Fatty Liver

What is Fatty Liver Disease?
Nonalcoholic fatty liver disease (or NAFLD) is a condition where excess fat is stored in your liver cells. This buildup of fat is NOT caused by heavy alcohol abuse. 

NAFLD is increasingly common in our society, affecting about 1/4th of our population.

Some individuals with NAFLD can develop a more aggressive form of fatty liver disease call nonalcoholic steatohepatitis (or NASH). This condition is marked by liver cell damage similar to the damage caused by heavy alcohol abuse. It causes inflammation in the liver that can progress to fibrosis (or abnormally large amounts of scarring in the liver), cirrhosis (or hardening of the liver), liver failure, and even liver cancer. 

What is the difference between NASH and NAFLD?
Simple Non-Alcoholic Fatty Liver Disease is when you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver disease typically does not progress to liver damage, cirrhosis, or other complications of liver disease.

NASH is a form of NAFLD where you have inflammation of the liver and liver cell damage, in addition to fat in your liver. Inflammation and liver cell damage can cause abnormally large amounts of scar tissue to form in your liver, which can lead to fibrosis, Cirrhosis of the Liver, liver failure and even Liver Cancer. 

How common is NAFL?
It’s estimated that about 30-40% of adults in the U.S. have NAFLD. Roughly, 3-12% of adults have NASH.

What Causes NAFLD?
Experts don't know exactly why some people accumulate fat in the liver and others do not. 
What we do know is that NAFLD and NASH are both linked to:

  • Obesity
  • Diabetes and Insulin Resistance  
  • People with fatty liver disease often have insulin resistance. This is where your body can make insulin but can’t use it well. Sugar builds up in your blood and your liver turns this excess sugar into fat and stores it.
  • High Cholesterol and High Triglycerides, and
  • Metabolic Syndrome 

What are my risk factors for developing NAFLD?
Risk Factors may include:

  • Obesity
  • Diabetes and Insulin Resistance
  • High cholesterol and High Triglycerides 
  • Metabolic syndrome
  • Polycystic ovary syndrome
  • Sleep apnea
  • Hypothyroidism and Hypopituitarism

What are my risk factors for developing NASH?
NASH tends to occur more frequently in:

  • Older individuals
  • Individuals with diabetes, and 
  • Individuals with greater waist circumferences 

What are the symptoms of NAFLD?
Most of the time the disease is asymptomatic; however, symptoms may include:

  • Fatigue and a generalized feeling of malaise
  • Elevated liver functions tests, and
  • Pain or discomfort in the right upper abdomen in the area of the liver

What are the symptoms of NASH?
Symptoms of NASH and advanced Cirrhosis include: 

  • Ascites or fluid accumulation in the abdomen
  • Swelling in the lower extremities
  • Weight loss or gain
  • Easy bruising or bleeding
  • Itchy skin and itchy palms
  • Red palms
  • Enlarged blood vessels just beneath the skin's surface
  • Esophageal Varices and GI bleeding
  • Enlarged spleen
  • Jaundice or yellowing of the skin and the whites of the eyes

What are the complications of fatty liver disease?

  • NASH can lead to cirrhosis of the liver and liver cancer. 
  • NAFLD does not. 
  • Between 5-12% of people with NASH will go on to develop Cirrhosis of the Liver.
  • Studies suggest that people with NAFLD have a greater chance of developing heart disease. Cardiovascular disease is the most common cause of death in people who have either form of NAFLD.

How can NAFLD be prevented?
Follow a healthy diet, maintain a healthy weight, lose excess fat, especially excess belly fat, exercise regularly, stay active, and follow medical advice and guidelines for the aggressive management of diabetes, high cholesterol, high triglycerides, and metabolic syndrome. 

Can fat be removed from the liver?
Fortunately fatty liver can be reversed if caught and addressed early. 

Research suggests losing weight is the single best thing you can do to control or reverse fatty liver. Even a 3-5% reduction in body weight can improve your liver health.

Treating underlying medical conditions such as diabetes, insulin resistance, high cholesterol, high triglycerides, metabolic syndrome, obesity, sleep apneas, PCOS, underactive thyroid, and underactive pituitary gland syndromes can all help to reverse the disease process. 

Make small shifts in your diet. 
Eat more fresh fruits and vegetables, berries, leafy greens, fish, nuts, high-fiber foods, beans and legumes, good fats, avoid excess carbohydrates, limit processed sugars, saturated fats, trans fats, and salt. 

Incorporate good fats into your diet. These include:

  • Omega-3 fatty acids found in fish, olive and canola oils, nuts, flaxseed, sunflower seeds, and almonds, and 
  • Monounsaturated fats found in plant sources like olives, nuts, and avocados. 

Steer clear of saturated fats, which can lead to more fat deposits in your liver. These include fats found in red meats, dairy products, certain baked goods, and fried foods. 

Alcohol can cause fat to build up in your liver so limit alcohol consumption, and avoid drugs known to be toxic to the liver. 

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