Non Alcoholic Fatty Liver Disease

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Every single day that I sit at my surgery desk, at least one patient – and usually a lot more than one – will sit with a resigned expression, sigh and say ‘I know I need to lose weight, you don’t need to tell me’. They say it in a number of predictable situations; sometimes they really are just that big, other times it is just a modest loss that is needed in order to improve their heart disease, cholesterol, arthritis or similar, and it seems that everybody knows that there are certain conditions that get better if you lose weight. They are right; I don’t need to tell them.

But what about liver disease? When I was in medical school, liver disease –cirrhosis in particular – was the unique fate of the alcoholics with a few other unfortunate hepatitis victims thrown into the mix. These days however, there is a new threat to the wellbeing of our livers in the form of obesity.

Non alcoholic fatty liver disease is very similar to liver disease in alcoholics except, as the name suggests, it happens in people who do not drink much alcohol. It was first discussed by the medical profession about thirty years ago, and even then it was clear that most people with ‘NAFLD’ (as it has become known) were overweight or obese. Before very long it became clear that being overweight or obese is not just related to NAFLD but is usually also the cause of it.

In much the same way as alcoholic liver disease there is a wide range of problems that may occur as a result of NAFLD, but thankfully most people do not experience the more serious ones. 20-30% of the adult population in most Western nations has some evidence of NAFLD, which is usually spotted by ultrasound scan, and most of those people will only ever have the early stages of it which does have some health implications but is reversible, mainly by the person concerned losing weight.

A few people do develop complications of NAFLD in the form of hepatitis. A small number of hepatitis patients will move onto the next stages of fibrosis (where the liver has a large quantity of scar tissue) or even cirrhosis and liver failure over the course of many years, and it is for this reason that NAFLD has been the subject of much research since its discovery a few decades ago – for a tiny minority of people, it really is a big deal.

One of the problems with NAFLD is that most people who have it are unaware of it as it rarely causes symptoms. It is usually found in people who are having blood tests or an ultrasound scan to investigate something else entirely. And for the medical profession, the other problem we have is that once we have diagnosed NAFLD we don’t really know how to make it better. We know that weight loss works, but as you know if you are a regular visitor to this site, the overwhelming majority of people who lose weight put it all back on again and more in a short time, so as a profession we have to think of other things.

There are no effective medical treatments for NAFLD at this point although several drugs including some existing diabetic medications are currently being researched as possibilities. The main thing for anyone with NAFLD is to lose weight as soon as possible, because just as it has been shown that the condition is caused by obesity, it is also clear that losing that obesity generally improves it, and also greatly reduces the chances of progressing to hepatitis or cirrhosis. So if you have either been told that you have NAFLD or you are concerned that you may have it, weight loss is the key and the Stop Dieting, Start Living course is a great place to start. Enough said about weight loss!

There are a number of dietary changes that can help to minimise the chances of developing NAFLD in the first place – people who do have it tend to eat diets that are high in meat products, saturated fats and soft drinks containing artificial sweeteners or sugar, and low in healthy fats such as those found in oily fish. So substituting meat for oily fish and vegetarian alternatives occasionally, reducing saturated fat intake and avoiding those drinks is advisable.

There are a few supplements that will probably help to minimise both the extent of NAFLD and the chances of developing complications – omega 3 oils have been shown to be quite effective, as has vitamin E. A good quality probiotic supplement is probably worth a try, although research about probiotics and their effectiveness in treating NAFLD is still ongoing.

In terms of things to avoid, the main one is high fructose corn syrup, an artificial sweetener that is found in just about anything processed these days. It has only been a significant part of our diets as a population for the last forty years or so, and some experts think it may explain at least part of the current obesity epidemic that has occurred at the same time. It has been linked to many health problems and really is best avoided for all sorts of reasons. One of the mantras of advising people to change their diets is that if you take something out of a diet then you need to replace it with something else – in the case of high fructose corn syrup, you really don’t need to, just get rid of it!

So if your doctor tells you that you have NAFLD, please don’t be alarmed but equally be proactive. In the long term people with NAFLD do have a slightly higher risk of diabetes and heart disease and eating the Fit For Life Forever way together with the other suggestions I have made here can go a long way to improve things, not just for your liver but for your health overall. What have you got to lose??


  1. Recently, I just gone through few articles about NAFLD and found that the causes include for NAFLD are like eating fired foods with a great amount of cholesterol , foods with high sugar, lack of workout or physical activities and more.

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