Fatty liver disease has become extremely common as rates of obesity and type 2 diabetes have risen around the world.
The condition develops when too much fat collects inside liver cells, even in people who drink little or no alcohol.
The condition was long known as non-alcoholic fatty liver disease, or NAFLD.
Medical experts now increasingly use the name metabolic dysfunction-associated steatotic liver disease, or MASLD, because the disease is closely connected with metabolic problems such as excess weight, insulin resistance and type 2 diabetes.
For many people, fatty liver causes no obvious symptoms at first. But in some cases, continued fat buildup can lead to inflammation, scarring and eventually severe liver damage.
Fatty liver disease is also closely linked with health problems outside the liver. People with the condition often have a higher risk of type 2 diabetes and heart and blood vessel disease.
Researchers have therefore been searching for practical ways to reduce liver fat. A study led by Huating Li of Shanghai Sixth People’s Hospital suggests that a special form of carbohydrate called resistant starch may help.
The research was published in the journal Cell Metabolism. It involved 200 people with fatty liver disease who were assigned to receive either resistant starch or a comparison starch.
Participants in the treatment group received resistant starch made from maize. They took 20 grams mixed with water twice a day before meals for four months.
The comparison group received a similar corn starch that was more easily digested. This allowed researchers to examine whether resistant starch itself produced benefits beyond simply adding starch to the diet.
After four months, people taking resistant starch had substantially less fat in their livers. Liver triglyceride levels were almost 40% lower compared with the control group.
Triglycerides are a form of fat used by the body to store energy. When too much accumulates inside the liver, it can contribute to fatty liver disease and may increase the risk of inflammation and damage.
The resistant starch group also showed improvements in blood tests linked with liver health and inflammation. Importantly, the researchers found that the benefits could not be explained only by differences in weight loss.
To understand why the starch might affect the liver, the scientists examined bacteria living in the participants’ intestines. The enormous community of bacteria and other microorganisms in the digestive system is often called the gut microbiome.
Resistant starch behaves differently from ordinary digestible starch. Much of it escapes digestion in the small intestine and travels farther through the digestive system.
When it reaches the large intestine, gut bacteria can ferment it. This process produces substances including short-chain fatty acids, which can influence the gut and metabolism elsewhere in the body.
The researchers found that resistant starch changed the participants’ gut bacteria. One notable change was a reduction in Bacteroides stercoris, a bacterial species that the researchers linked with metabolic processes related to liver fat.
This supports a growing idea in medicine that the gut and liver communicate closely. Substances produced by intestinal bacteria can reach the liver through the bloodstream and may influence inflammation, fat storage and metabolism.
The findings are appealing because resistant starch also occurs naturally in food. Sources can include green bananas, beans and other legumes, whole grains, and some cooked and cooled starchy foods such as potatoes or rice.
However, the amount and type of resistant starch in ordinary foods vary considerably. Eating one serving of cooled potatoes or a banana should not be assumed to reproduce the dose or effects of the supplement used in the clinical study.
The trial also lasted only four months. Researchers still need to determine whether the improvement continues over longer periods and whether resistant starch can reduce important outcomes such as liver scarring or serious liver complications.
The study nevertheless has useful strengths. It directly compared resistant starch with a control treatment in people who already had fatty liver disease and examined liver fat as well as changes in gut bacteria and blood markers.
The results also add to evidence that fatty liver disease is not simply a problem of eating too much fat. The way carbohydrates are digested, the bacteria living in the intestine and the body’s overall metabolism may all influence how much fat accumulates in the liver.
Resistant starch should not be viewed as a replacement for established approaches to fatty liver disease. Weight management when appropriate, regular physical activity, a nutritious diet and good control of diabetes, cholesterol and blood pressure remain important.
Still, the Cell Metabolism study provides an interesting clue about a relatively simple dietary strategy. If larger and longer studies confirm the results, resistant starch could eventually become one useful part of treatment for people with metabolic fatty liver disease.
For now, the research shows how closely food, gut bacteria and liver health may be connected.
A carbohydrate that largely escapes normal digestion may ultimately influence an organ far beyond the intestine, offering scientists another route for understanding and treating one of the world’s most common liver conditions.
If you care about liver health, please read studies that refined fiber is link to liver cancer, and the best and worst foods for liver health.
For more health information, please see recent studies about how to boost your liver naturally, and simple ways to detox your liver.
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