What is Fatty Liver Disease?

There are two main types of Fatty Liver Disease, but you may be more familiar with Alcoholic Fatty Liver Disease, which is caused by a high intake of alcohol over a period of time. The other type that you may not be aware of is already making waves in the healthcare community as it is not only it becoming more common, but it’s contributing to the rise in demand for liver transplants.

Non-Alcoholic Fatty Liver Disease (NAFLD), which is defined as too much fat accumulation in the liver, is being diagnosed rather frequently these days. Nearly 3 million people are diagnosed EVERY YEAR! From being practically non-existent in the early 1980s to a popular condition today shows how big of an issue we are really dealing with. Which brings us to this question, Why are more people being diagnosed with liver problems at such a fast rate?

One reason NAFLD rates are steadily climbing is that this disease was being treated wrong. Other reasons are contributed to our modernization of food processing and inaccurate dietary guidelines. When our dietary guidelines portrayed fat as the cause of fatty liver disease, heart disease, and obesity, the low-fat diet was adopted by many, and we started to see results, but not in the right direction. Rates for these conditions started increasing because it’s not fat, it’s the sugar. We now know a low-fat diet is not the correct way to address fatty liver disease, but in order to fully understand how to treat NAFLD, we must explore how fatty liver disease occurs in the first place.

NAFLD is one of the most common causes of liver disease contributing to increasing rates of liver transplants in the U.S.

What Causes Fatty Liver Disease?

There are several contributing factors to Fatty Liver Disease:

Your liver makes new fat from eating too many carbohydrates (starches & sugars). Primarily glucose and fructose, once ingested, head to the liver for processing. Glucose, from starches like potatoes and rice, can be used by any cell in the body including brain cells. Fructose, on the other hand, can only be processed by the liver. Therefore, consuming large amounts of fructose can lead to more fat build-up in the liver and progress to NAFLD faster.

• SUCROSE is 1/2 glucose and 1/2 fructose. Sucrose is table sugar and is hidden in many processed foods.
• Fructose is only metabolized by the liver and increases fat accumulation in the liver, fat cells, and other areas.
• Glucose can be used by any cell in the body, easing the workload for the liver. Glucose can be stored in the liver, muscles, and fat cells.

Sugars and starches are broken down in the liver and converted into triglycerides, a type of lipid, which are then released into circulation. Circulating lipids in the bloodstream increase risk for plaque buildup, atherosclerosis, increased blood pressure, and higher risk for cardiovascular disease including heart attack and stroke.

Your liver can only process about 12g of sugar a day and the rest is stored primarily as fat. With Americans averaging nearly 77g a sugar each day it’s no wonder obesity rates are skyrocketing.

Think of your liver as a bathtub that you keep pouring more soda into until eventually it overflows and causes a leak in the ceiling below. Now imagine that bathtub in your body and it’s allowing soda to overflow into your organs causing them to malfunction, leading to disease. When you eat a large amount of sugar, it floods your liver. Once and while is fine, but when you eat too much sugar every day for years, it takes a toll on your body, and given the number of hidden sugars in our food today, it’s no wonder the liver can’t keep up. When the liver has way too much sugar it’s trying to process, it starts making fat faster than it can export into circulation and fat starts to build up in the liver, leading to Fatty Liver Disease. Too much sugar, primarily fructose, in our diets is directly contributing to NAFLD.

Should You be Worried?

NAFLD means that there is an accumulation of fat molecules in the liver. The problem is that too much fat in the liver causes the liver to not work as well. Over time, if not addressed, this can lead to inflammation, a condition known as Non-alcoholic Steatohepatitis (NASH). NASH can eventually lead to cirrhosis, which is permanent scarring of the liver and increase the risk of liver cancer and liver failure.

How do you know if you have liver disease? Typically, NAFLD goes unnoticed since there are usually no symptoms until it’s progressed and potentially causes elevated liver enzymes that can be measured in your bloodwork. Your PCP will then usually order further bloodwork and imaging to assess the level of damage. Although NAFLD generally affects individuals around the age of 40s-50s, it’s becoming more popular in the youth as young as 10-13 years old. Many kids today are consuming large amounts of sugar, especially fructose, contributing to not only childhood obesity but also fatty liver disease, which is now the most common liver disease affecting children in the U. S. today.

“NAFLD is commonly associated with Metabolic Syndrome, obesity, diabetes, and hyperlipidemia. Nearly 80% of patients with Metabolic Syndrome have NAFLD” (Antunes et al., 2021).

What Can You Do?

The good news is Fatty Liver Disease, if caught early, can be reversed and possibly even healed with lifestyle changes.

Real talk, Fatty Liver Disease should be taken seriously because you only have one liver and it’s pretty damn important. The scary part, you may not have any symptoms until the liver becomes so clogged up with fat and liver cells are damaged, releasing enzymes into the blood. These enzymes (ALT/AST) can be an indication of NAFLD on your lab pannel. Therefore, it’s important to have regular check-ups with your PCP– and have your labs done!

Here Are My Tips For Fatty Liver Disease:

1. Limit Sugar- Since a fatty liver comes from a surplus of sugar, treating and possibly reversing NAFLD happens by limiting SUGAR. This includes all sugars, meaning starches and sweets. Look out for hidden sugars and try to avoid added sugars. If you have liver disease, a low-carb diet may benefit you by reducing the workload for the liver and clearing out the fat build-up. However, once the liver has recovered, you may no longer need to maintain such a low-carb diet, but you will want to be cautious about the types of carbs you’re eating.
2. Reduce Saturated Fats & Processed Foods- Processed foods filled with chemicals and dyes are harsh on the liver to digest causing more backups. Saturated fats, anything deep-fried, fatty meats, and baked goods, cause inflammation, higher cholesterol levels, and increased fat storage.
3. Lose Weight- Slowly! Rapid weight loss can actually cause NAFLD. Losing weight slowly over time leads to more sustained weight loss. This should be done with diet, exercise, stress management, and sleep hygiene modifications, not with diet pills and liquid cleansers.
4. Exercise- Can help lower cholesterol, improve liver function, and help you lose weight. Exercise helps to clear out stored sugar in the liver and allows the liver to replenish glucose reserves helping restore insulin sensitivity.
5. Medication Review- Review your medications with your PCP, including prescription and over-the-counter that could be affecting your liver, like Tylenol. Download the Medication Review Form.
6. Limit Alcohol- Alcohol can be damaging to the liver and alcohol is converted into fat, thus contributing to more weight gain and inflammation in the liver.
7. Increase intake of whole foods, unsaturated fats/omega 3 fatty acids- Olive oil, avocado, wild-caught salmon, chia, and flax seeds are considered healthy fats that help with increasing HDL cholesterol levels that then help to lower LDL and triglycerides. The Mediterranean diet promotes whole foods and healthy fats that have been shown to improve liver and overall health.

Some studies have shown that Vitamin E supplements or from food sources like almonds, sunflower seeds, and peanut butter, can help improve the liver. Increasing Vitamin D levels, which may help reduce inflammation. Vitamin D can be taken in a supplement form, from foods like fatty fish, or by sitting in the sun for a few minutes a day- with sunscreen of course!

Radishes have shown to be helpful in cleansing and detoxing the liver to improve function and help with weight loss. Check out my Healthy Radish & Green Apple Snack Recipe to learn about all the benefits radishes have to offer!

^{Disclaimer: The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health conditions without consulting your healthcare provider. Information used is based on experience and opinion, not 100% evidence. Always consult with a health care practitioner before relying on any information in this article or on this website. Some links in this article may contain affiliate links.}