Non Alcoholic Fatty Liver Disease (NAFLD) may not cause symptoms, but it’s become the most common liver condition in the West, affecting as many as 30% of individuals. It can progress to Non Alcoholic Steatohepatis (NASH), which causes liver inflammation and can lead to cirrhosis or liver cancer in about 10% of those affected.
As its name implies, NALFD is characterized by fatty infiltration of the liver. It is a by-product of our epidemic of obesity and is present in about 60% of obese individuals. It appears that increased consumption of carbohydrates, (especially fructose sources such as corn syrup in processed foods) stimulates production of fat in the liver. In addition, individuals with NALFD usually have insulin resistance which not only makes the liver disease worse, but also can lead to heart disease and diabetes.
The liver inflammation is further exacerbated by imbalanced intestinal flora. Obesity itself can also cause inflammation due to chemicals released by our fat cells.
NALFD generally causes no symptoms and it’s usually discovered by finding abnormal liver enzymes levels on routine laboratory testing. An ultrasound can confirm the presence of excess fat in the liver. Laboratory tests such as lipid profiles can detect insulin resistance.
The most important measure to take to combat NALFD is to lower one’s weight, especially by avoiding simple carbohydrates, sugars and high fructose corn syrup. Aerobic exercise will help with weight loss and muscle training can reduce insulin resistance.
A number of nutritional agents have been studied in the treatment of NALFD. Polyunsaturated Fatty Acids (PUFA’s), can be helpful. Omega 3 fish oils have been shown to reduce fatty infiltration on ultrasound, and they’re also anti-inflammatory and reduce insulin resistance. A recent study used Cinnamon (1500mg) to treat NALFD and found that liver enzymes improved (as well as blood sugar, lipids and inflammation markers).¹
Other agents frequently used to reduce liver inflammation and oxidative stress include milk thistle, Phosphatidylcholine and Lipoic acid. Lipoic acid is also a powerful tool to reduce insulin resistance. Vitamin D deficiency is associated with increased severity of NAFLD.
As mentioned above, imbalances in intestinal flora can affect liver inflammation. In fact, bacterial by-products from the intestine directly flow to the liver and stimulate its immune system. Previous studies have shown an improvement in liver pathology with probiotic treatment and a recent trial showed improved liver function tests and reduced markers of inflammations. ²
NALFD is an epidemic and is now being found in children. A dietary and nutritional program to counteract the problem is the best way to prevent it’s serious complications.
¹ Askari F, Rashidkhani B, Hekmatdoost A. Cinnamon may have therapeutic benefits on lipid profile, liver enzymes, insulin resistance, and high-sensitivity C-reactive protein in nonalcoholic fatty liver disease patients. Nutr Res 2014 Feb: 34(2); 143-8
² Eslamparast T, Poutschi H, Zamani F, Sharafkhan M, Malekzadeh R, Hekmatdoost A. Synbiotic supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. Am J Clin Nutr. 2014 Mar: 99(3): 535-42