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The liver is the largest organ in the body and is referred to as the powerhouse because it is involved in almost all nutrients and drug metabolism! Your liver helps to digest and use carbohydrates, protein, and fat, store and activate vitamins and minerals. The liver is also responsible for detoxifying substances such as drugs and alcohol. A healthy liver is usually reddish-brown, wedge-shaped with two lobes, and only contains a small amount of fat.

The first stage of liver disease is fatty liver disease and is usually termed the silent liver disease as it presents no symptoms in affected individuals. Fatty liver disease is reversible but when it goes unnoticed, can result in inflammation which can cause the death of liver cells and scarring of liver tissues (fibrosis) and consequently cirrhosis, which is the irreversible end-stage of liver disease.

Two main types of Fatty Liver Disease

Alcoholic fatty liver disease: This is the major cause of liver disease globally. Alcohol is usually metabolized/used up in the liver. When there is excess intake of alcohol, more than the liver can process per hour, the liver is forced to stop using fatty acids as fuel and focus on the alcohol. This leads to the accumulation of fat in the liver which is more evident in heavy drinkers and is the first stage of alcoholic liver disease.  Alcoholic fatty liver disease is reversible with abstinence from alcohol.

Non-alcoholic fatty liver disease: This is a build-up of fat in the liver in people with little or no intake of alcohol. This condition is quite common in individuals who are obese and/or have diabetes. Research conducted by the college of medicine Ibadan stated that each year, there are more 1.5million cases of non-alcoholic liver disease in Nigeria.  Nonalcoholic fatty liver has been strongly linked with an elevated amount of fat in the blood, obesity, and uncontrolled blood sugar. Nonalcoholic fatty liver disease has no health implication until it progresses to Nonalcoholic steatohepatitis (NASH) which is characterized by inflammation of the liver, moving to the next stage of fibrosis, and finally the scarring of the liver tissues also known as cirrhosis.

Symptoms of fatty liver disease

People with fatty liver disease usually present with no symptoms, however, on progression to inflammation and scarring of the liver, symptoms may include:

  1. Abdominal discomfort
  2. Fatigue
  3. Unexplained Weight-loss
  4. Generalized body weakness
  5. Yellowing of the skin and eyes
  6. Itchiness of the skin
  7. Accumulation of fluid at the legs, feet, hands, ankles, and abdominal swelling.

Diagnosis

Since fatty liver disease presents no symptoms, it is usually diagnosed during a routine medical checkup or your doctor may advise you do the test if he suspects symptoms of reduced liver functions.  The diagnosis is usually through a simple blood test showing elevated liver enzymes. Having elevated liver enzymes is a sign that a liver is inflamed, possibly due to fatty liver disease. Imaging tests such as Ultrasound, MRI, and CT Scan also help to show the extent of inflammation of the liver.

The complications of fatty liver disease

The main complication of fatty liver disease is liver failure, total damage of the liver (cirrhosis) and liver cancer in some cases. Once cirrhosis sets in, the liver can no longer carry out its functions.

Dietary Management of Fatty Liver Disease

Diet and lifestyle modification are currently the first-line treatment for fatty liver disease as there is no approved drug therapy for it yet. Management of fatty liver disease is crucial especially at the early stages to help reverse the condition. The following have been shown to effectively manage fatty liver disease

  • Aim to lose weight: a reduction in weight especially in cases of being overweight or obese can help in the treatment of fatty liver disease. Reducing daily calorie intake by 500 kcal has been shown to significantly decrease fat in the liver in several studies. However, very low-calorie diets should be avoided, as they can worsen the condition and increase inflammation in the liver.
  • Engage in physical activities: exercising for at least 30 to 45 minutes daily is recommended as this can help in reversing Fatty Liver Disease and maintaining a healthy lifestyle. One study found that reducing weight by 5% and exercising regularly was associated with a significant improvement in Non-Alcoholic Fatty Liver Disease.
  • Opt for unsaturated fats than saturated fats: a research study stated that saturated fat was observed to increase liver triglyceride levels than unsaturated fats. Opting for healthy fat options like your olive oil, sunflower oil, canola oil, avocado is beneficial as they help to reduce liver fat content.
  • Eat foods rich in probiotics: probiotics are micro-organism causing growth that is beneficial to the immune system and health in general. One main trigger of inflammation arises when micro-organisms are present in places where they do not belong to leading to an attack on the immune system and penetration to the body. Some of these components may end up in the liver causing inflammation. Findings suggest that the use of probiotics can help reduce inflammation. Probiotics can be gotten from fermented foods such as raw pap, kefir, and low-fat Greek yogurt.
  • Consistently choose a healthy diet: consuming fruits rich in fruits and vegetables, whole grains, low in fat, low in sodium (in some cases), and moderate in protein helps in managing Fatty liver disease
  • Avoid alcohol consumption: this is especially helpful for those with alcoholic liver disease. Total abstinence from alcohol helps to significantly reverse fatty liver disease and liver inflammation.

Summary:

Making healthy lifestyle changes can help protect the liver and prevent it from degenerating in the long term. It is very important to seek a registered dietitian’s help if you have been diagnosed with fatty liver disease to enhance your lifestyle changes. Reach out to your doctor if you have not been diagnosed but already feeling symptoms related to liver disease.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093692/
  2. https://emedicine.medscape.com/article/175472-overview#a6
  3. https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease
  4. https://www.fattyliverfoundation.org/science
  5. Shah K, Stufflebam A, Hilton TN, Sinacore DR, Klein S, Villareal DT. Diet and exercise interventions reduce intra-hepatic fat content and improve insulin sensitivity in obese older adults. Obesity (Silver Spring). 2009;17(12):2162-2168.
  6. Larson-Meyer DE, Newcomer BR, Heilbronn LK, et al. Effect of 6-month calorie restriction and exercise on serum and liver lipids and markers of liver function. Obesity (Silver Spring). 2009;16(6):2162-2168.
  7. Suzuki A, Lindor K, St Saver J, et al. Effect of changes on body weight and lifestyle in nonalcoholic fatty liver disease. J Hepatol. 2005;43(6):1060-1066.

 

 

 

 

 

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