Tips, tricks to avoid non-alcoholic fatty liver disease
My older sister, Georgia, was my hero. As a young boy in a rough Pittsburgh neighborhood, I wish I had a big brother to help me navigate safely and develop the kinds of skills needed to survive and thrive. Georgia took the role, teaching me how to play baseball, and if I fought, she wouldn’t let me give up. We were very close throughout life, and it was a blow when I lost her recently to a non-alcoholic fatty liver.
I try to stay on top of health issues as best I can, but I have to admit when it came to fatty liver disease, I was caught completely off guard. As is commonly believed, I had assumed that chronic alcohol consumption caused the accumulation of excess fat in the liver, which could ultimately lead to cirrhosis (a life-threatening liver disease that causes permanent scarring and hardening of the liver). From my sister’s experience, I learned that people who never touch a drop of alcohol can also accumulate excess fat in the liver.
Georgia hardly ever consumed alcohol, apart from an occasional toast in which she could take a sip of wine. For the most part, despite gaining considerable weight in middle age and beyond, she was still vibrant and energetic, eager to engage and seek out new experiences. A good example is when my brother-in-law retired and she convinced him to immediately go on a world cruise that lasted 107 days.
Shortly after the world cruise she started to descend, gradually at first, then much faster as she seemed tired and weak all the time. Soon, she developed water retention in her abdomen, causing extreme swelling. She also suffered rapid weight loss due to muscle wasting.
Medical tests revealed fatty liver, but it was too late, she was running towards liver failure.
What causes excess liver fat and inflammation?
If alcohol isn’t a problem, but you have excess fat in your liver that isn’t causing any damage, that’s called non-alcoholic fatty liver disease (NAFLD). It affects more people than I imagined, about 10-20% of Americans. Despite the accumulation of fat in the liver, chances are you have no idea what the problem is.
Does that mean you can ignore it? No not at all. The reason for this is that in 20% to 30% of cases, NAFLD progresses to more serious liver disease.
When excess liver fat is associated with inflammation, it is called non-alcoholic steatohepatitis (NASH). NASH causes liver damage and re-emphasizes the impact of inflammation that is at the root of so many chronic health issues. Eventually, NASH can progress to severe cirrhosis with life-threatening implications, as was the case with my sister.
So, without consuming a lot of alcohol, why could you accumulate too much fat in your liver? One possibility is obesity, which causes prediabetes, a condition in which your cells are resistant to the effects of insulin, but it has probably not been discovered or diagnosed. However, if insulin resistance gets worse, prediabetes turns into Type 2 diabetes.
Either way, prediabetes and type 2 diabetes can cause glucose to build up in the blood and this excess glucose can be taken up by the liver and converted into fat. When the fat created from glucose stays in the liver, instead of being released and stored elsewhere in the body, the fat content of the liver increases.
How to treat non-alcoholic fatty liver disease?
As mentioned above, if you have non-alcoholic fatty liver disease (NAFLD) but no inflammation, you may not have any symptoms and may not be aware of it. So how is it diagnosed?
There are several options to detect a problem, including abdominal ultrasound and liver enzyme testing. More advanced tests include computed tomography or magnetic resonance imaging of the abdomen. These tests are helpful, but they cannot distinguish between NAFLD and NASH, and eventually liver biopsies may be needed.
NAFLD may not require special medical treatment, but it is wise to be proactive and make lifestyle changes. This involves embracing the “usual suspects” including improving your diet and exercising regularly to reduce body fat. This will hopefully reduce a possible source of the problem, insulin resistance (prediabetes) which can progress to true type 2 diabetes. Also, avoid alcohol.
On the other hand, if you suffer from NASH (fat accumulation plus inflammation), serious symptoms are likely and they will get your attention. As mentioned, my sister suffered a severe loss of energy and swelling in her abdomen. When this occurs, it suggests that the disease is very advanced and specialized medical intervention is needed.
Sound familiar? It should.
The arteries that supply the heart can be 80% clogged before you experience the first symptom, probably chest pain in men. In women, the first symptom can vary and be confusing, such as pain in various parts of the body that seems unrelated to the heart. Either way, the fact is that the American way of life, which emphasizes poor diets and a sedentary life, promotes all sorts of health problems that seem to come out of nowhere.
On the contrary, as was the case with my sister, her condition had been brewing and progressing for many years before revealing itself with serious symptoms.
Don’t Ignore These Chronic Diseases Before It’s Too Late
Chronic illnesses that destroy health and lead to premature death (heart disease, cancer, diabetes, fatty liver disease, etc.) often have several things in common, including (1) excess body fat, especially around the waist ; (2) they progress slowly over many years; and (3) they go unnoticed until serious damage is done. With that in mind, I was concerned when my sister gained considerable weight late in life and encouraged her to do something about it. Sometimes she complied but quickly reverted to her old ways.
The problem is that there was no clear evidence of non-alcoholic fatty liver disease or the price it was paying. No symptoms of any kind, meaning she had little incentive to follow the diet and exercise programs I recommended.
Unfortunately, when the problem became known, it was too late.
Contact Bryant Stamford, professor of kinesiology and integrative physiology at Hanover College, at [email protected]