Thread by @lowcarbGP

1/4: GRAPH OF THE WEEK! Abnormal liver function, fatty liver #NAFLD #NASH now affects 20% of the developed world BUT WHY? For years I thought it was drugs or alcohol, so did the Three gastroenterologists who saw this lady between 1996 and 2009 Look rapid improvement on low carb

2/4 Who knew but we make liver fat not from dietary fats but sugar and starchy carbs Its called De novo lipogenesis. Guess what insulin and glucose is involved, look doi.org/10.1172/JCI134… The liver fat produced is called triglyceride and is more important than I used to think

3/4 So its like insulin pushes blood glucose into liver cells which turn it into triglyceride. Over time the liver fills with this fat hence #fattyliver #NAFLD also inflammation may set in #NASH My free @rcgp podcast is here only 18 mins @MartinRCGP elearning.rcgp.org.uk/mod/page/view.…

4/4 So back to our patient Now it is not a surprise to see she has maintained the best triglyceride level for TEN YEARS by cutting sugar and starchy carbs But look at the seemingly inverse relationship with the HDL Which is nice to see as its protective -up is good @FatEmperor