Non Alcoholic Fatty Liver Disease

15 Mar Non Alcoholic Fatty Liver Disease

Non Alcoholic Fatty Liver Disease – What to do about your own Foie Gras

Fatty liver disease (FLD), is a reversible condition in which proper fat metabolism is reduced, and abnormal amounts of large globs, or vacuoles, of triglyceride fat accumulate in liver cells through a process called steatosis. Although it can be caused by excessive alcohol intake and the resulting inflammation, today we’re going to take a look at the more common version, which is on the rise, as metabolic syndromes, and obesity, become increasingly more common.

Most individuals with NAFLD, don’t even know they have it. After all, the condition doesn’t present with any particular symptoms. The usual manner in which one might get diagnosed with the condition, would start with their liver enzymes being flagged on routine bloodwork with their family doctor. On following up, the family doctor might ask whether they’ve been consuming an excessive amount of alcohol recently, or as the case is, more bluntly, simply asking ‘Are you an alcoholic?’

If the answer is in the negative, then the doctor will refer the patient for an abdominal ultrasound to assess the cause of the raised liver enzymes. If the ultrasound displays fatty infiltration of the liver, which typically requires the fat content to exceed 5% of the liver’s volume, then the diagnosis is given.

Medical risk factors for NAFLD can include having type II diabetes mellitus, of which 70% have NAFLD, and unsurprisingly, insulin resistance, which is both a cause and consequence of having a fatty liver. Likewise, obesity is a significant risk factor for NAFLD, although it can occur in lean individuals as well. Lastly, inflammatory conditions, such as having elevated inflammatory markers such as homocysteine or CRP, or chronic inflammation of the liver itself, as in hepatitis C, can likewise predispose an individual to developing NAFLD.

In terms of lifestyle risk factors, leading a sedentary life, along with an excess consumption of calories, refined carbohydrates, and fructose, do not help matters, and lead to a greater incidence of NAFLD. This is because excessive refined carbs and fructose are directly associated with higher blood levels of triglycerides in general. Furthermore, studies have shown that excess fructose consumption not only raises blood pressure and triglyceride levels, but also increases inflammation and insulin resistance in the liver. Combining that with a lack of exercise further encourages insulin resistance to arise.

Dietary deficiencies in folate, and choline have also been implicated as dietary risk factors. One can address these short comings by having more dark leafy vegetables which are rich in folate, and egg yolks, cod, shrimp, almonds, broccoli and dairy products for their choline content. Eating foods rich in the amino acid methionine, such as meat, fish, sesame seeds and brazil nuts, can also be helpful, as methionine can be used by the body to make choline.

Other dietary factors that play a role include consuming vegetable oils that are rich in inflammatory omega-6 polyunsaturated fats, which may also be hydrogenated, leading to further issues with trans fats. Examples of these types of oils include corn, canola, and soybean oil, all of which can also be found in commercial mayonnaise and salad dressings. The healthier alternative is to simply use a high quality omega 9 olive oil, which is monounsaturated.

Most surprising of all, is that studies have shown that reducing carbohydrate consumption and increasing saturated fat instead, as in a ketogenic diet, can help the liver shed some of the fat accumulation in as little as three days, as long as there is sufficient dietary choline present.

TAKE AWAY:

NAFLD is a condition that can be prevented and reversed through a ketogenic diet, or at minimum a lower refined carbohydrate and fructose free diet, that includes omega 9 monounsaturated olive oil over omega 6 vegetable oils, as well as foods high in folate and choline.