Fatty liver disease can often be cured with lifestyle changes

Dr. Gabe Mirkin

More than 80 million North Americans have non-alcoholic fatty liver disease (NAFLD), and many are unaware they have it because most people with fatty liver disease have normal liver function blood tests at first. stages of the disease. The American Association of Clinical Endocrinology, supported by the American Association for the Study of Liver Diseases, has just released new guidelines for the diagnosis and treatment of NAFLD (presented at the AACE annual meeting on May 12 2022 and published in endocrine practice2022 May 1;28(5):528-562).

Fatty liver disease is common even in people who never drink alcohol (Gastroenterology, August 23, 2018). Today, fatty liver disease is much more likely to be caused by eating foods with lots of added sugar and/or eating mammal meat. Since blood tests are often normal in early cases of NAFLD, the disease is often diagnosed with an ultrasound image that shows fat as white spots throughout the liver.

NAFLD can usually be treated in its early stages with an anti-inflammatory diet and exercise program, any weight loss program, and even bariatric surgery when obesity is extreme. Currently, there are no FDA-approved drugs to treat NAFLD, but some drugs such as pioglitazone or glucagon-like peptide-1 agonists may increase the benefits of lifestyle changes.

Without drastic lifestyle changes, NAFLD can lead to diabetes, heart attacks, strokes, liver cancer, liver failure, liver transplants, and premature death. Over 70% of patients with type II diabetes and over 90% of obese patients with diabetes have NAFLD, and over 20% of these patients already have permanent damage called cirrhosis, where healthy liver tissue is replaced by scar tissue.

How Belly Fat Predicts Fatty Liver Disease and Type II Diabetes
People who store fat primarily in their belly are also more likely to store a large amount of fat in their liver. You can often identify who is susceptible to fatty liver disease and type II diabetes just by looking at a person. People with large bellies and small buttocks are at very high risk for diabetes and heart attacks (JAMA, 2017;317(6):626-634). To prevent your blood sugar from rising too high after eating, your pancreas releases insulin which is believed to reduce high blood sugar levels by driving sugar from the bloodstream into the liver. However, if your liver is full of fat, the excess fat prevents the liver from accepting sugar and blood sugar may rise even higher (Eur J Gastroenterol Hepatol2016 Dec;28(12):1443-1449). A sharp rise in blood sugar results in high levels of insulin in the blood which converts blood sugar into a type of fat called triglycerides. Then the insulin drives the triglycerides into your liver. Having high triglycerides and a big belly increases a person’s chances of having high levels of insulin in the blood and high levels of insulin in the arteries to cause heart attacks. Insulin also works on your brain to make you eat more, on your liver to make more fat, and on the fat cells in your belly to store that fat. Lean people with NAFLD are at high risk for diabetes and heart disease (MedPage todayMay 14, 2022).

• Belly fat storage is a greater risk factor for diabetes than just being overweight and is arguably the most common cause of type II diabetes in North America today (BMC Public Health, November 18, 2019). In one study, 11% of 5,228 non-obese people had excess belly fat, and those normal-weight people with large bellies had significantly higher levels of blood pressure, fasting blood sugar, total cholesterol, and triglycerides. indicating an increased risk of diabetes and heart problems. attacks.

• Measuring a person’s waist circumference is a simple and effective way to see if people who are not overweight are still at increased risk of diabetes (Arch Med Sci Civil Dis, 2019 Jul 22;4:e64–e71). Men are at increased risk for diabetes if their waist circumference is over 38 inches, and women if it is over 36 inches.

To see Excess fat in your liver increases the risk of heart attacks, strokes and dementia

My recommendations
If you have a big belly, dramatic lifestyle changes can save your life. I believe everyone should follow a anti-inflammatory lifestyle which helps prevent excess fat from being deposited in the liver.
• Lose weight if you are overweight
• Eat lots of vegetables, fruits, beans, nuts and other seeds
• Avoid sugary drinks (including fruit juices) and foods
• Limit refined carbohydrates — flour-based foods such as baked goods, pasta, and most dry breakfast cereals.
• Avoid red meat and processed meats
• Avoid smoking and recreational drug use, and avoid or limit alcohol
• Try to exercise every day

Dr. Gabe Mirkin is a villager. Learn more about www.drmirkin.com

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