The Fat Trap: How Fatty Liver is Sneaking Up on Your Health

Fatty liver disease, once considered a condition primarily associated with heavy alcohol consumption, has become increasingly prevalent in recent years, affecting individuals across age groups and lifestyles. In this blog, we'll delve into the intricacies of fatty liver disease, shedding light on its causes, symptoms, and available treatment options.

What is Fatty Liver Disease? Fatty liver disease, also known as hepatic steatosis, occurs when fat accumulates in the liver, exceeding 5-10% of its weight. This condition can be categorized into two main types: alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). While AFLD is linked to excessive alcohol consumption, NAFLD typically occurs in individuals who drink little to no alcohol, making it a growing concern worldwide.

👉 Did you know that the largest solid organ in our body is silently battling a condition that could lead to severe consequences? Join us as we delve into the world of Fatty Liver Disease, a condition with around 500 different functions in our body – yes, we're talking about our liver! Contrary to common belief, Fatty Liver Disease isn't just linked to alcohol consumption. The alarming rise in obesity cases is fueling an epidemic of excessive fat build-up in the liver. It turns out, we might need to rethink our dietary choices and lifestyle to help our liver win this battle.

 In this video, I'm wearing multiple hats: medical doctor, Plant-based diet expert, mindset and lifestyle coach all rolled into one. But here's the kicker – I'm not just here to give you the same old spiel about Fatty Liver disease. Nope, I'm here to shake things up and show you how a smart approach to wellness can truly make a difference.

You see, it's not just about talking the talk; it's about walking the walk. And in this video, I'm going to do just that. I'll share insights, strategies, and tips to help you control your liver health and kick Fatty Liver disease to the curb.

So, why should you stick around? Well, because I'm not here to sugarcoat things or sell you a quick fix. I'm here to empower you with knowledge and equip you with the tools you need to make lasting changes. Whether you're a seasoned health enthusiast or just starting your journey to wellness, there's something here for everyone.

So grab a seat, buckle up, and get ready for a journey towards better health. Trust me, when you're done watching, you'll be inspired, informed, and prepared to take charge of your liver health like never before. Let's do this!

Diabetes Management: How Everyday Habits and Lifestyle Affect Blood Sugar

Management of diabetes needs awareness. Learn what triggers, increases, and/or decreases your blood sugar and how to manage them regularly.

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It can be difficult to maintain blood sugar levels within the healthy range set by your doctor. That's because many different things can influence your blood sugar to rise or fall unexpectedly.

Your blood sugar level may be affected by the following:

Food

Eating well is essential to good health, regardless of whether or not you have diabetes. However, understanding how different foods affect blood sugar levels is essential for everyone with diabetes. It's not just the foods you eat but also the quantities and combinations you make.

The most common type of diabetes is Type 2 diabetes, caused by insulin resistance. Studies have shown that a whole-food, plant-based diet can reverse insulin resistance. I invite you to listen to my podcast to learn about whole food plant-based diet nutrition.

Physical Exercises and Activities

Include regular physical activity as part of your strategy to control your diabetes. Sugar is burned as fuel by your muscles during physical activity. Regular exercise improves insulin sensitivity in the body.

Your blood sugar level will go down because of all these things. More intense exercise produces longer-lasting results. However, even relatively light tasks, such as cleaning, gardening, or being on one's feet for long periods, might help lower blood sugar.

Medication

When diet and exercise aren't enough to control your diabetes, your doctor may prescribe insulin or another diabetes medicine to help bring your blood sugar levels down to a more normal range. However, the time and quantity of these doses greatly affect the drugs' efficacy. Your blood sugar levels can be affected by medications you take for diseases other than diabetes.

Stress

Long-term stress might raise blood sugar levels because of the hormones your body produces in response to stress. Stress hormones such as cortisol and glucagon can directly increase blood sugar. Stress can also indirectly increase blood sugar by inducing cravings and stress eating, making it even more challenging to stick to your regular healthy diet. There are ways to deal with stress without negatively impacting your body and raising your blood sugar.

Listen To Podcast on How to Manage Stress

Conclusion

You can better prepare and manage blood sugar changes if you have a firm grasp of all the factors that contribute to these changes. Talk to your doctor or diabetes health care team if you have problems maintaining a healthy blood sugar level.

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What You Should Know About Fatty Liver Disease

An increasing number of obesity cases is driving an epidemic of a condition of excessive fat build-up in the liver. It is commonly called fatty liver disease (FLD) or hepatic steatosis.

A healthy liver contains a small amount of fat but when extra fat builds up in the liver and reaches 5% to 10% of your liver’s weight, it becomes a problem. Thus, understanding, diagnosing, and treating this progressive condition are becoming health priorities.

The Liver

The liver is a reddish-brown, wedge-shaped, unequal two-lobed organ located just below the diaphragm, to the right of the stomach, and overlies the gallbladder. It is around 6 inches wide, and weighs approximately 3.3 pounds, making it one of the largest and heaviest organs in our body.

The liver is responsible for up to 500 separate functions, usually in combination with other body organs and systems. Various liver functions are carried out by the hepatocytes (liver cells). Given its size, the liver has multiple life-supporting functions such as:

• Producing bile that helps with the digestion

• Producing proteins necessary for growth

• Storing iron needed by our red blood cells

• Regulating glycogen storage and converting nutrients into energy

• Producing substances that help blood clot for wound healing

• Producing immune factors for immunity

• Removing bacteria and toxins in our body for detoxification

Types of Fatty Liver Disease

Fatty liver disease has two types:

• Non-alcoholic fatty liver disease (NAFLD)

• Alcoholic liver disease

NAFLD is further subdivided into:

• Simple fatty liver

• Non-alcoholic steatohepatitis (NASH)

Don't let these terms get you confused. It is important to distinguish between simple fatty liver and NASH. Why? Because having a simple fatty liver does not cause liver-related sickness whereas having NASH means you have an inflammation or injury in your liver cells. NASH increases the risk of progression to more serious conditions like fibrosis (scarring) of the liver, liver cirrhosis, and liver cancer.

Statistics

It is not yet clear why some people with NAFLD develop simple fatty liver and others develop NASH. Most people with NAFLD have simple fatty liver and not NASH. In the U.S., about 3% to 7% only of the US population has NASH.

Fatty liver occurs more often in adult males. It also affects about 10% of children in the U.S. NAFLD affects about 30% of people in Western countries and 10% of people in Asia. Fatty liver is more prevalent in Hispanic people than Caucasians, while Black people have the lowest susceptibility. Therefore, you have a greater chance of developing the fatty liver disease if you are Hispanic or Asian.

For people with NAFLD, there is about an 80% 10-year survival or recovery rate. However, the rate of progression of fibrosis is estimated to be 1 per 7 years in NASH and 1 per 14 years in NAFLD, with an increasing speed.

More than 90% of heavy drinkers develop fatty liver while about 25% develop the more severe alcoholic hepatitis.

Recently, the term Metabolic dysfunction-Associated Fatty Liver Disease (MAFLD) has been proposed to replace NAFLD. MAFLD is a more inclusive diagnostic name as it is based on the detection of fatty liver by biopsy, medical imaging, or blood tests but should be accompanied by either overweight/obesity, type 2 diabetes mellitus, or metabolic dysregulation. The new definition no longer excludes alcohol consumption or the coexistence of other liver diseases. Using this more inclusive definition, the global prevalence of MAFLD rises to 50.7%.

If we use the "old" NAFLD definition, 80% of obese people, 35% of whom progress to NASH, and up to 20% of normal-weight people have NAFLD despite no evidence of excessive alcohol consumption.

Signs, Symptoms, Diagnosis

Most individuals with fatty liver are asymptomatic. If there are symptoms, it may be occasional tiredness or pain in the upper right side of the abdomen. Thus, fatty liver disease is usually detected by accident when an abdominal ultrasound, CT scan, or MRI is requested for another reason or unrelated medical conditions and your doctor may be the first one to spot it. Because fatty liver disease often has no symptoms, people would only know it until the disease progresses to liver cirrhosis.

Elevated liver enzymes on a blood test for other conditions may raise a red flag. It is a sign of possible liver injury. To make a diagnosis, your doctor may order:

• Ultrasound or CT scan to get a picture of the liver.

• Liver biopsy to determine how far advanced the liver disease has progressed.

Elevated liver enzymes are found in 50% of patients with simple steatosis. A simple blood test may help to determine the magnitude of the disease by assessing the degree of liver fibrosis. Histological diagnosis by liver biopsy is the most accurate measure of fibrosis and liver fat progression as of 2018. It takes a liver biopsy to know if a person has simple fatty liver or NASH. But the infrequent complications and cost of a liver biopsy make this impractical for people with NAFLD.

Causes

Fatty liver is commonly associated with diabetes, hypertension, obesity, and dyslipidemia, but can also be due to any one of these:

• Alcohol use - it is one of the causes of fatty liver due to the production of toxic metabolites like aldehydes during the metabolism of alcohol in the liver.

• Abnormal metabolism - aside from the mentioned metabolic syndromes, abetalipoproteinemia, glycogen storage diseases, Weber–Christian disease, acute fatty liver of pregnancy, and lipodystrophy are considered to cause fatty liver.

• Nutritional causes - obesity, insulin resistance, and malnutrition are the most common nutritional causes of fatty liver. Total parenteral nutrition, severe weight loss, refeeding syndrome, jejunoileal bypass, gastric bypass, jejunal diverticulosis with bacterial overgrowth may also cause fatty liver.

• Drugs and toxins such as amiodarone, methotrexate, diltiazem, expired tetracycline, highly active antiretroviral therapy, glucocorticoids, tamoxifen, environmental hepatotoxins (e.g., phosphorus, mushroom poisoning)

• Other causes such as celiac disease, inflammatory bowel disease, HIV, hepatitis C (especially genotype 3), and alpha 1-antitrypsin deficiency

Some people get the fatty liver disease without having any pre-existing conditions. But these risk factors make you more likely to develop it:

• Being obese or overweight.

• Having Type 2 diabetes or insulin resistance.

• Having metabolic syndrome (insulin resistance, high blood pressure, high cholesterol, and high triglyceride levels).

• Taking certain prescription medications, such as amiodarone, diltiazem, tamoxifen, or steroids.

Risks & Complications

Fatty liver disease doesn’t cause major problems for most people. However, it can turn into a more serious problem if it progresses into liver cirrhosis. Untreated liver cirrhosis eventually leads to liver failure or liver cancer.

NAFLD is intimately related to conditions like diabetes and obesity. It’s also linked to an increased risk of cardiovascular disease. The primary risks include alcohol, type 2 diabetes, and obesity. Other risk factors include certain medications such as glucocorticoids and hepatitis C.

Less than 10% of people with cirrhotic alcoholic FLD will develop hepatocellular carcinoma, the most common type of primary liver cancer in adults. But up to 45% of people with NASH without cirrhosis can develop hepatocellular carcinoma.

Treatment

If you have been diagnosed with fatty liver disease, it is important to keep your liver as healthy as possible and avoid anything that can further damage your liver. Treatment of NAFLD is generally by dietary changes and exercise to bring about weight loss. Decreasing caloric intake by at least 30% or by approximately 750–1,000 kcal/day results in an improvement in hepatic steatosis. In more serious cases, medications that decrease insulin resistance, hyperlipidemia, and those that induce weight loss such as bariatric surgery as well as Vitamin E have been shown to improve or resolve liver function. For those who are severely affected, a liver transplant may be an option.

Here are some important things you should do:

• Don’t drink too much alcohol. How much is too much remains debatable, but it’s probably best to avoid alcohol completely.

• Make sure that none of your medications are toxic to the liver. Even acetaminophen may be harmful if you take too much for too long.

• Get vaccinated to protect against hepatitis A and B.

• Control other health conditions that might also affect your liver, and check with your doctor if you might have other underlying, treatable diseases contributing to your fatty liver.

• Get regular screening tests for liver cancer if you already have cirrhosis.

Unfortunately, there are no FDA-approved medications for fatty liver disease. So far, the two best drug options affirmed by the American Association for the Study of Liver Diseases for biopsy-proven NASH are vitamin E (an antioxidant) and pioglitazone (used to treat diabetes). However, not everyone will benefit from these treatments, and there has been some concern about safety and side effects. If you have NASH, it’s best to ask your doctor whether these treatments are appropriate for you, as they are not for everyone.

Conclusion

Our body has an amazing ability to repair itself. So is our liver. Thus, fatty liver can be reversed. If you avoid alcohol, lose weight, and change your diet it is possible to reduce liver fat, inflammation, and reverse liver damage.

If you have questions regarding fatty liver disease, feel free to schedule a consultation. I will help and work with you and suggest changes that would help you. Who knows? One of the plans we offer might suit your needs. Or if you want to hear from me talk about Lifestyle Medicine, feel free to listen to our podcast or contact us.

Sources:

Armand, Wynne. 2019. “Fatty Liver Disease: What It Is and What to Do About It” Harvard Health Blog. January 10, 2019.

Castera, Laurent, Mireen Friedrich-Rust, and Rohit Loomba. 2019. “Noninvasive Assessment of Liver Disease in Patients with Nonalcoholic Fatty Liver Disease.” Gastroenterology 156 (5): 1264-1281.e4.

Francque, Sven M., Giulio Marchesini, Achim Kautz, Martine Walmsley, Rebecca Dorner, Jeffrey V. Lazarus, Shira Zelber-Sagi, et al. 2021. “Non-Alcoholic Fatty Liver Disease: A Patient Guideline.” JHEP Reports: Innovation in Hepatology 3 (5): 100322.

Wikipedia Contributors. 2019a. “Liver.” Wikipedia. Wikimedia Foundation. July 6, 2019.

———. 2019b. “Fatty Liver Disease.” Wikipedia. Wikimedia Foundation. November 2, 2019. https://en.wikipedia.org/wiki/Fatty_liver_disease.