Non alcoholic fatty liver disease (NAFLD) wasn’t even on our radar screen 30 years ago. Today, it affects as many as 1/3 of Americans and is the leading form of liver disease in the United States.
Worse yet, it shows no signs of slowing down and threatens to overwhelm liver transplant programs in the coming decade.
According to Dr. Michael Curry, a hepatologist at the Beth Israel Deaconess Medical Center in Boston, about 80% of people with non alcoholic fatty liver disease will not develop a significant form of liver disease. In the other 20%, the condition will progress to non alcoholic steatohepatitis (NASH) and about 20-30% of NASH patients will progress to liver cirrhosis and end stage liver disease.
In the United States that means as many as 6 million people could be looking for liver transplants in the near future.
The fatty liver epidemic is a silent, but very real threat to the health of many Americans and one Dr. Curry believes could overwhelm liver transplant programs and create a situation where we’re simply unable to treat so many patients.
But non alcoholic fatty liver disease isn’t just an American problem. Recent reports out of England, Malaysia, and other countries show similar signs that fatty liver could quickly become a worldwide epidemic.
Let’s take a closer look at the disease.
What is non alcoholic fatty liver disease?
Doctors and medical professionals once believed fatty infiltration of the liver leading to liver damage and liver cirrhosis was caused by excessive alcohol consumption. They termed this condition alcoholic fatty liver disease.
While it’s true excessive alcohol consumption CAN and DOES cause liver damage, doctors soon realized there was something else going on when they started seeing patients with the same signs of liver damage, but who had no history of alcoholism. This condition soon became known as non alcoholic fatty liver disease.
Put simply, non alcoholic fatty liver disease is the accumulation of fat (triglycerides) in liver cells due to non-alcohol related causes that can eventually lead to liver inflammation, liver scarring, liver cancer, complete liver failure, and death.
Some of the contributing factors to fatty liver disease include obesity, type II diabetes (diabetes mellitus), metabolic syndrome, high fat, high fructose, and high glycemic diets coupled with a sedentary lifestyle, hypertension (high blood pressure), high cholesterol, medications and toxins, and insulin resistance.
Non alcoholic fatty liver disease generally progresses through the following stages:
- Simple steatosis (fatty liver)
- Fatty liver with inflammation (non alcoholic steatohepatitis, NASH)
- Fatty liver with liver hardening and liver scarring (liver cirrhosis)
- Liver cancer and/or complete liver failure
- Death unless a liver transplant is performed
When too much fat accumulates in the liver, it clogs the spaces surrounding hepatocytes (liver cells), causes the liver to become larger and heavier, impairs the livers ability to filter toxins and other harmful substances from the blood, and reduces its ability to metabolize fats.
The earliest stage of fatty liver disease, simple steatosis, is usually easily reversed by dietary and lifestyle changes. However, as liver damage becomes more severe, it can lead to cell death and scarring (liver cirrhosis), at which point it often becomes irreversible and requires a liver transplant to save the life of the patient.
Why is non alcoholic fatty liver disease so dangerous?
Fatty liver disease is closely associated with obesity and according to the Centers for Disease Control and Prevention, two-thirds of Americans are either overweight or obese. This means it’s a very real threat for almost everyone.
The disease is so dangerous because it is what the National Institutes of Health refers to as a “silent disease”. Non alcoholic fatty liver disease develops over a long period of time, but many people experience few, if any, symptoms until the condition worsens to non alcoholic steatohepatitis (NASH) or cirrhosis.
Some people may experience a dull or aching pain on the right side of their abdomen, but most don’t. This pain is generally associated with the liver growing larger due to inflammation and stretching the lining of the liver or pressing against other organs. Other fatty liver symptoms include a swollen stomach or ankles, vomiting blood, general fatigue, nausea, loss of appetite, and jaundice.
Since the condition has few symptoms, it sneaks up on you and many people fail to seek fatty liver disease treatment early on when the condition is often reversible through a proper fatty liver diet and exercise.
The Fatty Liver Diet Guide can show you exactly which foods to eat and which to avoid if you have a fatty liver and provides precise fatty liver diet plans and even fatty liver diet recipes for those who want to be proactive at slowing and reversing the condition before it becomes untreatable.
To make matters worse, doctors can easily miss the disease even with the help of ultrasounds and CT scans, and even tests for elevated liver enzymes in the bloodstream aren’t 100% reliable. Many times the disease is first noticed during routine checkups or during blood tests for other conditions. A liver biopsy is the best way to get a definitive diagnosis.
Annual checkups with your doctor are important to help increase the chance a fatty liver is caught early.
If left untreated, NAFLD can bring about much more severe symptoms including brain changes (hepatic encephalopathy) that result from harmful toxins reaching the brain. A healthy liver filters these toxins from the blood so they never reach the brain. A damaged liver is unable to do so which can result in things like memory lapses, trouble sleeping, lack of coordination and balance, and damage to other organs of the body.
These more severe fatty liver disease symptoms can often be rather alarming. For example, hepatologists such as Dr. Kevin Mullen from the Case Western Reserve University School of Medicine and Dr. Michael Curry from the Beth Israel Deaconess Medical Center in Boston report seeing patients who have:
- Exhibited symptoms very similar to Alzheimer’s and dementia
- Mistakenly put their laundry in the refrigerator
- Forgotten events that just took place the same day
- Found themselves in a scalding hot shower and forgot how to turn it off
- Walked around the neighborhood naked
Although seldom talked about, the liver performs over 500 known functions and is a bigger workhorse than even the heart. Thus, maintaining liver health should be a primary concern for everyone. Failing to do so is a true death sentence.
Who is at risk of getting non alcoholic fatty liver disease?
The short answer to this question is: everyone.
Fatty liver disease can affect men, women, and children of all ages and nationalities. It is most commonly found in people who suffer from type II diabetes and those who are overweight and/or obese (particularly around the mid section).
A recent study out of England suggests as many as 500,000 children between the ages of 4 and 14 in that country could be at risk of developing life-threatening liver disease in the future due to being overweight. A poor diet coupled with a lack of exercise are the leading culprits.
Some experts believe non alcoholic fatty liver disease will become a silent killer for this generation of children if the obesity epidemic is not kept under control. Most experts also agree that the biggest risk factor to developing non alcoholic fatty liver disease is being overweight. This is true for both children and adults.
How to treat non alcoholic fatty liver disease
Currently there is no single fatty liver treatment for ridding the body of non alcoholic fatty liver disease. However, if you suffer from a fatty liver or feel you are at risk of developing fatty liver disease, then here are a few guidelines you should follow to help prevent and reverse the condition:
- Lose weight gradually and keep it off long-term. Stay away from fad diet programs that recommend starvation diets or extreme gastric bypass surgeries that can actually further exasperate a fatty liver. Instead, try programs like Fat Loss Factor and Paleo Burn to target fat in your mid section.
- Stay active and exercise at least 30 minutes per day. Recent studies show resistance exercises can help improve a fatty liver and may be easier for people who are overweight and/or obese because they put less demand on the cardio-respiratory system.
- Make dietary changes that limit fat consumption to less than 30% of the daily caloric intake. Be cautious of generalized diet advice such as “eat more fruits and vegetables” as some fruits (particularly those containing large amounts of fructose) can be harmful for people with non alcoholic fatty liver disease. See the Fatty Liver Diet Guide and Fatty Liver Bible for specific diet plans and foods that can be used to reduce liver fat and improve fatty liver disease.
- Smaller, frequent meals are often better than large feasts for fatty liver patients.
- Antioxidants such as silymarin (found in milk thistle) and vitamins C and E can help improve liver health when taken in the right ratios and dosages.
- Don’t miss annual health checkups and stay in touch with your doctor on a regular basis. These are important for catching fatty liver disease early and giving you the best chance of beating the disease before it progresses to liver cirrhosis or liver cancer.
- Reduce strain on the liver by treating related conditions such as type II diabetes and hypertension.
- Most importantly, if you’re overweight chances are you already have a fatty liver or will develop a fatty liver in the near future. Be proactive in treating non alcoholic fatty liver disease early on and don’t wait for it to worsen before you take action. By then it may already be too late.