Fatty fat fat. My usual motto is “fat is where it’s at!” when it comes to including healthy, real food, paleo style fats in your diet. HOWEVER, I have to modify this statement for this post. While consuming healthy fats is good for you for zillions of reasons, well maybe not quite zillions but a lot of reasons for sure, one thing you don’t want to have is a fat[ty] liver!
I know, random topic. Here’s the deal. I was talking to a friend of mine over the weekend, having dinner and drinking wine, and we got on the topic of fatty liver. Talking about fatty liver while drinking alcohol sounds appropriate don’t you think? Given we were curious about the subject based on recent rumblings amongst our circle of friends, I decided to so some R.E.S.E.A.R.C.H.!
Having some fat in your liver is normal. Some people with excess fat in the liver simply have what’s called a fatty liver. While this is not normal, it is not serious if it doesn’t lead to inflammation or damage. But if fat makes up more than 5% to 10% of the weight of your liver, you may have alcoholic or nonalcoholic liver disease, both of which can lead to serious complications.
Fatty liver (FL), also known as fatty liver disease (FLD), is a condition where triglycerides accumulate in the liver. Triglycerides are a type of fat found in your blood and your body uses them for energy. There are many causes, but FLD generally occurs in those that consume alcohol in excess, and in those who are obese. FLD can be associated with other diseases that influence fat metabolism, and metabolic syndrome. Metabolic syndrome is a combination of high blood pressure, high blood sugar, too much fat around the waist, low HDL cholesterol, and high triglycerides. Metabolic syndrome increases your risk for heart disease, diabetes, and stroke. There may be nutritional factors contributing to FL as well, such as gastric bypass, diverticulosis, and bacterial overgrowth. FL can be also be related to drugs and toxins, and other things like HIV, IBD (irritable bowel disease) and hepatitis C. So while you may think FLD is most commonly associated with alcohol consumption, there can be other causes as well.
First let’s address alcohol related fatty liver disease. There are some interesting stats. At least I find them interesting. But I also just like stats in general. That’s kinda how I roll.
*More than 15 million people in the U.S. abuse or overuse alcohol.
*Almost all of them, between 90% to 100%, develop fatty livers.
*Fatty liver can occur after drinking moderate or large amounts of alcohol.
* Fatty liver can even occur after a short period of heavy drinking (acute alcoholic liver disease).
Genetics or heredity can play a role in alcoholic liver disease too [feel free to thank your folks]. This is because genetics and heredity can affect how much alcohol you consume and your likelihood of developing alcoholism. They also can have an effect on the levels of liver enzymes you have that are involved in the metabolism of alcohol. Obesity and diet can also contribute to the development of alcoholic fatty liver disease.
Ok, so what about nonalcoholic fatty liver disease (NAFLD)? NAFLD is now the most common cause of chronic liver disease in the U.S.! Some people with NAFLD have what’s called nonalcoholic steatohepatisis (NASH). Steatohepatisis is when there is inflammation and liver damage present. NASH is similar to alcoholic liver disease, but people with this type of fatty liver disease drink little or no alcohol. NASH can lead to permanent liver damage (cirrhosis), and is one of the leading causes of cirrhosis.
More stats, yay! These are in relation to NAFLD and NASH.
*Up to 20% of adults may have either NAFLD or NASH.
* More than 6 million children have one of these conditions. Yes, children!
The cause of NAFLD is not clear, but certain factors tend to increase risk. In some cases no risk factors are present. NAFLD tends to run in families. Studies also show that an overgrowth of bacteria in the small intestine, and other changes in the intestine may be associated with NAFLD. Some researchers now suspect this may play a role in the progression of NAFLD to NASH. NAFLD also shows up most often in people who are middle-aged and overweight or obese, and in those with high cholesterol, high triglycerides (dietary sugar and alcohol consumption contribute here), diabetes and prediabetes or insulin resistance. Yep, lifestyle. Boom. Given many other identified health issues that have come to rise in the last several decades that can be attributed to lifestyle related factors, this does not surprise me. Of course I’m referring at least in part to the standard American diet (SAD). Oh the havoc that thing has wreaked!
Fatty liver disease often has no symptoms. If the disease advances, which usually occurs over the course of years or even decades, it can cause problems like fatigue, weight loss or loss of appetite, nausea, weakness, brain fog (confusion, trouble concentrating), pain in the center or right upper part of the abdomen, an enlarged liver and even skin discoloration (usually on the neck or underarm area).
With alcoholic liver disease, symptoms may worsen after episodes of heavy drinking, and with NAFLD, the disease process can stop or reverse, or it may worsen. If cirrhosis develops, signs and symptoms can include fluid retention, muscle wasting, internal bleeding, jaundice (yellowing of skin and eyes), and eventually liver failure.
Diagnosis often occurs during a routine checkup. The doctor might notice that your liver is slightly enlarged, or she might see signs of fatty liver on a blood test, because during routine blood tests, elevations in certain liver enzymes may show up. A fatty liver may also show up on imaging tests, such as an abdominal ultrasound. The only way to confirm a diagnosis of fatty liver disease is with a liver biopsy.
The treatment of fatty liver depends on its cause. In general, treating the underlying cause will reverse the worsening of the condition if implemented at an early stage. Again to be clear, we can gather that the two main known causes of fatty liver disease are an excess consumption of alcohol and diet (both of which can be exacerbated by genetics).
If you have alcoholic liver disease and you are a heavy drinker, quitting drinking is the most important thing you can do. Even for those with NAFLD, avoiding alcohol may help.
If you are overweight or obese, do what you can to lose weight in a healthy way. Avoid diets rich in refined, rapidly digested carbohydrates. Yes, that means sugar and processed food/carbohydrates. This includes limiting foods such as bread, grits, rice, potatoes, corn, and concentrated sugar. In other words, EAT REAL FOOD! And get some exercise too.
Avoiding unnecessary medications is also important. The liver is a detoxification filter for your body, so putting any sort of chemical weirdness into your body adds stress to the liver as it works to cleanse your system. Medications can be hard on the liver. If you don’t need to take them, don’t. Of course talk to your doctor before stopping (or starting) any medications. Even vitamin and mineral supplements can cause health problems and adversely affect the liver, especially if your liver is already compromised. The best way to get the benefits of vitamins and minerals is through sources of REAL FOOD that contain those vitamins and minerals. Again, talk to your doctor about any medications and/or supplements you are taking if this topic is of concern.
[In case you were wondering, not only does your liver detoxify your body, it also functions in protein synthesis, and produces biochemicals needed for digestion. You can’t survive without a liver!]
If liver cirrhosis becomes severe, the treatment is liver transplant. And that ain’t gonna be no fun.
The moral of the story is this. EAT REAL FOOD, get your workout on, and depending on your condition, either drink in moderation or better yet STOP DRINKING. And make sure your doctor is kept in the loop.