The latest fad diets promise to reduce the fat in your liver. This is a noble aim--the amount of fat in your liver correlates closely to cardiovascular risk. Liver fat also appears to increase insulin resistance, though it is interesting to note that very recent research has found that pancreatic fat has a strong relationship to the development of Type 2 diabetes and may in fact be more important than liver fat.

The problem with the premise behind the fad diets, though, is that there is no significant research showing any treatment, be it a drug, diet or exercise, to be uniformly effective in reducing pre-existing liver fat.

The studies usually cited to advance one or the other dietary approach as a cure for fatty liver are either correlational studies, rodent studies, or studies that examine only surrogate markers--lab tests--rather than studies that biopsy the liver to see how much fat is in it.

The correlational studies are those where the researchers link a population's reported food intake with their risk of developing fatty liver. This kind of research may point to factors that cause fatty liver--though it also may not, given the poor track record of these kinds of studies, since they are based on questionnaires that do not accurately reflect what people really eat.

The correlation studies suggest that eating a high carbohydrate diet raises the risk of developing fatty liver. Fructose in particular seems to pile on the liver fat but any diet that results in high triglyceride levels looks like one that can damage the liver.

But the problem in applying this data to reversing liver disease is this: Once you develop a condition that correlates to a food intake pattern, it is not at all clear that eliminating the causative foods will eliminate the condition.

In the case of fat-related problems, you have only to remember that once new fat cells form, they never go away. You can reduce the amount of fat in each cell, but the cells themselves remain. (This is one reason why Avandia and Actos are such worrisome drugs, because they work by creating new fat cells in the arms and legs, cells that you are stuck with for life after taking these drugs.)

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