic steatosis in living-donor liver transplantation. Transplantation 80: 608–612PubMedCrossRef Nakamuta M, Morizono S, Soejima Y, Yoshizumi T, Aishima S, Takasugi S, Yoshimitsu K, Enjoji M, Kotoh K, Taketomi A, Uchiyama H, Shimada M, Nawata H, Maehara Y (2005) Short-term intensive treatment for donors with hepatic steatosis in living-donor liver transplantation. Transplantation 80: 608–612PubMedCrossRef
13.
go back to reference Nomura F, Ohnishi K, Ochiai T, Okuda K (1987) Obesity-related nonalcoholic fatty liver: CT features and follow-up studies after low-calorie diet. Radiology 162: 845–847PubMed Nomura F, Ohnishi K, Ochiai T, Okuda K (1987) Obesity-related nonalcoholic fatty liver: CT features and follow-up studies after low-calorie diet. Radiology 162: 845–847PubMed
14.
go back to reference Papadia FS, Marinari GM, Camerinei G, Murelli F, Carlini F, Stabilini C, Scopinaro N (2004) Liver damage in severely obese patients: clinical-biochemical-morphologic study on 1,000 liver biopsies. Obes Surg 14: 952–958PubMedCrossRef Papadia FS, Marinari GM, Camerinei G, Murelli F, Carlini F, Stabilini C, Scopinaro N (2004) Liver damage in severely obese patients: clinical-biochemical-morphologic study on 1,000 liver biopsies. Obes Surg 14: 952–958PubMedCrossRef
15.
go back to reference Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA (1980) Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. Radiology 137: 727–729PubMed Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA (1980) Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. Radiology 137: 727–729PubMed
16.
go back to reference Posulka PS, Bistrain BR, Benotti PN, Blackburn GL (1986) The risks of surgery in obese patients. Ann Intern Med 104: 540–546 Posulka PS, Bistrain BR, Benotti PN, Blackburn GL (1986) The risks of surgery in obese patients. Ann Intern Med 104: 540–546
17.
go back to reference Schwartz JM, Linfoot P, Dare D, Aghajanian K (2003) Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high fat, low-carbohydrate and low-fat, high-carbohydrate isoenergenic diets. Am J Clin Nutr 77:43–50 Schwartz JM, Linfoot P, Dare D, Aghajanian K (2003) Hepatic de novo lipogenesis in normoinsulinemic and hyperinsulinemic subjects consuming high fat, low-carbohydrate and low-fat, high-carbohydrate isoenergenic diets. Am J Clin Nutr 77:43–50
18.
go back to reference Sjostorm CD, Lissner L, Wedel H, Sjostorm L (1999) Reduction in incidence of diabetes, hypertension, and lipid disturbance after intentional weight loss induced by bariatric surgery: the SOS intervention study. Obes Res 7: 477–484 Sjostorm CD, Lissner L, Wedel H, Sjostorm L (1999) Reduction in incidence of diabetes, hypertension, and lipid disturbance after intentional weight loss induced by bariatric surgery: the SOS intervention study. Obes Res 7: 477–484
19.
go back to reference Solga S, Alkhuraishe AR, Clark JM, Torbenson M, Greenwald A, Diehl AM, Magnuson T (2004) Dietary composition and nonalcoholic fatty liver disease. Dig Dis Sci 49: 1578–1583PubMedCrossRef Solga S, Alkhuraishe AR, Clark JM, Torbenson M, Greenwald A, Diehl AM, Magnuson T (2004) Dietary composition and nonalcoholic fatty liver disease. Dig Dis Sci 49: 1578–1583PubMedCrossRef
20.
go back to reference Volek J, Sharman M, Gomez A, Judelson D, Rubin MR, Watson G, Sokmen B, Silvestre R, French D, Kraemer W (2004) Comparison of energy-restricted very low carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutr Metabol 1: 1–13CrossRef Volek J, Sharman M, Gomez A, Judelson D, Rubin MR, Watson G, Sokmen B, Silvestre R, French D, Kraemer W (2004) Comparison of energy-restricted very low carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutr Metabol 1: 1–13CrossRef
Metadata
Title
The effect of a low-carbohydrate diet on the nonalcoholic fatty liver in morbidly obese patients before bariatric surgery
Authors
O. Benjaminov
N. Beglaibter
L. Gindy
H. Spivak
P. Singer
M. Wienberg
A. Stark
M. Rubin
Publication date
01-08-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9182-8

Other articles of this Issue 8/2007

Surgical Endoscopy 8/2007 Go to the issue