This condition, which is extremely common today, has both negative and positive connotations. Negative in the sense that it is a rather serious disease that we are causing ourselves through our lifestyle – and there is also good news: we can change it. And we need to, because there is almost no cure – only lifestyle change can help.
It is such a common condition that it affects one in three people in affluent Western countries. In most cases it is not the only one, but is associated with other diseases of civilisation, i.e. metabolic syndrome. (In some very rare cases it is genetic, i.e. an inherited metabolic disease: this is already found out in infants.)
What is fatty liver?
What the name implies: small lipid droplets form in the liver cells in small lipid pockets, and these excess fats accumulate in the liver. Normally, the liver has less than 10% fat. In medical terminology, Non-Alcoholic Fatty Liver Disease (NAFLD) refers to anything that is not caused by alcohol or viral infection. A more serious condition is NASH (Non-Alcoholic Steato-Hepatitis), where inflammation destroys the organ as well as fat accumulation.
A ‘simple’ fatty liver is not in itself a serious, life-threatening disease, but it is a reliable indicator of a metabolic derailment. However, in the absence of lifestyle changes, it will deteriorate further and develop into chronic hepatitis. The inflammation continues to worsen, and the liver scars and dies in areas of fatty degeneration. The final consequence of the disease is cirrhosis, which eventually leads to fatal organ failure, and the only way to save the patient’s life is a liver transplant.
A rather grim outcome for a problem that can be stopped in almost all its stages by ourselves, within our own reach.
What causes fatty liver?
– If the liver problems are not caused by alcohol addiction, the person concerned is likely to be in the risk group of overweight or obese people, 80% of whom have the problem.
– Other risk factors may include type 2 diabetes, insulin resistance, various pancreatic diseases, high blood lipids, thyroid disease, especially hypothyroidism.
– Unfortunately, long-term use of certain medications (e.g. steroids, hormones) may also contribute, due to their hepatotoxic effects.
– It is a very sad fact that, due to the almost epidemic obesity, the structural deterioration of the liver is also starting in younger and younger people.
– Acute fatty liver of pregnancy is a separate group, which fortunately is very rare, as it is a very serious condition that endangers both mother and foetus.
Almost all of the conditions listed above are conditions that we cause ourselves. Lifestyle and diet are responsible for all the diseases of civilisation, and fatty liver is no different. Regular excessive calorie intake, a diet rich in industrially processed, refined carbohydrates and toxic vegetable oils, low in fibre and minerals. The combination of these will be the first step to a persistently elevated insulin action, which disrupts fat metabolism and causes, among other things, fatty liver, which will soon be associated with insulin resistance.
Persistently high calorie intake, combined with chronic physical inactivity, low natural sunlight and regular poor quality sleep, is almost inevitable: metabolic syndrome.
The effect of fructose on the liver
Research has shown that refined, rapidly absorbed carbohydrates, which come in abundance with fats, are an important contributor to the development of fatty liver.
When we consume natural, unrefined complex carbohydrates, we are not doing our bodies any harm – in fact, we are doing them a lot of harm. During their slow degradation, we get a steady glucose load, which works the insulin-producing pancreas, but essentially all our cells help to process the glucose we absorb. Our muscles store it, our brains burn it and all our organs consume it as needed. There is nothing wrong with this process, our bodies recognise it as natural and adapt to it. Eating fruit, for example.
When we consume refined table sugar, however, it is a completely different case: beet sugar, cane sugar and sucrose are a mixture of a disaccharide, half of which is glucose and half fructose. So with refined sugar, we are also consuming plenty of fructose, but in a completely different form than, say, fresh fruit. The variable fructose content in fruit comes with water, vitamins, slow-digesting and indigestible fibre, so it does not overload the digestive system. The slow-absorbing natural fructose is almost entirely processed in the intestinal wall, with very little reaching the liver.
Fructose, on the other hand, causes unfortunate fatty liver after only a few months of continuous consumption (Stanhope 2009, DiNicolantonio 2017) Unfortunately, a little is not without risk: the effects add up and slowly and gradually coat the liver with fat molecules. Fructose is a special sugar that, unlike glucose, can only be removed by the intestinal wall and the liver, up to the limit of its capacity. After that, it can only store it and, in a manner most comparable to alcohol, causes fatty liver and, over time, toxic organ damage everywhere.
It cannot be stressed enough: fatty liver and our related metabolic diseases , the metabolic syndrome, have a common source: our lifestyle. Lack of exercise, and foods rich in worthless oils, refined carbohydrates, glucose and fructose, but low in fibre. Knowing this, however, the prevention, reversal and cure is fairly simple: regular exercise, natural food rich in real nutrients. Of course, the diet must be absolutely personalised, given that not everyone is associated with the same civilisational diseases, or to the same extent.
We can always find out what state our liver is in, indicated by elevated levels of the liver enzymes gamma-GT, GPT, GOT in the blood count. In some cases, a Fibroscan scan may also be necessary. Fatty liver has no marked, noticeable and exclusive symptoms. A sign may be the characteristic apple-type obesity localised to the abdomen. In advanced stages, it may cause general symptoms such as weakness, fatigue and reduced exercise capacity. Symptoms may also include a protruding stomach, bloating, heartburn, skin discomfort, increased sweating, dark urine, and a plaquey tongue.
It is rarely associated with pain in the abdomen or right rib cage, but this is not a completely reliable symptom because the liver has no sensory nerves and therefore does not hurt when its function is impaired or there is a problem. Typical jaundice indicates a serious condition and requires immediate medical intervention.
Treating fatty liver with lifestyle change steps
As fatty liver is very rare on its own, i.e. 90% of cases are associated with co-morbidities, treatment should always be absolutely personalised.
Weight loss can be achieved through diet, a personalised and appropriate diet and regular exercise appropriate to the condition. Exercise improves blood circulation, the ability of the blood to transport oxygen and nutrients, and the hormone-producing organs.
Weight loss in itself improves the histological changes in the liver, using up the fat molecules that cover the organ. Losing weight at the right rate can reduce fatty liver disease by as much as 50 percent.
Optimising blood sugar metabolism
In addition to different types of diabetes, impaired glucose tolerance and insulin resistance are important to treat in fatty liver. It is usually treated with medication combined with personal diet and nutritional supplements. If fatty liver is associated with problems with sugar metabolism, avoidance of glucose and fructose is extremely important, as explained in the previous part of this article. In this condition, even very little consumption is not advisable, as two vital organs are under attack. Nowadays, it is not at all difficult to substitute the sweet taste, as there are many healthy, natural sugar substitutes available.
Reducing high blood fat levels
Just as our body is a holistic unit that works together in a closely interdependent way, our poor choices can affect many organs. However, lifestyle change brings with it the great phenomenon that improvement is also body-wide. In other words, taking the steps listed in the previous points will bring with it a reduction and resolution of high triglycerides and cholesterol.
It is also worth adding that if you have high blood fat levels, you should also reduce your intake of healthy fats and concentrate heavily on your intake of vasoprotective compounds such as onions, red and black berries and green leafy vegetables.
Medication for fatty liver
As I have mentioned several times, self-care and lifestyle changes are also essential in the treatment of fatty liver because there is currently no drug treatment. Research has shown that obeticholic acid, which is currently only available in clinical trials, has a proven effect, although it shows promise as a treatment for fatty liver.
What foods should we eat?
1. Whole grains, pseudo-grain: useful sources of energy, high fibre content benefits all conditions of metabolic syndrome
2 Avocados: rich in healthy fats, avocados can slow down the process of liver damage.
3 Sunflower seeds: the antioxidant vitamin E they contain helps the liver function.
4 Olive oil and porcini: high in omega-3, they can reduce liver enzymes.
5. coffee: research shows that 2-3 good quality coffees a day without sugar and milk reduce abnormal liver enzyme production, have a strong anti-free radical effect and reduce structural remodelling of the liver.
6. Eat all green vegetables: broccoli, Brussels sprouts, kale, spinach and other green leafy vegetables.
7. Fermented and sprouted foods: low in carbohydrates thanks to pre-digestion and support the balance of the microbiome. Such as sauerkraut, kimchi, miso, kefir, yoghurt. And for sprouting, you can buy special seeds, from cassava to mung beans.
8. Tofu: experiments have shown that foods containing soy protein, such as low-fat tofu, can reduce the amount of fat deposited in the liver.
9. fish: tuna, trout, salmon, mackerel and sardines contain high levels of omega-3 fatty acids, which not only help to maintain healthy fat levels but also have anti-inflammatory effects. However, those who prefer not to eat animal sources can get their omega-3 from algae, just as fish does.
10 Oily seeds: nuts, almonds and other seeds also help maintain healthy liver function due to their high omega-3 content and high fibre content.
11. All onions, but especially garlic: antibacterial, antiviral, antiseptic, helps with weight loss and lowers blood fat.
1. Nettle leaf helps to cleanse the liver, but is also beneficial for bile and stomach upset. It is a blood purifier and helps remove waste products. Its tea should be taken as a cure, after 6 weeks with a 4 week break.
2. walnut leaf, which can be drunk occasionally after meals to improve digestion. It is particularly recommended after courses of antibiotics. It strengthens liver activity and increases blood circulation. Drink as a tea after meals.
3. Its cold-pressed oil should be consumed by the spoonful daily.
The list of foods and herbs that are beneficial for the liver shows that regeneration is not a difficult process once you have decided to change your lifestyle. Whether we treat this humble but indispensable organ as a preventive or curative measure, we are taking a very important step towards prolonging our lives.