Recently my doctor told me that I have a fatty liver. After going for an ultrasound to see if I have goldstones, my doctor told me I have a fatty liver and should reduce my fat intake and reduce my weight. What is a fatty liver and why we should worry about it?
Nonalcoholic fatty liver disease (NFLD) As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells.
Nonalcoholic fatty liver disease is common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people. Globally 1 in 4 people have NFLD and in the USA is not like 1 in 3.
Why should we worry about it?
Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure.
In the USA, NFLD cost is a 32 million dollars, close second to Stroke spending which is a 34 million dollar disease. This cost come from both inpatient and outpatient treatment, emergency room visits, organ transplantation, procedures, medications and mortality.
Treatment
Treat the obesity, recommend weight loss. Weight loss along with increase exercise and healthy low fat diet.
In obese and morbidly obese patients would recommend weight loss medications if not able to loose weight. Can also consider gastric bypass or sleeve in patients who are morbidly obese or obese with at least one risk factor such as diabetes or hypertension.
Weight loss tips: which is better low fat or low calorie diet. While low fat diet maybe a better option either one when done correctly can lead to weight loss.
While exercise doesn’t lead to weight loss, it can increase metabolic rate and increase caloric deficiency. Being a couch potato will lead to increase risk of obesity and metabolic syndrome. Most metabolic syndrome patients will have a non-alcoholic fatty liver.
Adding fiber to the diet can help lead to weight loss. The pilot study in which patients did not change their usual diet and did not exercise. Patients had to consumed 35 gm of fiber per day and modified their protein to be lean and was limited to 0.8gm/kg/day. These patients lost an average of 4.4 lbs. in 12 weeks.
Another reason to love fiber:
In a recent Randomized Controlled Trial (RTC) study conducted in diabetes patients show that 10.5 gm of psyllium per day lead to:
- Decrease in weight of 7 lbs. of the psyllium group vs the control group after 8 weeks.
- A decrease in A1C from 8.5 to 7.5.
The good news is that with treatment a fatty liver can be reverse before you advance to cirrhosis.
Fatty Liver can also be the result of several conditions and diseases
Diabetes (Type 2)
Being overweight or obese
High cholesterol or triglycerides
Metabolic syndrome
Polycystic ovary syndrome
Sleep apnea
Underactive thyroid (hypothyroidism)
Underactive pituitary gland (hypopituitarism)
Non-alcoholic Fatty Liver Disease is mostly associated with insulin resistance and there for is most common in patients with diabetes and obese patients.
Milk Thistle
Milk Thistle has been used in Europe to treat liver problems and hepatitis. Clinical trials have had mixed results, two rigorous studies found no benefit.
What foods to avoid:
- Alcohol
- sugar
- soda
- trans fats
- starchy carbohydrates
Avoid OTC medications, foods with a lot of preservatives and chemicals.
Try to eat more non-starchy vegetables, fruits, whole grains, lean protein, and healthy fats. Keep in mind small portions are better than large meals.
