You are probably well aware of the symptoms of liver toxicity due to a poor lifestyle. Liver disease, on the other hand, is commonly prescribed to people who consume too much alcohol. Recently, another type of liver disease has been on the rise. Non-alcoholic fatty liver disease (NAFLD) is a different type of liver disease that is not affected by alcohol intake. [1] Instead, it is caused by the high level of accumulated fat within the liver. A normal liver is about 5 – 10% fat. Anymore than that can be harmful and lead to NAFLD or, the more threatening and harmful version, nonalcoholic steatohepatitis (NASH). At its worst, NAFLD or NASH can lead to liver failure or liver cancer.
Who Is at Risk for NAFLD?
The liver acts as a filter for the body by separating helpful nutrients and discarding harmful substances. Consequently, the liver encounters many hard-to-handle toxins, as well as lipids or fat cells. Since NAFLD is affected by the amount of fat in the liver, individuals who are overweight or obese are often at risk. Also, people with diabetes or high blood pressure can develop the disease. NAFLD has also been seen in people who undergo rapid weight loss. It has been discovered that 25% of Americans are affected by NAFLD. [2] It is more common in women than in men and is also most prevalent in people ages 40 – 60.
What Are the Symptoms of NAFLD and What Does it Do?
Typically, NAFLD presents with few or no symptoms, [3] but possible signs include: fatigue, weakness, weight loss or loss of appetite, nausea, abdominal pain, and jaundice. NAFLD is usually confirmed via blood tests and ultrasounds. The disease affects the body negatively by causing inflammation in the liver. This inflammation can lead to scarring of the liver tissue which can affect liver functions. If left unchecked, the inflammation and scarring can lead to the escalated form of NAFLD which can, as mentioned above, lead to liver failure.
How Can I Prevent NAFLD?
The best way to avoid developing non-alcoholic fatty liver disease is by leading a healthy lifestyle. If you eat healthy foods, especially ones that support your liver, get regular exercise, and limit your alcohol intake, you should be able to lower your risks of developing NAFLD or NASH. [4]
Has NAFLD affected you or someone you know? Leave a comment and share your experience with us.
Between 30-40% of American adults have nonalcoholic fatty liver disease (NAFLD), a condition with no visible signs that rarely causes symptoms. Despite its near-invisibility, NAFLD raises the risk of heart disease, diabetes, cirrhosis, and liver cancer. What’s more, a recent study suggests that people with a high-risk variant of the PNPLA3 gene are much more likely to have NAFLD if they’re obese than if they’re thin. [1]
NAFLD actually refers to several stages of disease. Most people have a form of the disease known as “fatty liver,” in which more than 5% of the liver is made up of fat cells. It is often related to obesity, poor diet, and a sedentary lifestyle.
A poor diet and a sedentary lifestyle are the natural precursors to obesity. And in people with the gene variant, obesity may be a precursor to a fatty liver.
Study co-author Jonathan Cohen, professor of internal medicine at UT Southwestern Medical Center, explains:
“If you are obese and lack the variant, then there is a good chance that you won’t have excess fat in your liver. But if you are obese and do have the variant—particularly if you have two copies of the variant—you are very likely to have excess fat in your liver.” [1]
Oddly enough, in most people with NAFLD, liver problems like inflammation and scarring aren’t much of a problem. Insulin resistance – which can lead to type 2 diabetes and cardiovascular disease – is much more of a concern.
However, an advanced form of NAFLD, called nonalcoholic steatohepatitis, or NASH, affects 3% to 12% of U.S. adults. Dr. Jaideep Behari, associate professor and founder of the University of Pittsburgh Medical Center’s Fatty Liver Clinic, says:
“This form is characterized by inflammation and cell injury. Cells are dying and there’s progressive scarring, which can lead to cirrhosis and even liver cancer.” [1]
Research suggests that people with diabetes, high blood pressure, high cholesterol, and excess fat around their middle are more at risk for NASH; but researchers say it isn’t clear why some people develop the more advanced form of NAFLD, while others never do. Some people actually alternate between the two forms of the disease.
“Sometimes people exercise more and eat a healthier diet while at other times they’re being less healthy. They’re going back and forth with their lifestyle, and the condition of their liver is going back and forth as well.” [1]
Not everyone who has NAFLD is obese, either. According to Behari, doctors are seeing an increase in people with normal body weight presenting with the disease. This is referred to as “lean fatty liver.” Certain ethnic groups with lower BMIs have a greater chance of developing lean fatty liver, too, including people of Asian descent.
Dr. Hobbs, Director of the McDermott Center, a Howard Hughes Medical Institute (HHMI) Investigator, and a Professor of Internal Medicine and Molecular Genetics, says that all obese people who have NAFLD can benefit from weight loss, but “those who have the risk allele in PNPLA3 are likely to benefit more.” [2]
A “Western-Style” Diet may Increase the Risk of NAFLD
Researchers used participants in the Rotterdam Study to examine the dietary components of NAFLD in elderly adults. They presented their findings in April to the International Liver Congress in Amsterdam.
The team collated data from 3,440 people, of which 30% were considered lean and the remaining 70% were considered overweight. The participants’ diets were assessed using a 389-item food frequency questionnaire.
Using an ultrasound, researchers detected NAFLD in 35% of the participants.
Source: GB Health Watch
Total protein intake was linked to an increased risk of NAFLD, which was primarily driven by animal protein. The link was particularly strong in obese individuals. Even after researchers adjusted for metabolic factors, animal protein – but not total protein – remained a significant risk factor.
Dr. Louise Alferink says:
“The results from this study demonstrate that animal protein is associated with NAFLD in overweight elderly people. This in line with a recently proposed hypothesis that a Western-style diet, rich in animal proteins and refined food items, may cause low-grade disturbances to the body homeostasis, glucose metabolism, and acid-based balance.
Another interesting finding is that, although current guidelines advise against foods containing fructose, such as soda and sugar, our results do not indicate a harmful association with mono- and disaccharides with NAFLD per se. In fact, we even found a slight beneficial association, which was attenuated when adjusted for metabolic factors.” [3]
Glucose is a monosaccharide, and sucrose is a disaccharide. Simply put, they are naturally occurring sugars. [4]
The authors believe this slight beneficial association might be because of healthy food items in the mono- and disaccharide food groups, such as antioxidant-rich fruits and vegetables. [3]
So, at the end of the day, the advice for avoiding and/or improving conditions like NAFLD and NASH may end up sounding very familiar: Consume less meat, eat more fruits and vegetables, and stay away from processed food and added sugar.
A vegan or vegetarian diet is one way to accomplish that. A Mediterranean diet – repeatedly shown in studies to be one of the healthiest eating patterns – may also help, for people who don’t want to totally give up meat.
Says Behari:
“For the majority of patients, lifestyle modification is way more effective than any drug. All of these chronic disorders—fatty liver, diabetes, heart disease—share an underlying metabolic component, and the same common-sense healthy living principles apply for all of them.” [1]
People who have a high body mass index (BMI), excess weight circumference, and Type 2 diabetes have a greater risk of developing liver cancer, a large new study finds. [1]
One expert in the United Kingdom (U.K.) is even calling for a shift in attitude so that obesity is seen as a red flag for having an increased risk of liver cancer.
The Study
In the study, BMI and waist measurement were used as 2 markers for excess belly fat. Type 2 diabetes was also used as a marker, due to its close association with obesity.
Researchers compared the rates of liver cancer, which have more than tripled in the U.K. since the 1970’s, against 1.57 million adults who were cancer-free when they enrolled in 14 different studies.
Liver cancer rates were compared among patients with and without obesity and diabetes to determine how much of a role these factors play in developing the disease.
Researchers controlled for age, sex, alcohol use, smoking, and race. [2]
An Increased Risk
The team found that for every 5-point increase in BMI, there was a 38% increase in the risk of liver cancer among men and a 25% increase among women. [1]
For every 2-inch increase in waist circumference, the risk of liver cancer increased by 8% – even after controlling for BMI.
In all, they found that being overweight increased the relative risk for liver cancer by between 21% and 142% as BMI increased. [2]
Participants who also had Type 2 diabetes were 2.61 times more likely to be diagnosed with liver cancer. The risk also increased in higher BMI. [3]
No association between BMI and cancer was found if the participant had hepatitis, a cause of liver cancer so strong that it overwhelms every other cause. However, among those without hepatitis, the increased risk was significant. [2]
Association Does Not Equal Causation
Peter Campbell, a director at the American Cancer Society, which participated in the research, says:
“We found that each of these three factors was associated, robustly, with liver cancer risk. All three relate to metabolic dysfunction. This adds substantial support to liver cancer being on the list of obesity-associated cancers.” [3]
Like the U.K., the incidence of liver cancer has tripled in the United States, where it is the 6th most common type of cancer.
In May, a review of more than 1,000 studies by the WHO’s International Agency for Research on Cancer showed that being overweight or obese increased the risk for at least 13 types of cancer. Those 13 types are:
Esophageal
Colorectal
Breast
Uterine
Kidney
Gallbladder
Pancreatic
Thyroid
Ovarian
Brain
Multiple myeloma
Blood
Stomach
Researchers said that the only risk factor that seemed to be more significant was smoking.
Obesity can cause metabolic and hormonal abnormalities, as well as chronic inflammation, which are all contributors to cancer.
Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.
