In professor Roy Taylor’s research, he discovered that the primary cause of type 2 diabetes was the excess accumulation of fat in the liver and pancreas. Fatty liver and diabetes have a co-occurrence rate of 70 %.
While weight gain is associated with fatty liver and type 2 diabetes, it is not the primary cause. But to remove excess fat from the liver and pancreas in people who have developed type 2 diabetes, weight loss is essential.
As Roy Taylor points out, many people are overweight and do not have diabetes, and people with a normal weight and BMI that do have diabetes. People with a normal BMI who have non-alcoholic fatty liver disease are at increased risk for developing diabetes mellitus and metabolic syndrome if they do not implement dramatic lifestyle changes.
The Personal Fat Threshold
The common denominator underlying type 2 diabetes is excess fat in the liver and pancreas. Weight is connected to diabetes, as everyone has their own safe personal fat threshold. This means that some people can safely store large amounts of fat under the skin and in adipose tissue (fat tissue) before accumulating excess fat in the internal organs such as the liver and pancreas.
Other people are not so lucky and have a low personal fat threshold and reduced ability to store fat safely. Thus, these individuals can develop fatty liver and diabetes even with a normal BMI.
Understanding this information and coming across Professor Roy Taylors’ research was very insightful for me as I am prone to insulin resistance, had mild gestational diabetes in the past, and, more recently, an elevated fasting blood sugar just outside the normal range even though I have a “normal BMI.”
Symptomatically, I have always suspected my liver to be the organ underlying my blood sugar issues and other health issues, including SIBO. Dr. Roy Taylor’s research demonstrates the link between fatty liver and diabetes, as liver fat levels were measured in the studies he conducted.
When people with type 2 diabetes lose weight, liver fat levels decrease to within normal ranges, and blood glucose levels normalize. On average, most people with type 2 diabetes have to lose 15 kg for their diabetes to be reversed.
The most crucial factor is that people must reduce their weight to be below their personal fat threshold, which will differ between individuals.
The Counterpoint Study
In the counterpoint study, the average liver fat level in type 2 diabetes averaged 13%, much higher than the normal range of liver fat under 5%. Even more shocking is that the participants were unaware of any liver problems!
After implementing a low-calorie diet consisting of liquid protein shakes and nonstarchy vegetables, the participants lost weight, reduced their liver fat levels into normal ranges, and thus reversed their diabetes.
It is also important to note that pancreas fat levels also decreased, resulting in the beta cells producing more insulin.
One of the most fascinating results of the counterpoint study is that within seven days of implementing the very low-calorie diet, the participants’ fasting blood sugar fell within the normal ranges as fat levels reduced in the liver!
Cause of type 2 diabetes
According to Professor Roy Taylor’s research, the cause of type 2 diabetes is excess fat in the liver and pancreas due to the overconsumption of calories. When someone reaches their personal fat threshold, and thus their ability to safely store fat in adipose tissue, the excess calories consumed are converted to fat and begin accumulating in the liver and pancreas.
In our modern culture, food is everywhere, and many people are overconsuming calories and thus slowly gaining weight over time. Once you reach your personal fat threshold, those excess calories become extremely harmful to the body as they are converted into fat stored in the liver and pancreas.
As Roy Taylor says, an extra mouthful of food every day adds up. It leads to fatty liver and diabetes, especially if you never implement intermittent fasting or days of eating fewer calories than you are burning.
Low-calorie diet for fatty liver and diabetes
Since excess calories drive weight gain and fat accumulation in the liver, the key to reversing fatty liver and type 2 diabetes is a low-calorie diet. All calories, when they are overconsumed, contribute to excess fat in the body, whether they come from fat, protein, or carbs. For this reason, the best diet to reverse fatty liver is a hypocaloric diet.
Professor Roy Taylor recommends a hypocaloric diet of no more than 800 calories per day during the initial phase of rapid weight loss. This phase lasts for eight weeks for most people with type 2 diabetes.
The simplest way to implement this diet is by using a liquid formula protein shake with the essential vitamins and minerals the body needs. Drink the shake 3x a day as a meal replacement, then enjoy 100-200 calories of nonstarchy vegetables.
Once weight loss is achieved, liver fat is normalized, and blood glucose drops back to normal, slowly reintroduce healthy whole foods, being mindful of portion sizes and not overeating. Weight regain due to excess calorie consumption will lead to fatty liver and diabetes return if you regain the weight and surpass your personal fat threshold.
While it is possible to reverse fatty liver and type 2 diabetes, the duration of diabetes does impact your ability to reverse diabetes. Short duration diabetes of 5 years or less has a much higher chance of reversal than someone who has had diabetes for 20 years or more. If you have packed on extra pounds or are in the prediabetic range, take action now to prevent fatty liver and diabetes from developing.
APOE 4 and Diabetes
I focus on a lower-fat plant-based diet to maintain my weight as I have an APOE4 gene. This gene is involved in fat transportation; thus, I have a reduced ability to process and clear fats. Based on my research, avoiding saturated fats that increase insulin resistance is best, especially if you have this gene.
If I overconsume saturated fats and oily foods such as nachos, pizza, and cheese, especially at my dinner meal (which I don’t often do), I would get a higher fasting blood sugar reading the next day.
On the flip side, the consumption of beets at my dinner meal would improve my fasting blood sugar the following day, especially on days that I ate a low-fat plant-based diet where I did not overeat and ate a lighter dinner meal.
Research has found the E4 allele of the APOE gene to be an independent risk factor for developing type 2 diabetes. For anyone with this gene, a low-fat diet recommended by Robby and Cyrus from Mastering Diabetes may also be necessary to reverse insulin resistance. While there is not a lot of research on the link between APOE 4 and diabetes, I have always suspected it to be part of the reason why I am prone to insulin resistance and a higher fasting blood sugar outside the optimal range even with a NORMAL BMI on the low end of normal!
With so many contradicting diets for weight loss, such as the low-fat or keto diet, I love that Roy Taylor simplifies the advice. According to Roy Taylor, the best diet for fatty liver and diabetes is a hypo-caloric diet.
Meaning you are eating fewer calories than you are burning. A hypocaloric diet allows your body to tap into the liver, pancreas, and adipose fat for fuel to burn. Get rid of the excess fat, and your non-alcoholic fatty liver disease and diabetes can be reversed!
Many people don’t know that they have a fatty liver or are prediabetic, as you may not initially have any symptoms. For this reason, having your fasting blood sugar levels checked is a good idea. My blood sugar post meals were always in range, yet my fasting blood sugar was slightly elevated. In the morning, after an overnight fast, your liver puts excess sugar into the bloodstream due to insulin resistance.
Get your fasting blood sugar checked by your doctor, or take your health into your own hands and purchase your own blood glucose meter and test strips to monitor your blood sugar levels. After gaining an extra 10 pounds, I randomly checked my fasting blood sugar in the morning. I was surprised when I got a reading of 5.8 as I did not have any significant symptoms aside from a bit of weight gain, stomach pudge. I had mild gestational diabetes in the past but reduced my fasting blood sugar to well within normal ranges.
Many people with non-alcoholic fatty liver are asymptomatic. In some cases, the liver enzymes alanine aminotransferase and aspartate are elevated. However, liver enzymes may not be elevated in all cases of NAFLD. The prevalence of fatty liver and diabetes is estimated to be greater than 70 % in obese adults with type 2 diabetes.
While there are genetic factors that can predispose someone to type 2 diabetes, the primary environmental risk factors are increased calorie intake and decreased physical activity. Reducing your calorie intake to lower your body weight while concurrently increasing your physical activity, such as a 10-minute walk after every meal, is an effective and easy way to improve insulin sensitivity.
Research has shown that weight loss achieved by exercise and diet is effective in preventing and treating non-alcoholic fatty liver in overweight people with type 2 diabetes. Bariatric surgery, which drastically decreases someone’s caloric intake, has been shown to reverse NAFLD in type 2 diabetics.
Resources and additional information for reversing fatty liver and diabetes
For more information, I highly recommend reading Life Without Diabetes, written by Professor Roy Taylor, a leading Diabetes Researcher. Check out this podcast with Roy Taylor on the Proof with Simon Hill, as this information will change your life if you have a fatty liver and diabetes.
Also be sure to read the PDF slides for his research studies in the links below including
- Counterpoint (PDF: 678KB)
- Counterbalance (PDF: 701KB)
- pancreas fat (PDF: 207KB)
- the DiRECT study (PDF: 95KB)
- personal fat thresholds (PDF: 481KB)
- Physiological mechanisms lecture to ADA (PDF: 375KB)
- Insulin secretion recovery during remission (PDF: 274KB)
- Pancreas volume during remission (PDF: 136KB)
- ReTUNE Study Slides
Check out some of these low-calorie smoothies and shakes I created that were inspired by his book and work!
Since fatty liver is associated with type 2 diabetes I also focus on including foods, teas and supplements that are good for fatty liver such as:
- Beets for diabetes
- Apple cider vinegar for fatty liver
- Hibiscus tea for fatty liver
- Cherries for Fatty Liver
- Omega 3 fats
- phosphatidylcholine for fatty liver and the PEMT gene
- Magnesium for insulin resistance