Fatty Liver Expert: Your Liver Is Filling With Fat Right Now - Dr David Unwin

Let’s start simple: your waist should be less than half your height, and belly fat is far riskier than weight on your arms or legs. We’ve normalized soft midsections while a huge share of people with type 2 diabetes do not know they have it, losing roughly 100 days of life for every year it stays out of control.

We’ve laid out everyday foods—cereal, a potato, white rice, a banana, and a chocolate bar—and I guessed how much sugar I thought each had.

Using my teaspoon-of-sugar model based on glycemic load, white rice is the shocker at about ten teaspoons, cornflakes around eight, a chocolate bar about seven and a half, a ripe banana near six, and a big potato roughly five. This is about behavior change and choosing the health future you want.

Before we dive in, hit follow so you never miss our best episodes. Dr David Unwin is here—named among the most influential doctors in the UK—and I asked him what’s top of mind.

We all face multiple possible health futures, and it’s harder than ever to pick wisely with so much conflicting advice. I’m seeing a wave of poor metabolic health in younger people that simply did not exist when I started practice, and we’ve treated growing bellies as normal when they’re not.

Whatever your age, uncontrolled type 2 diabetes shortens life, and many do not realize they have it. Heart disease remains a major killer, and cancer risk is also rising in people with diabetes.

Here’s the insulin basics we all should know: carbs become glucose, high glucose harms arteries quickly, and insulin moves glucose into cells or turns the excess into fat. My own biscuit habit grew my waist and stuffed my liver with fat, which drove insulin resistance, then a pancreas overwhelmed by fat—the long silent period before sugars spiral.

Act early and the odds are with you: in my practice, about 93 percent with prediabetes normalize blood sugar on low carb, roughly 73 percent if we catch type 2 early, and around 50 percent after five years. The longer you wait, the harder it gets.

Glycemic index compares foods to glucose, but glycemic load is better because it factors portion size and density—watermelon, for instance, is mostly water, so the load can be low compared to a dense sweet.

For 25 years I followed guidelines, prescribed more drugs, and watched health decline; it felt like a small failure every time I added another pill. A turning point came when a patient normalized her sugars by cutting bread, rice, and cereals while ignoring her metformin—and she was right.

My wife Jen found a low-carb book, our partners pushed back, so we ran free evening groups, cooked together, and measured everything. We saw liver tests improve in weeks, weight and blood pressure fall, A1c drop, and I felt sharper, calmer, and needed less sleep.

I used to tell people to eat less and move more, then blame them when it failed; the failure was mine because the advice did not work. Lifestyle is not an add-on—it’s central.

Even very smart friends ask if pizza is healthy or if a big carbonara counts as a health food, and top athletes were taught to load up on carbs without understanding sugar. The basics are not getting through.

We barely teach nutrition, and people snack sugar on sugar all day with very little protein. That pattern feeds constant hunger.

Juice hits fast, spikes sugar, insulin overcorrects, and you’re hungry again—my old biscuit loop. Here’s a powerful fact: all the sugar in five liters of normal blood is about one sugar cube; it’s easy to overwhelm that with a single snack, which my continuous glucose monitor shows me in real time.

Food labels and marketing are confusing; how do we shop smarter?

Build meals around protein, add green veg, and use flavor from full‑fat mayo, butter, or olive oil rather than sugary sauces. If you buy packaged food, check carbs as well as sugar; every four grams of net carbs is roughly a teaspoon of sugar.

Think of starch as glucose molecules holding hands; digestion breaks them apart into sugar. Even a small slice of bread can act like several teaspoons of sugar, and if you have insulin resistance, low‑carb bread or none is best—use a CGM to test your own response.

When I cut carbs or fast, cravings vanish and my hunger drops. On keto, brain fog clears and the urge to snack fades.

Many notice that superpower—less hunger and fewer cravings the lower the carbs go. I guide people by their goals and let results steer how low they choose to go.

My goals are clear: steady mental flow for work and TV, looking good for my partner, staying strong, and extending my health span. I do not want my father’s trajectory, so the choices I make now shape the curve of my later life.

That’s your preferred future. Jen’s GRIN model helps lock it in: define your Goal, list your Resources, take small Increments, then Notice what’s working.

Consistency beats all‑or‑nothing for me, and a friendly accountability group keeps me honest. Shrinking the size of “success” helps me keep momentum.

GRIN shifts you from guilt to hope—goals first, then your tools, small steps, and real‑time feedback. It turns consults into energizing conversations instead of misery marathons.

How do we help loved ones who are clearly sliding but resist change?

It’s brutal—addiction brings chaos and secrecy, and policing creates deceit. Jen realized she was addicted to ultra‑processed foods, and many smart people are; one patient was eating bread from the bin at four in the morning even after it was sprayed with detergent.

What worked for him was a combo: low carb, a CGM for instant feedback, and a low dose GLP‑1 to quiet cravings, which let him abstain; he lost weight and got his knee surgery. Another patient who relapsed lost toes, then fought back into remission—this is real addiction, not “carb creep.”

What’s step one today if someone feels out of control with food?

Start with honesty about the problem, name the trigger foods, and make an abstinence plan; ask for gentle support because judgment backfires. Jen’s book, Fork in the Road, channels all proceeds to a charity for food addiction.

The cancer links are sobering—regular sugary drinks tie to higher cancer risk and faster biological aging. It makes me ask whether any “treat” is worth that trade.

We pour effort into treatment and far too little into prevention; beyond smoking, diet is a leading driver of cancer. Measured against the risks, our snack culture is madness.

Health span matters more than lifespan if the extra years are sick ones, and in the UK health span is falling while life expectancy inches up. The US has an even wider gap, meaning more years unwell.

Ultra‑processed food is costing each UK taxpayer roughly seven thousand pounds a year once lost productivity is counted, and many are too unwell to work. That is a national emergency as well as a personal one.

For a quick at‑home check, we’ve got a piece of string to test waist versus height.

Fold the string to your height, mark the halfway point, and wrap it around the widest part of your belly; your waist should be less than half your height.

People always tell me I’m taller than they expected—probably because I’m usually sitting down.

Grab a string as long as your height, cut it in half, and see if it circles your waist; if it does, you’re likely in a safer spot, because belly fat tracks with insulin resistance more than what the scale says.

I squeaked by, which is both funny and painfully honest.

I aim for real food with lower carbs, solid protein, and healthy fats, but soil depletion means some nutrients, especially magnesium, are hard to get from food now, and age and acid-reducing meds make absorption worse.

Pick the form to fit your body: citrate if you run constipated, glycinate or threonate if you want calmer sleep or mood; I learned how crucial magnesium is from a farmer losing cows to “staggers” and a patient whose seizures were actually deficiency-driven.

Blood tests can miss it because most magnesium lives inside cells, so a careful trial is often the simplest check.

My daily five are magnesium, vitamin D because I’m indoors and Black, creatine, a fiber supplement to nudge down LDL, and a multivitamin, all tuned by recent lab work.

That sounds sensible, and I’d just warn against the carrier-bag approach to supplements; more is not always better, especially fat-soluble vitamins.

I tried two services recently, including a new scan that mapped my body and labs in minutes for about three hundred pounds, which beat the old seven-thousand-pound, all-day check that took weeks to report; it flagged low omega-three and a high LDL, so I adjusted.

Screening should end with practical steps, not fear; telling someone their risk without giving them levers to pull only creates panic and clinic overload.

What sold me was speed, clarity, and a kind doctor, and I still feel the unfairness that many cannot access private options.

I stay in the public system because health inequality troubles me, and while it’s stark by region, social media can spread useful knowledge at almost no cost.

I try to anchor advice in real-world outcomes from unselected patients we’re assigned, updated over time, which keeps me honest when headlines contradict each other.

Our tradition is a closing question from the last guest: if humanity reached out to a more intelligent species, who should speak for us, and why?

I’d send David Attenborough—age, wisdom, and a lifetime caring for biodiversity and sustainable food make him a gentle, credible ambassador I think even aliens would warm to.

Before we wrap, you deserve real credit: your stories make the science stick—like the cow and magnesium—and your kindness, humility, and clarity build a bridge most experts never do.

Thank you; decades in practice taught me to read faces, adjust on the fly, and make ideas land without jargon.

Please do more of this; that rare blend of rigor and warmth moves people.

If you want to help, follow me on X at low-carb GP, support the Public Health Collaboration charity, and treat your health like an experiment—pick a goal, measure, and learn.

Continuous glucose monitors personalize that process beautifully.

They’re affordable online, and with permission they make a thoughtful gift that can change habits overnight.

Seeing your own spikes is believing; mine stays flat because I avoid foods that jack it up, and even stress shows up, which is why your calm style matters.

A last note: type 2 diabetes is now arriving in pediatrics, and many specialists trained before this shift, so we’ve been helping them get up to speed fast.

Dr. David Unwin, thank you; that was a joy.