Leslie Beck's Q and A on fatty liver disease

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Leslie Beck's Q and A on fatty liver disease

Leslie Beck, Canada AM nutritionist
Published Wednesday, March 5, 2008 8:08AM EST

Text:

Question: What exactly is fatty liver disease?

Answer: Non-alcoholic fatty liver disease (NALFLD) is a range of liver conditions that develop in people who drink little or no alcohol. It is thought to begin with and a mild type, called fatty liver, which is an accumulation of fat in liver cells. The excess fat comes from fatty foods and also from sugars that the liver turns into fat. Fatty liver is a benign condition; by itself it does not cause liver damage. However, a liver infiltrated with fat is more vulnerable to further injury which can lead to inflammation and scarring and a more serious form of fatty liver disease called non-alcoholic steatohepatitis (NASH). Up to 20 percent of those with NASH develop irreversible, advanced scarring called cirrhosis. Scarred liver tissue results in blocked blood flow, making it difficult for the liver to carry out essential tasks such as purifying the blood, making proteins, and regulating hormones. Fatty liver rarely causes symptoms. It's usually detected when routine blood tests show elevated liver enzyme levels. It can also be discovered by an ultrasound examination of the abdomen.

Question: How common is it?

Answer: It's becoming much more prevalent thanks to our rising obesity rates. And as obesity rates continue to rise, so will the number of people diagnosed with fatty liver disease. Today, NAFLD is the fastest growing liver ailment - it affects 1.4 million Canadians. And we are starting to see it diagnosed it in young kids too.

Question: What causes fatty liver disease?

Answer: Well, contrary to popular belief, fatty liver disease is not caused by alcohol, or drug use for that matter. In Canada, the most common cause of fatty liver disease is obesity. According to the Canadian Liver Foundation, 75 percent of obese individuals are at risk for developing a fatty liver. But you don't have to be overweight to develop the condition. In the documentary Super Size Me, Morgan Spurlock's month-long McDonald's binge led to signs of a fatty liver. Even at his heaviest, the 6-foot 2-inch Spurlock was not considered overweight. His daily intake of fat and sugar exceeded what his liver could handle. You're also more likely to develop a fatty liver if you have diabetes, high blood cholesterol, high blood triglycerides (fats), or metabolic syndrome.

Question: What can you do to prevent it - or treat it if you already have a fatty liver?

Answer: Weight control, proper nutrition, and physical activity are the cornerstones of treating - and preventing - non-alcoholic fatty liver disease.

Lose excess weight. If your body mass index is over 25, losing weight can reduce the amount of fat in your liver. Most studies of weight loss in NAFLD have demonstrated an improvement in liver function tests. The recommended target for weight loss is 10 percent of a person's body weight over six months. Weight loss should be gradual. Rapid weight loss - more than 1 kg (2 lbs.) per week - can worsen liver damage.
Reduce fat. A low fat, calorie-reduced diet will reduce fatty deposits in the liver. If your LDL cholesterol is also elevated, limit your intake of saturated fats. Choose lean meats, poultry breast, legumes and non-fat dairy products. Minimize your intake of cholesterol-raising trans fats by avoiding commercial baked goods, snacks foods and fast foods that are made with them. (Read the Nutrition Facts box.)
Choose carbs wisely. Since the liver processes sugar into fat particles, curb your intake of candy, desserts, drinks and other foods that contain refined sugar. Studies also suggest that reducing your intake of all carbohydrates - sugars and starchy foods - can also dramatically reduce liver fat content. Keep portion size of cereal, rice, potato, pasta and breads small.
Choose low glycemic. According to animal research, swapping fast-burning (high glycemic) for slow-burning (low glycemic) carbohydrates may help treat and prevent fatty liver disease. In the study, mice fed a high glycemic diet for six months had twice the amount of fat in their bodies, blood and livers than those on a low glycemic diet.
Low glycemic foods - which are gradually converted to blood sugar - include grainy breads, steel cut oats, 100 percent bran cereals, brown rice, sweet potatoes, pasta, apples, citrus fruit, legumes, nuts, milk, yogurt and soymilk.
Boost C and E. It's thought that vitamins C and E may reduce liver damage caused by free radicals, unstable oxygen molecules that damage cell membranes. While there isn't enough evidence to support taking supplements, it's wise to increase your intake through diet.
Exercise regularly. Moderate to high intensity exercise - 30 minutes 3 to 5 times per week - such as power walking or jogging can help improve blood sugar and blood fat levels and may reduce liver fat content.
Avoid alcohol. If you have NAFLD, especially non-alcoholic steatohepatitis (NASH), avoid alcoholic beverages. Speak to doctor about medications that may harm the liver and should be avoided.