How Fat Is Your Liver?

Metabolic associated fatty liver disease (MAFLD), formerly named non-alcoholic fatty liver disease is becoming increasingly common around the world, especially in Western countries.

It is estimated that nearly 1 billion people are afflicted globally and 1 in every 3 people in the UK has early stages of MAFLD, where there are small amounts of fat in their liver. Early-stage MAFLD does not usually cause any harm, but if left untreated can lead to serious liver damage, including cirrhosis. MAFLD not only increases the risk of liver failure but also the risk for other health conditions such as type 2 diabetes, cardiovascular disease, chronic kidney disease, osteoporosis, and some type of cancers.

Oxidative stress is one of the key mediators of liver damage and is a major contributor to the progression of the disease

Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver.

The main stages of NAFLD are:

1. Simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells

2. Non-alcoholic steatohepatitis (NASH) – a more serious form of NAFLD, where the liver has become inflamed; this is estimated to affect up to 5% of the UK population

3. Fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally

4. Cirrhosis – the most severe stage. This damage is permanent and can lead to liver failure.

A few more obvious risks of developing MAFLD are:

• Overweight or obesity 
• Sleep apnoea 
• High levels of triglycerides in the blood 
• Type 2 diabetes 
• Insulin resistance 
• High blood pressure 
• High cholesterol smoking age (over 50)

How is it diagnosed?

Fatty Liver Disease (MAFLD) can be diagnosed by a simple scan. Fibroscan is an ultrasound technology for your liver, which measures scarring and fatty changes in your liver.

How is it treated?

There are currently no approved drugs to treat patients with fatty liver disease. However, modification of diet, physical activity and lifestyle can help reduce the risk of progression to the next stage of liver disease and in some cases has shown to even reverse the condition.

How nutrition plays it’s part

Research has found that low carbohydrate diets have shown more significant results for weight loss compared to low fat diets. A low carb diet is defined as 90g of carbohydrate, 0.8 g protein per kg weight and 30% fat per day.

The Mediterranean diet has shown to reduce the risk of diabetes, obesity, insulin resistance and hypertension.

What is a Mediterranean Diet?

This diet and way of eating is characterised by, increasing the intake of fresh fruit and vegetables, nuts and seeds, plus fresh fish and avoiding processed foods and foods high in sugar content.

Low GI foods

The glycaemic index or GI is the rate at which carbohydrate foods release glucose in your blood. If a carbohydrate food releases glucose quickly, they are called High GI foods. Low GI foods helps to maintain blood sugar levels and doesn’t cause a sudden spike.

The role fibre plays

Dietary fibre is the non-digestible form of carbohydrate which is not digested the small intestine and reaches the large intestine or colon. Clinical studies suggest fibre provides a wide range of benefits in areas such as weight management, gut health and blood glucose control.

Healthy Fats

• Monounsaturated Fatty Acids (MUFAs) such as nuts, seeds, olives and avocados
• Polyunsaturated Fatty Acids (PUFAs) especially long-chain omega-3 rich foods such as fish, chia seeds, hemp seeds and flaxseeds. Reduce the intake of saturated fats and trans fats (typically found in processed foods).

The Mediterranean diet has shown to reduce the risk of diabetes, obesity, insulin resistance and hypertension.

Oxidative stress related to MAFLD

Oxidative stress is an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage. Oxidative stress is one of the key mediators of liver damage.

Factors that may increase a person’s risk of long-term oxidative stress include:

• Obesity
• Diets high in fat, sugar, processed foods
• Exposure to radiation
• Smoking cigarettes or tobacco
• Alcohol consumption
• Certain medications
• Pollution
• Exposure to pesticides or chemicals
• Chemicals in skincare and makeup

Your body’s cells naturally produce powerful antioxidants, such as alpha lipoic acid and glutathione. The foods you eat supply other antioxidants, such as vitamins C and E.

They help protect your cells from damage caused by oxidative stress.

Dietary antioxidants to include in your diet:

• Vitamin C: found in oranges, peppers, mango, watermelon, papaya, kiwi, pineapple.
• Vitamin E: found in almonds, peanuts, hazelnuts, sunflower seeds, green leafy vegetables
• Carotenoids including beta-carotene and lycopene: found in carrots, sweet potatoes, spinach, kale, apricots, asparagus, beets, tomatoes, watermelon, pink grapefruit, pink guava, papaya.
• Selenium: found in brazil nuts, macadamia nuts, hazelnuts, fish, turkey, chicken, spinach, green peas, beans, and potatoes.
• Zinc: found in oysters, shrimp, beans, nuts, whole grains, sesame seeds, pumpkin seeds.

Ways to keep your gut healthy

Poor gut microbiota plays a significant role the onset of fatty liver disease. Whereas prebiotic foods and probiotics have shown to reduce the intestinal inflammation and improve insulin sensitivity.

Great sources of prebiotic foods include legumes, leeks, garlic, onion, asparagus, banana, artichoke, chicory.

Probiotics are live bacteria often described as “good” bacteria that helps to keep your gut bacteria healthy and balanced. Good sources are live yoghurt, kefir, non-dairy yogurts, fresh pickles, miso, fermented foods.

Be sure to exercise

Regular physical activity is an important pillar of healthy living. Research has shown that resistance exercise, i.e., squats and push-ups and resistance bands help to improve the characteristics of metabolic syndrome in some patients with MAFLD.

Get a good night’s sleep

Sleep plays a vital role in maintaining physical and mental health. Getting enough quality sleep can reduce the risk of many serious conditions.

Although we are seeing a rise in fatty liver disease in our Western diets, there are lifestyle and diet changes you can make to combat the risks and to lead a much healthier lifestyle overall.

Article written for Thrive Magazine Winter 2020 issue >>