Humans existed for approx. 190,000 years exclusively as hunter-gatherers when finding food was unpredictable. Less than 12,000 years ago we started moving to agriculture based civilizations which eventually led to overabundance of inexpensive grains like wheat, corn and rice and excessive consumption of carbohydrates – Rotis, Tortillas, Pitas, Rice – in geographies most impacted by Non-alcoholic Fatty Liver Disease (NAFLD). Now, NAFLD, affects 1 in 4 adults across the world. You have a significantly higher risk -1 in 3- if you are from South Asia, Middle East or Latin America, while in Africa only 1 in 10 are affected.
What Is Fatty Liver and why should you care?
Fatty liver occurs when too much fat builds up in liver cells. It is normal to have small amount of fat in these cells. However, it is considered fatty if it is more than 5%. Non-alcoholic fatty liver (NAFL) is the initial, reversible stage of a more serious liver disease. Over time, NAFL may lead to a more serious liver condition known as non-alcoholic steatohepatitis, or NASH. NAFL is also linked to an increased risk of heart disease and diabetes.
According to Dr. Ron Sinha, MD, Palo Alto Medical Foundation “Unfortunately, NAFLD often goes undiagnosed because this kind of fat is called “visceral fat” and may not be visible like subcutaneous fat.“ What is really troubling about visceral fat is it creates a perception that your body size is normal and people assume they are healthy and keep consuming excess carbohydrates.
What causes NAFLD? – Carbs are the leading contributor
High intake of Carbohydrates: Frequent intake of carbohydrates, especially rice, breads and refined carbs promote liver fat storage, especially when high amounts are consumed by overweight or insulin-resistant individuals.
It is hard for people to give up their Carbs – rotis, tortillas, rice and pita breads. Good news.. there are low carb rotis and flat bread options being introduced by smaller innovative food companies. These Rotis not only low in carbs, but also high in protective good fats ( like the fats found in Avocado, Nuts, fish and Olive oil) ..which is the best food combination to avoid, fight and reverse NAFLD.
To reduce Liver Fat I need cut back on Carbs AND Increase Non Saturated Fat (Good Fats) in my diet. Really ! Sounds illogical! The reason is only 16% of Liver fat in people with NAFLD comes from fat they eat. Rather, most liver fat comes from your body converting excess carbohydrates (the pizza, the rice, the sugary drinks, the low fat yogurt that is packed with sugar) into fat – a process called de novo lipogenesis.
Numerous Studies have shown that the combined effect of low carb diet rich in good fats are more effective in reducing NAFLD and insulin resistance than just low carb diets. In one study, 14 obese men with NAFLD were put on very low carb (Keto diet) along with diet rich in good fat and natural fiber. After 12 weeks, 13 of the men experienced reductions in liver fat, including three who achieved complete resolution of fatty liver.
Hidden Risk: Even short term consumption of diet high in calories and refined carbs can result in a 27% increase in liver fat, even though your weight may only increase by 2% !
ELIMINATE Sugary beverage consumption: Sugar-sweetened beverages like soda and energy drinks – Gatorade or Vitamin Water – and fruit juices are high in sugar and fructose. NAFLD is now being seen in children especially children of high risk ethnic groups – Indians, Latinos – due to alarming increase in childhood obesity caused by these foods and excessive consumption of carbohydrates
The rate at which the carbs get converted into fat increases significantly if you are consuming fructose-rich foods and beverages – even “supposedly healthy” foods like Starbuck’s Zero Fat sugary lattes, Vitamin Water, Healthy Power bars, Zero Fat yogurt with syrupy “fruits”
If you are overweight or obese, your fat cells create low-grade inflammation that may promote liver fat storage. It’s estimated that 30–90% of obese adults have NAFLD. Weight loss is one of the best ways to reverse fatty liver if you are overweight or obese. The best part of loosing weight to deal with excess liver fat is the improvement in liver fat and insulin sensitivity continues even after some weight is regained.
Exercise – Focus on High Intensity Interval Training. While endurance exercise or resistance training can reduce the amount of fat stored in the liver, High-intensity interval training seems to be most effective in reducing liver fat.
However working out regularly is very important for reducing liver fat, so select exercises that you can sustain and commit to.
Avoid inflammation causing foods– Avoid packaged foods even if they are markerd “healthy” if they have oils like Palm, Canola, Soya or preservatives and chemicals that you cannot spell.
Excess belly fat: Normal-weight people may develop fatty liver if they are “viscerally obese,” meaning they carry too much fat around the waist.
Impaired gut health: There is emerging evidence that suggests that having an imbalance in gut micro-biome may contribute to NAFLD.
Early warning signs that you should monitor for risk of NFLD are:
- Elevated insulin levels
- Elevated triglyceride levels.
- Slight pain or fullness in the right or center abdominal area
- Elevated levels of liver enzymes.
Non Alcoholic Fatty Liver Fatty liver is serious health risk that can go undetected leading to catastrophic health outcome. If you are Indian, South Asian, Middle Eastern or Latino you have a significantly higher risk. Kids on high sugar, high carb diets are at increasing risk. Fortunately, it can be reversed if addressed at an early stage. A balanced diet of Low Carb and Good fats, elimination of inflammatory packaged foods and exercise can prevent, reduce or reverse Fatty liver.
Stay Informed! Stay Healthy.
MORE ON NAFLD
Click here for a great blog by Dr. Ron Sinha – WHERE’S YOUR BODY FAT? A LOOK AT BODY SHAPES AND HEALTH RISKS ACROSS DIFFERENT ETHNIC GROUPS-INDIANS, ASIANS, CAUCASIANS.
Compared with a healthy liver (left), a fatty liver (right) appears enlarged and discolored.You can see the large white fat deposits in nonalcoholic fatty liver disease, while black spots – inflammation and scarring- are visible in more advanced and dangerous stage called nonalcoholic steatohepatitis