Spotlight on a Silent Epidemic: Non-Alcoholic Fatty Liver Disease (and 5 Ways to Prevent it)

Published on October 23, 2017 by Courtney Ranieri

While we usually associate fatty liver with excessive alcohol consumption, there is another form of liver disease known as Non-Alcoholic Fatty Liver Disease or NAFLD that develops in people who drink little to no alcohol. NAFLD can remain ‘silent’ for many years, with few signs or symptoms.

The prevalence of NAFLD is increasing at an alarming rate. The risk of developing NAFLD in obese people is 75%. With almost 20 million obese Canadians, NAFLD is a growing health epidemic.

Eating excess calories causes fat accumulation in the body. One of the locations fat is stored is in the liver. This buildup of fat in the liver causes NAFLD and has serious consequences. These include progression to Non-Alcoholic Steatohepatitis (NASH), liver fibrosis, cirrhosis, and liver failure.

What are risk factors for NAFLD and NASH? 

  • Obesity (BMI > 29)
  • Weight circumference >35 inches for women and >39 inches for men
  • Type 2 Diabetes
  • High levels of cholesterol/triglycerides
  • High blood pressure (>130/85)
  • Poor diet - including consumption of high-fructose corn syrup
  • Smoking

Even if you do not have any of these risks, some populations are predisposed to developing NAFLD.

What are the symptoms?

  • Patients with NAFLD may have no noticeable symptoms in the early stages, which is why is it is known as a ‘silent disease’.
  • Symptoms include fatigue, malaise, upper right abdominal pain, enlarged liver and elevated liver enzymes.
  • It is important to be aware of these symptoms, especially if you have any of the risk factors above as the consequences of NAFLD that are serious and can lead to liver failure.

What can you do to help prevent NAFLD?

1) Maintain a healthy BMI

  • The number one thing you can do to prevent NAFLD is to maintain a healthy BMI.
  • If you are obese or overweight, losing weight and maintaining a healthy waist size significantly decreases the risk of developing NAFLD.

 2) Eat a healthy diet

  • Eat a healthy, well-rounded diet full of vegetables, leafy greens, fresh fruit, lean meat and complex carbohydrates.
  • It is important to be conscious of caloric intake and ensure you are not overeating.

 3) Eliminate high-fructose corn syrup from your diet

  • One of the biggest dietary contributors to the development of NAFLD is high fructose corn syrup.
  • High fructose corn syrup is found in many packaged foods including sodas and soft drinks, candy, bread, cereals, baked goods and even seemingly healthy foods such as salad dressings, yogurt and granola bars!
  • Be conscious and read all food labels in order to avoid high-fructose corn syrup.

 4) Exercise

  • Exercise for a minimum of 150 minutes per week (while walking is great, this should include be heart-pumping, sweat-inducing exercise).

5) Nutritional Supplements including L-Carnitine, Betaine, and Vitamin E

  • There has been some promising research in the field of nutritional supplements for NAFLD.
  • Most supplements for NAFLD focus on antioxidants and methylation support to benefit the liver and prevent the deposit of fat and further inflammation.
  • Consult with a Naturopathic Doctor or healthcare practitioner before starting any supplements or treatments.

References

Abdelmalek MF, Suzuki A, Guy C, et al. Increased fructose consumption is associated with fibrosis severity in patients with nonalcoholic fatty liver disease. Hepatology 2010; 51:1961–1971.

Abdelmalek, M. (2001). Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. The American Journal Of Gastroenterology, 96(9), 2711-2717. http://dx.doi.org/10.1016/s0002-9270(01)02691-0

Ji, Hong-Fang et al. Effect of vitamin E supplementation on aminotransferase levels in patients with NAFLD, NASH, and CHC: Results from a meta-analysis. Nutrition. 30 (9): 986 - 991.

Jin R, Le NA, Liu S, et al. Children with NAFLD are more sensitive to the adverse metabolic effects of fructose beverages than children without NAFLD. J Clin Endocrinol Metab 2012; 97:E1088–E1098.

Kathirvel E, Morgan K, Nandgiri G, Sandoval BC, Caudill MA, Bottiglieri T, French SW, Morgan TR. Betaine improves nonalcoholic fatty liver and associated hepatic insulin re- sistance: a potential mechanism for hepatoprotection by betaine. Am J Physiol Gastrointest Liver Physiol 2010; 299: G1068-G1077

Musso G, Gambino R, Cassader M, Pagano G. A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease. Hepatology. 2010;52(1):79–104.

Wilkins, T., Tadkod, A., Hepburn, I., & Schade, R. (2013). Nonalcoholic Fatty Liver Disease: Diagnosis and Management. Aafp.org. Retrieved 14 October 2017, from http://www.aafp.org/afp/2013/0701/p35.html#afp20130701p35-b30

Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R, et al. Long term nutritional intake and the risk for nonalcoholic fatty liver disease (NAFLD): a population based study. J Hepatol 2007; 47:711–717.