Have you Heard about Non-Alcoholic Fatty Liver Disease?
When asked about liver diseases, I think it’s likely that many people would first think of those related to alcohol abuse, but Non-Alcoholic Fatty Liver Disease (NAFLD) is surprisingly common and it seems that far fewer people know about it. This is when the liver develops a build-up of fat in people who do not drink more than the recommended amount of alcohol. It can potentially lead on to more serious conditions such as cirrhosis or liver cancer if it goes untreated. Cirrhosis is scarring due to long term damage which prevents the liver from working properly. NAFLD is far more likely to develop in people who are overweight and it is closely associated with internal inflammation which tends to occur with many common chronic health conditions, as well as obesity, and this may exacerbate the damage. As well as this, people with NAFLD are more likely to have high blood pressure, type 2 diabetes or heart problems. Initially there aren’t any symptoms at all, so many people will have this in the early stages and not know about it. Surprisingly it is estimated that about 1 in 3 people in the UK will have some signs of fatty liver and that about 5% of the population will have the next stage, which is when the liver shows some degree of inflammation.
What can be done about it?
There isn’t any medicine to help NAFLD but there is considerable research into diet and lifestyle improvements that have shown benefits. Here are some examples:
Firstly, eat your greens! Researchers have found that a substance in broccoli, cauliflower, kale and cabbage called indole helps to prevent NAFLD and helps improve the health of those people who have the disease. These come under the group of cruciferous vegetables (from the Brassica group) which is quite a range. You don’t need to eat mountains of these, but aim to always include them in your 5-a-day.
· Bok choy
· Brussels sprouts
· Spring greens
We need fibre! Our gut bacteria are also able to produce indole but we do need to ensure we eat plenty of fibre which acts as food for the right kind of bacteria. Researchers found that those with lower levels of indole in their blood tended to have more fat in their liver and vice versa. It was particularly associated with those who were overweight or obese, finding them to be 7-10 times more likely than the general population to develop NAFLD.
It is encouraging that the National Cancer Institute (USA) also mentions the benefits of indole, a type called indole-3-carbinol, from cruciferous vegetables (the Brassica group) and notes their anti-inflammatory and cancer-fighting properties. It’s important to note here, that vegetables provide fibre; it doesn’t only come from whole grains like bran or wheat such as in wholemeal bread.
Fizzy drinks are no go! Stop drinking soft drinks with artificially added sugars because they contain a form of sugar that is rapidly absorbed and stored as fat. They are associated with NAFLD, type 2 diabetes, obesity, heart disease and more. A diet rich in sucrose and fructose causes fat to be quickly made and stored in the liver.
Fast food contains hidden sugar. If you were making the same kinds of food yourself you wouldn’t include sugar in it! For example, if you made burgers at home you’d probably add minced beef, finely chopped onion, various herbs, salt and pepper and probably egg and flour to bind the mixture together. Would you add sugar? Unlikely, I should think. How about bolognaise sauce or fish pie – do you add sugar to those? It is to promote addiction, and sugar is very addictive! It’s unrealistic to avoid all sugar in life, but these hidden sugars can quickly build up and contribute a lot to your daily intake. Another important thing to remember is that junk food is low in fibre which is vital to creating benefit for NAFLD.
When you eat is also important. Researchers found that a high calorie diet with high meal frequency increased fat in the liver as well as around the waist, whereas increasing the size of a meal didn’t. This just goes to show that the problem isn’t only about calories. Snacking between meals was found to contribute to weight gain as well as fatty liver, however, people who ate the same amount of calories over all, but stuck to three meals without snacking in between, didn’t have the same effect. Fascinating! Our digestive systems weren’t designed to be working during every waking hour – we really need to give them a break!
Exercise is vital. It’s important but you don’t need to go breaking any world records – it can be low but consistent, appropriate to each individual’s ability. Our bodies are constantly sending and receiving internal messages between cells, and exercise helps to improve the quality and efficiency of these messages. This effect enables our organs to function well to help avoid ill health and disease. In one research study they found physical inactivity linked to the severity of fatty liver disease irrespective of body weight. We know that being overweight is a risk factor for NAFLD, but this demonstrates just how important it is to be active. For millions of years our ancestors had to be physically active simply in order to obtain their food. Over the centuries, to enable survival, our bodies have become efficient at storing food for energy (as fat) to help us in times of famine. Only nowadays, in the Western world, the famine never comes!
Support in taking action against NAFLD
So, this is an overview of NAFLD and has hopefully shown that diet and lifestyle changes can help to support the liver in its many functions and provide benefits for NAFLD. Dietary changes are most effective when taking a step by step approach, as everyone has different sticking points to overcome. For example, do you need help with meal plans to fit in with your family? Do you need inspiring recipes? Do you find that staying motivated is hard? This is what I do as a Nutritional Therapist, so if you’d be interested in working with me with regard to your own diagnosis, or risk, of NAFLD please contact me for a 20-minute, free, no-obligation chat to see if you think it’s the right path for you.