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Fighting a Fatty Liver

A couple of years ago my doctor asked me how much alcohol I was drinking because my blood test came back with abnormal results.  I don’t drink very much or very often so i was surprised by the question.  It turns out that the most common disease in America is called NALFD (non-alcoholic fatty liver disease) or fatty liver, for short, and is a major risk factor for diabetes, heart attacks, and even cancer. It can progress to Non Alcoholic Steatohepatis (NASH), which causes liver inflammation and can lead to cirrhosis or liver cancer in about 10% of those affected.

Fat and the liver: Though the exact effect of excess fat on the liver isn’t well understood, it appears to create problems on a spectrum. At the low and least harmful end, the liver may be able to perform its many functions even while it contains too much fat. However, once inflammation and swelling occur in the organ, scarring can result as the liver tries to heal itself. This is a hallmark symptom of liver injury in advanced non-alcoholic fatty liver disease: collagen is laid down, and fibrosis or thickening of the liver tissue ensues. As the disease progresses, about 10% of cases will develop over the next ten years into the much more serious NASH, or non-alcoholic steatohepatitis. NASH can lead to cirrhosis or hardening of the liver, liver failure, liver cancer, and death.

What causes it?  The high fructose corn syrup found in our processed foods is the single biggest cause of fatty liver. Soda, which, frighteningly, is the number one source of calories in the American diet, is the biggest cause of fatty liver.

Who gets non-alcoholic fatty liver disease? Though the exact causes of NAFLD are not known, most of the people who develop it are obese, have type 2 diabetes or have metabolic syndrome, which is associated with insulin resistance. What’s more, the severity of NAFLD increases with the degree of obesity, and abdominal or belly fat seems to increase the risk of dangerous NASH, even in patients with a body mass index (BMI) in a normal range.

Genetic factors influence each individual component of the syndrome, and the syndrome itself. A family history that includes type 2 diabetes, hypertension, and early heart disease greatly increases the chance that an individual will develop the metabolic syndrome.

Environmental issues such as low activity level, sedentary lifestyle, and progressive weight gain also contribute significantly to the risk of developing the metabolic syndrome.

Metabolic syndrome is present in about 5% of people with normal body weight, 22% of those who are overweight and 60% of those considered obese. Adults who continue to gain five or more pounds per year raise their risk of developing metabolic syndrome by up to 45%.

While obesity itself is likely the greatest risk factor, others factors of concern include:

  • Women who are post-menopausal
  • Smoking
  • Eating an excessively high carbohydrate diet
  • Lack of activity (even without weight change)

How do you know if you have it?

There are blood tests available that can detect a fatty liver. You can also see it on an ultrasound. And if your test comes back abnormal, you are in trouble. But even if your test comes back normal, you might not be out of the woods. It’s important to know that a liver function test doesn’t always detect a fatty liver. An ultrasound can be more sensitive.

The bottom line is, if you eat a lot of sugar and flour, if you have a little bit of belly fat, or if you crave carbs, starch, and sugar, you probably have this.

How to fix your fatty liver

The most promising treatments for NAFLD are weight loss (including bariatric surgery) and exercise. There are some really simple things you can do:

  • Cut out all high fructose corn syrup from your diet. If you see it on any label for any product—whether it’s a salad dressing or ketchup or tomato sauce—don’t eat it.
  • Reduce or eliminate starch. Get rid of white, processed flour. Even whole grain flours can be a problem.
  • Add some good things to your diet to help heal your fatty liver. Add plenty of fruit, vegetables, nuts, and seeds. Add lean animal protein like chicken and fish. Add good oils like olive oil, macadamia nut oil, avocados, coconut butter, and fish oil. Good fats like these are anti-inflammatory, and they help repair your liver.
  • Improve your metabolism through exercise. This is a fabulous way to improve insulin resistance and reduce fatty liver.
  • Supplements:  Polyunsaturated Fatty Acids (PUFA’s), can be helpful. Omega 3 fish oils have been shown to reduce fatty infiltration on ultrasound, and they’re also anti-inflammatory and reduce insulin resistance. A recent study used Cinnamon (1500mg) to treat NALFD and found that liver enzymes improved (as well as blood sugar, lipids and inflammation markers).

More information:

On a lighter note (pun intended) I really like doing the online Body Age quizzes. A thorough one (which incidentally gave me a happy analysis) can be found at: http://www.biological-age.com.