As far as health threats are concerned, unless you’ve been diagnosed with a liver disease you probably don’t think too much about that particular organ. Heart disease and cancer tend to get the lion’s share of attention in newspapers and on TV. But as far as life-threatening diseases are concerned, non-alcoholic fatty liver disease—NAFLD for short—ranks as the worst of them all…and it’s becoming an epidemic.
NAFLD results when fat builds up in liver cells. The term non-alcoholic is used to separate the liver damage that occurs in alcoholics from those people who don’t drink excessive amounts of alcohol. The rise in the incidence of NAFLD goes hand-in-hand with the rise in the number of people who are overweight and obese. In fact, 80 percent of obese patients have NAFLD.
But you don’t have to carry extra pounds to get the disease. Even some lean people develop NAFLD. It affects 16 percent of people with a normal body mass index (BMI).
Even children and teens are developing NAFLD at an alarming rate. In one study, researchers found NAFLD in 14 percent of 564 children studied.
Over three timespans (1988-1994, 1999-2004 and 2005-2008), the prevalence of NAFLD doubled from 5.51 percent to 11 percent. Between 1988-1994, 46.8 percent of all chronic liver diseases were related to NAFLD, but by 2005-2008, this number had skyrocketed to 75.1 percent. By the year 2030, the prevalence of NAFLD in Australia is expected to rise by another 50 percent.
A Stealthy Enemy
The scary part is that NAFLD often has no symptoms until it has progressed to the point where it’s more difficult to reverse with behavior changes, such as exercise and an improved diet. It’s often discovered accidentally when routine liver tests show elevated liver enzymes. And there’s no medication that can treat the disease, although in its earliest stages, weight loss and dietary changes can help.
If NAFLD is left unchecked, it can progress into non-alcoholic steatohepatitis (NASH). This results in cirrhosis marked by scarring of the liver known as fibrosis that is as severe as the damage caused by alcoholism. At this stage, people who suffer from NASH can experience symptoms such as jaundice, stomach pain, swelling of the legs and fatigue.
What’s to Blame for NAFLD?
Being overweight or obese is at the top of the list for risk factors of NAFLD. Even just having a big belly can up your risk, too. Belly fat—known as central obesity—is a sign that visceral fat is developing on your organs. Visceral fat, otherwise known as intra-abdominal fat, is sandwiched between your internal organs and your torso. It’s this type of fat that’s linked to many health concerns, including NAFLD. Visceral fat triggers chronic, low-grade inflammation, which contributes to liver injury.
Central obesity is a hallmark of metabolic syndrome, a cluster of risk factors for heart disease that also includes high blood pressure, high triglycerides, high blood sugar and low HDL “good” cholesterol. If you have metabolic syndrome, you’re also at increased risk for NAFLD.
Fructose and Sugar—Guilty as Charged
Researchers have found that drinking beverages sweetened with high-fructose corn syrup increases the production of lipids, disturbs insulin sensitivity and increases central obesity in overweight or obese adults, all of which are problems that can lead to NAFLD.
Studies also have found that people who have NAFLD eat and drink more fructose compared to people without the disease. And consuming fructose is associated with more severe NAFLD.
Eating lots of snacks high in fat and sugar also tips the scales in favor of fatty liver. In a six-week study of lean men fed either a high-calorie diet that included high-fat/high-sugar drinks between meals, a high-calorie diet with high-sugar drinks between meals or a balanced diet without between-meal snacks, scientists found that belly fat increased in the high-fat/high-sugar group and in the high-sugar-frequency group.
Liver insulin sensitivity also decreased in the high-fat/high-sugar-frequency group. Plus, triglyceride levels rose in the liver of the subjects consuming the high-fat/high-sugar snacks and the subjects consuming only the high-sugar snacks. The changes were independent of caloric content and body weight gain.
Even Lean People Aren’t Safe
Although being overweight or obese is the primary risk factor of NAFLD, it’s not the only one. That may explain why some people who are lean develop the disease. In fact, many of these normal-weight NAFLD patients don’t have any of the classic risk factors for NAFLD, such as diabetes, hypertension, high triglycerides, low high-density-lipoprotein cholesterol, central obesity and metabolic syndrome.
Other Risk Factors
Besides obesity, genetic predisposition is another risk factor for NAFLD. This might offer an explanation as to why some lean people get the disease. It’s possible that the lean people in the study mentioned above had what’s known as a lisosomal acid lipase deficiency. This deficiency lowers levels of an enzyme that helps break down lipids and triglycerides, causing fat to accumulate.
These days, your liver is working overtime thanks to all the toxins it’s exposed to from the environment. The liver is responsible for detoxifying these environmental chemicals.
This adds to the liver’s total burden and may make it more vulnerable to disease. Some environmental chemicals such as bisphenol-A (BPA) are directly linked to weight gain and harmful changes in the liver. In obese male children, BPA was linked to elevated levels of the liver enzyme aspartate aminotransferase and high diastolic blood pressure.
Do You Have NAFLD?
If there is a suspicion you have NAFLD, you need to test your liver enzymes, along with your triglyceride and cholesterol levels. If the tests come back abnormal, you may also order an abdominal ultrasound. A liver biopsy—considered the gold standard for diagnosing NAFLD—also is a possibility.
The good news is that the sooner you’re diagnosed with the disease, the easier it is to control. And even if you don’t have NAFLD, if you’re overweight, now is a good time to put into practice some of the following suggestions before it’s too late.
If you’re overweight, start a daily exercise routine and watch what you eat. Not surprisingly, eating anything that causes you to pack on the pounds, especially in your abdominal region, will increase your risk of NAFLD.
To make a difference in your liver’s health, you’ll need to lose three to 10 percent of your body weight.
Even if you’re not overweight, daily exercise comes with a whole slew of benefits that have nothing to do with weight loss, including protecting the health of your liver.
Eat lots of vegetables, fruit, nuts and fish high in omega-3s such as salmon. Studies have shown there’s an association between diets low in vitamin C, vitamin K, folate and omega-3 fatty acids and an increased risk of NAFLD
Avoid sugar and high fructose corn syrup. As noted earlier, they’re linked to central obesity and increased levels of triglycerides, as well as other changes that might lead to NAFLD.
Two Liver-Healthy Supplements
As you’re losing weight, be certain to eat lots of fiber and take a good detoxification supplement. During weight loss, all the environmental toxins that were stored in fat cells are released into the body and sent to the liver, which is already working overtime to fight off the inflammation and other harmful changes associated with being overweight.
When it comes to NAFLD specifically, berberine is an ideal choice. In type 2 diabetic patients with NAFLD, berberine supplementation improved the results of a liver ultrasound, lowered liver enzymes, triglyceride levels and LDL “bad” cholesterol, while raising levels of HDL “good” cholesterol.
Vitamin D3 is another important nutrient for anyone who’s at risk for NAFLD. People who have NAFLD have lower levels of this vitamin compared to people who don’t have the disease, leading researchers to believe low vitamin D levels might make a person more vulnerable to NAFLD. This same association with low vitamin D levels is found in NAFLD patients who have normal total body fat, indicating that vitamin D deficiency might make even some lean people susceptible to the disease.
Fighting Fatty Liver
Non-alcoholic fatty liver disease is a threat that’s easy to fight—if you catch it soon enough. That’s why it’s important to act now. Begin a daily exercise routine and toss out the cookies, baked goods and soft drinks that are lingering around your house. And consider supplementing with berberine and vitamin D3.