NMU – 173 Growing Incidence of Fatty Liver Problems and Lifestyle Solutions
Lifestyle Medicine Update No 173 (September 15, 2020)
with Dr. James Meschino
Topic: Growing Incidence of Fatty Liver Problems and Lifestyle Solutions
Sources: Diseases (2018); Antioxidants (2018); World J Gastrointestinal Pathophysiol (2-17); Nutrients (2019); World J Hepatol (2019), World J Hepatol (2017)
We are seeing a growing incidence of fatty liver disease problems in our society and around the world. Fatty liver problems are divided into two main groups; those caused by excess alcohol intake and those not caused by excess alcohol intake. To reverse early-stage fatty liver problems caused by excess alcohol intake the solution is quite simple – drink less alcohol or abstain from alcohol consumption altogether. But what is alarming is the exponential rise in fatty liver problems not caused by alcohol intake. In fact, it is estimated that 25% of the world’s population currently has this problem, affecting 30% of the U.S. population (97 million Americans). The recent rise in non-alcoholic fatty liver problems, known as NASH (non-alcoholic steatohepatitis) is largely attributable to the rising incidence in overweight and obesity statistics in many countries. However, many non-overweight individuals are also developing fatty liver problems, which the evidence indicates is primarily due to over ingestion of simple sugars (especially high fructose diets and soft drinks or sodas), and unhealthy fats (foods high in saturated fats, deep-fried foods, and trans fats). The reason this is important is because fatty liver problems are the first step in the development of liver fibrosis leading to cirrhosis (a life-threatening condition), as well as primary liver cancer, known as hepatocellular carcinoma. In fact, as a result of increased fatty liver problems in our society, the once quite rare hepatocellular carcinoma, is becoming a much more prevalent form of cancer in our modern society.
We are now seeing an increasing number of people with non-alcoholic fatty liver problems progressing directly to liver cancer (hepatocellular carcinoma), without first developing cirrhosis. Data shows that non-alcoholic fatty liver degeneration is the fastest growing indication for liver transplant in patients with primary liver cancer (hepatocellular carcinoma). Not only that, but individuals with fatty liver problems are at high risk for the development of diabetes, and premature death, and complications from cardiovascular disease. Some people inherit genes that increase their risk for non-alcoholic fatty liver problems, but even in these cases, the principal cause is diet and lifestyle.
There are no drugs that effectively reverse this form of fatty liver degeneration. The treatment and reversal of the non-alcoholic fatty liver disease come down to changes in diet and lifestyle, as well as the possible inclusion of some supplements shown to also help reverse this problem. Regarding diet and lifestyle, the emphasis should be on things that will lower insulin secretion and improve insulin function, as high insulin levels convert more of the calories you eat into fat within liver cells, which is the underlying problem in fatty liver disease. So, regular endurance exercise is very helpful. Something as simple as a 30-minute power walk each day can help to lower insulin levels and improve insulin function in the body, which decreases the conversion of carbohydrate and protein calories into fat within the liver. Consuming fewer foods and beverages with simple sugars is also critical, which also reduces the conversion of carbohydrates into fat within the liver. Also, it’s important to avoid bad fats, such as high-fat meat and dairy products (red meat, pork, processed meats, butter, cheese ice cream) as well as deep-fried foods (like French fries and chicken wings) and foods with trans-fats and other undesirable fatty foods, such as cream sauces, creamy salad dressing, tahini sauce, and mayonnaise to name some common offenders.
So, in the end, the goal is to consume lean protein foods (chicken breast, turkey breast, egg whites, fish, soy-based proteins) that are not deep-fried or breaded, reduce intake of heavily sweetened foods and beverages like pastries, candy, and sugar-sweetened soft drinks and to use lower-fat dairy products (like 1% or non-fat milk or yogurt), avoid cheese, butter, cream, whipped cream, and ice cream, and replace creamy salad dressing with olive oil and vinegar, avoid tahini sauce and mayonnaise, and use tomato sauce or olive oil-based sauces (Aglio e olio) in place of cream sauces on pasta.\ Get in your 10,000 steps per day or the equivalent via other types of endurance exercise. This overall strategy can not only reverse non-alcoholic fatty liver problems, but it also prevents the problem from developing in the first place, along with preventing the development of metabolic syndrome (pre-diabetes) and type 2 diabetes.
In the next update, I will explain the research showing what specific dietary supplements (and doses) have been shown to also reverse non-alcoholic fatty liver problems. I think you’ll be surprised and impressed with what we have learned from the human studies conducted thus far.
But how would you know if you have a fatty liver problem in the first place? Well, at your next annual physical examination make sure your doctor includes your fasting triglyceride level and liver function tests in your blood panel work-up to screen for a potential fatty liver problem that may be festering behind the scenes. This problem can have no signs or symptoms. It is picked up by using the blood tests I have mentioned. If not reversed in the early stage this problem can easily progress to life-threatening liver cirrhosis or primary liver cancer (hepatocellular carcinoma).
I have included the research references in the text below.
1. Perumpail BJ et al. Potential therapeutic benefits of herbs and supplements in patients with NAFLD. 2018, 6(3):80 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165515/
2. Yousef MH et al. Fatty liver without a large “belly”: Magnified review of non-alcoholic fatty liver disease in non-obese patients. World J Gastrointest Pathophysiol 2017, 8(3):100-107 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561430/
3. Aydos LR et al. Nonalcoholic fatty liver disease induced by high-fat diet in C57bl/6 Models. Nutrients 2019, 11(12):3067 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949901/
4. Velazquez KT et al. Prolonged high-fat feeding promotes non-alcoholic fatty liver disease and alters gut microbiota in mice. World J Hepatol 2019, 11(8):619-637 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717713/
5. Cholankeril G et al. Hepatocellular carcinoma in non-alcoholic steatohepatitis: Current knowledge and implications for management. World J Hepatol 2017, 9(11):533-543 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395802/
6. Hadi HE et al. Vitamin E as treatment for non-alcoholic fatty liver disease: Reality of Myth. Antioxidants 2018, (1):12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789322/
Eat Smart, Live Well, Look Great,