Indubitably, some people find VLC "stressful" -- studies show elevated cortisol, which few of us need! I withhold judgement, myself, because i suspect that there are confounders in that kind of study. I mean -- a lot of "people" (lab rodents included) have a hard time adapting from a glucose metabolism to fat/ketone-burning, and among the two-legged kind, there's also environmental stressors which can make it even harder.
What i'd like to know more about, though, is comparative "stress" scores in those who have elevated glucose and insulin, compared with those who don't. It has borne in upon me that to process glucose places a huge burden upon our bodies! So why don't we ever hear paleos/Optimals talk about the stressfulness of a high-carb diet?
When we eat a very large amount of carbohydrates, many bodily resources are also eaten up! We have to supplement vitamins and minerals JUST TO BURN SUGAR that burning fatty meat does not require. We have to be concerned about acquiring vitC, which was a non-issue to early Native-American buffalo-centric eaters. We need magnesium, as well -- bigtime. We also know that more thyroid-hormone is REQUIRED to process the body's fuel, as more carbohydrate is consumed. More nutrients, too, but after my busy weekend i'm feeling too lethargic to want to hunt them down. ;-)
What brought this up is a 2010 discussion on Hyperlipid about how primary liver-damage is on obesity causation. Some folks seem to think that metabolic derangement comes first and fatty-liver and fibrosis follow behind, and others that all you have to do is insult your liver enough and the rest will happen as a result. "Associations" in diet and disease are a bitch! Elevated liver enzymes connect with all sorts of metabolic-syndrome correlatives, but that don't mean diddly-squat until someone runs a well-planned study that defines the mechanism.
It all just made me think that maybe the body's adaptive capabilities are extended sufficiently by dealing with this potentially-dangerous substance, but when you throw in even more stressors like a hepatitis-C infection or toxin exposure, it just becomes more than the poor liver (and thyroid and pancreas, etc) can reasonably handle. We can handle a dose of industrial pesticide, OR we can handle a bolus of glucose, but we can't handle both, maybe?
A massive cascade of Unfortunate Events leads to the kind of breakage that requires significant special knowledge and resolve and effort to undo -- and which you'll NEVER learn if your dietary advice comes from mainstream sources. And maybe not even then, as Peter points out that NAFLD is reversible but that fibrosis is forever.
EDIT: I typed too soon! George corrected that last statement ... so as Emily Litella used to say, "never mind!" :-)