Non-alcoholic fatty liver disease sounds like one of those fancy conditions that only affects 0.001% of the population.
In reality, the numbers are a stark contrast to this. An estimated 10-46% of the entire population has fatty liver but never know this (hence the large variability in the actual diagnosed numbers).
Most people will never manifest any symptoms, but there are quite a few that do. Are you at risk for manifesting symptoms? Maybe. Truth be told, it can happen to anybody. Especially given the decline in truly nutritious food consumed by the masses.
The good news is that it is treatable; sometimes completely reversible. And while prevention is also quite possible, most people never hear about the disease until they are diagnosed.
In this blog post, we will take a deep dive into what NAFLD is, and what you can do about it if diagnosed.
What is NAFLD?
NAFLD is a fascinating and complex disease that affects millions of people worldwide. This condition stands for "non-alcoholic fatty liver disease" and is characterized by fat accumulation in the liver.
What makes this disease particularly interesting is that it is not caused by alcohol consumption as was typically the case, but instead by a combination of dietary and lifestyle factors.
The liver is an essential organ that plays a critical role in maintaining our overall health. It filters out toxins, produces bile to aid in digestion, and stores vital nutrients such as vitamins and minerals.
When too much fat accumulates in the liver, it can lead to inflammation, scarring, and damage to the liver cells, which can cause serious health problems.
The early stages of NAFLD are typically asymptomatic, which means that most people may not even know that they have it. However, as the disease progresses, it can lead to more severe symptoms. The good news is that NAFLD is preventable and treatable, and there are many lifestyle changes and interventions that can help reduce the risk of developing this condition and improve liver health.
Types Of NAFLD
Unknown to many people, there are two forms of NAFLD.
- Simple fatty liver or hepatic steatosis: This is the more common and milder form of NAFLD. In this type of NAFLD, the liver contains an excessive amount of fat but has no signs of inflammation or liver cell damage. Simple fatty liver typically doesn't cause any symptoms and doesn't usually progress to more severe forms of liver disease. Many "healthy" people may have this without ever knowing it.
- Non-alcoholic steatohepatitis (NASH): NASH is a more severe form of NAFLD that can cause inflammation and damage to liver cells. In this type of NAFLD, the liver becomes inflamed, and scar tissue may form. This can lead to more serious complications, such as cirrhosis, liver failure, and liver cancer. Unlike simple fatty liver, NASH can cause pronounced symptoms and can progress to become more severe over time.
Causes of NAFLD
As we previously mentioned, NAFLD is brought on by lifestyle choices (which do not include alcohol consumption but may be worsened by it). Strong contributors include:
Obesity and Metabolic Syndrome
One of the primary risk factors for developing NAFLD is obesity. Metabolic syndrome, which is a cluster of conditions that includes obesity, high blood pressure, high cholesterol, and insulin resistance, is also a significant risk factor for NAFLD.
Metabolic syndrome can cause changes in the liver that promote the accumulation of fat and inflammation, which can lead to the development of more severe forms of NAFLD.
Insulin resistance is a condition in which the body's cells become less responsive to the hormone insulin, which regulates blood sugar levels. When insulin resistance occurs, the liver produces more insulin than the body needs and contributes to the accumulation of fat in the liver. Insulin resistance is often associated with obesity, type 2 diabetes, and metabolic syndrome, all of which are significant risk factors for NAFLD as mentioned above.
Type 2 Diabetes
Type 2 diabetes is a metabolic disorder that occurs when the body is unable to produce enough insulin or use insulin effectively. This can lead to high levels of glucose in the blood, which can cause damage to the liver over time. In addition to increasing the risk of developing NAFLD, type 2 diabetes can also worsen existing liver damage and increase the risk of developing more severe forms of the disease.
Coupled with the fact that most type 2 diabetics exhibit very poor insulin sensitivity and you can quickly see how and why poor glucose management can make things take a turn for the worst very easily.
High Cholesterol and Triglycerides
Elevated levels of cholesterol and triglycerides in the blood can accelerate the development of NAFLD. When levels of these lipids are high, they can accumulate in the liver and contribute to the formation of fatty deposits.
High cholesterol and triglycerides are conditions often associated with obesity, metabolic syndrome, and type 2 diabetes, making the comorbidities the perfect storm.
Rapid Weight Loss and Malnutrition
Rapid weight loss and malnutrition can also contribute to the development of NAFLD. When the body is deprived of nutrients, the liver may produce more glucose and fat, leading to increased accumulation within hepatocytes.
This is because the body dislikes change, and will do its best to maintain the status quo, especially when changes come about too rapidly.
Slow, sustained weight loss will not have this net effect, but rapid crash diets or those that cause you to prohibit a slew of foods can predispose you to a malnourished state and NAFLD.
Rapid weight loss can also cause changes in the liver that promote the development of more severe forms of NAFLD, such as NASH.
What Are The Symptoms of NAFLD?
NAFLD is often asymptomatic during the early stages, meaning that a person may not experience any noticeable symptoms. There are several reasons why this is the case.
First, the liver can tolerate/accumulate a significant amount of fat before symptoms arise. The liver is an organ that is capable of storing and processing large amounts of fat, and in the early stages of NAFLD, the liver may contain a relatively small amount of fat, which may not cause noticeable symptoms.
Additionally, the liver does not have many nerve endings, unlike other organs in the body. This means that it may not send pain signals to the brain even if there is inflammation or other types of damage present.
Early symptoms may also be mild or non-specific, making it challenging to identify NAFLD as the cause. Moreover, NAFLD is often detected by chance during routine medical exams or imaging tests for other conditions. The disease also progresses slowly, taking years or even decades for the condition to develop into more severe forms of liver disease, why is which it seems innocuous at first glance.
Fatigue tends to frequently occur as one of the symptoms of NAFLD. But why is that? Well, there are a few potential explanations.
Firstly, inflammation could be the culprit. NAFLD is associated with chronic low-grade inflammation in the liver, which can contribute to fatigue. This happens when inflammation becomes chronic, and the body produces more cytokines, signaling molecules that regulate the immune response. These increased cytokine levels have been linked to fatigue and other symptoms of inflammation.
Another possible cause could be the insulin resistance. When you have insulin resistance, your liver may produce more glucose than your body needs, which can damage it over time. This damage can impair the liver's ability to store and release glucose, leading to fatigue and low energy levels. Insulin resistance is a hallmark of metabolic syndrome and a significant risk factor for NAFLD development.
NAFLD can also cause hormonal imbalances that can contribute to fatigue. The liver plays a crucial role in regulating hormones, including sex hormones, thyroid hormones, and cortisol. When the liver isn't functioning correctly due to NAFLD, these hormones may be disrupted, leading to fatigue and associated symptoms.
Then there's the fact that when the liver isn't functioning correctly due to NAFLD, it may not be able to store or produce essential nutrients like vitamins and minerals. These nutritional deficiencies can lead to fatigue and other symptoms.
Lastly, NAFLD may disrupt sleep patterns, leading to fatigue. If you have NAFLD, you might be more likely to experience insomnia or sleep apnea, a condition where breathing is interrupted during sleep. Sleep apnea can cause fatigue, daytime sleepiness, and other symptoms that can impact your quality of life.
This is why we always recommend a whole-food multi-nutrient supplement that covers all important bases and can prevent deficiencies from popping up.
Abdominal Discomfort or Swelling
There are several potential mechanisms by which NAFLD can cause abdominal swelling or pain.
One possible explanation is the accumulation of fat in the liver itself. As fat accumulates in the liver, it can cause the liver to enlarge, which can contribute to abdominal distention and discomfort. In more severe cases of NAFLD, the accumulation of fat in the liver can lead to inflammation and damage to liver cells, which can cause further abdominal pain.
Then there's the possibility of liver fibrosis developing. Fibrosis occurs when the liver becomes scarred due to excessive inflammation and damage to liver cells.
As fibrosis progresses, it can lead to an enlargement of the liver and cause severe swelling and discomfort.
In the most severe cases of NAFLD, fibrosis can progress to cirrhosis, a condition characterized by extensive scarring of the liver tissue and impaired functioning of the organ.
Jaundice is a common symptom of advanced liver disease, including non-alcoholic fatty liver disease (NAFLD). But why does it develop? There are a few reasons behind this.
One possible explanation is liver damage and inflammation, which can disrupt the liver's ability to remove bilirubin from the blood. Bilirubin is a yellow pigment produced by the breakdown of red blood cells, and is normally removed from the body by the liver. When the liver is structurally or functionally damaged, bilirubin can accumulate in the bloodstream, leading to jaundice, and a characteristic yellowing of the skin and eyes.
Another possible cause of jaundice in NAFLD is cholestasis, a condition in which the flow of bile from the liver to the intestine is disrupted. Bile is a fluid produced by the liver that helps digest fats and absorbs nutrients. When the flow of bile is disrupted, it can build up in the liver and bloodstream, leading to jaundice.
Finally, advanced forms of NAFLD, such as non-alcoholic steatohepatitis (NASH) and cirrhosis, can cause liver failure, which can lead to jaundice. Liver failure occurs when the liver is severely damaged and can no longer function properly. When this happens, bilirubin and other toxins can accumulate in the bloodstream at will, leading to jaundice and other far more serious complications.
Treatment and Prevention Strategies
Ideally, it is best you never deal with fatty liver in the first place. However, human nature is fickle, and not everyone will have the same willpower, dietary preference or genetics that all contribute to its development.
That being said, there are still steps within your power that you can take to prevent it from rearing its ugly head, or if you have a positive diagnosis and need to turn things around, all hope is not lost.
- Reduce intake of added sugars: Consuming too much added sugar is a significant risk factor for NAFLD. Added sugars, especially simple ones such as those found in sugary drinks, candy, desserts, and processed foods, can contribute to insulin resistance and inflammation processes in the body.
- By reducing the intake of added sugars, individuals with NAFLD can help reduce the accumulation of fat in the liver and improve liver function. Choosing whole foods and natural sweeteners such as fruit and honey can help satisfy sweet cravings while providing additional nutrients and fiber.
- Increase intake of fiber: Fiber is an important nutrient that can help improve insulin sensitivity and reduce inflammation, both of which are important factors in NAFLD. Consuming fiber-rich foods such as fruits, vegetables, whole grains, and legumes can help improve liver function and reduce liver fat.
- Soluble fiber, in particular, has been shown to be effective in reducing liver fat and improving insulin sensitivity in individuals with NAFLD. Foods high in soluble fiber include oats, beans, lentils, nuts, seeds, and some fruits and vegetables.
- We recommend a serving of Field of Greens daily to help meet your requirements for fruits and veggies.
- Limit intake of saturated and trans fats: Consuming too much saturated and trans fat can increase the risk of NAFLD. Saturated fats are found in animal products such as meat, butter, and cheese, as well as some plant-based oils.
- Trans fats are primarily found in processed foods such as baked goods, fried foods, and snacks. Limiting the intake of these fats can help reduce inflammation and liver damage, and improve liver function. Choosing healthier fats such as olive oil, avocado, nuts, and seeds can provide important anti-inflammatory compounds that can help reduce liver damage and improve function.
- Monitor portion sizes: Consuming too much food, even if it is healthy, can contribute to weight gain and increase the risk of NAFLD. Monitoring portion sizes and eating until satisfied, not stuffed, can help prevent or treat NAFLD. Using smaller plates, measuring portion sizes, and taking time to eat slowly and mindfully can all help you manage your portions and reduce the risk of overeating.
There is some evidence to suggest that certain supplements may be helpful in preventing or treating NAFLD. These include:
Omega-3 Fatty Acids
Omega-3 fatty acids are a type of healthy fat found abundantly in fish. Studies have shown that omega-3 supplements may help reduce liver fat, inflammation, and insulin resistance in individuals with NAFLD.
It is also great for reducing triglyceride levels, a known contributor to inflammatory conditions including liver and cardiovascular disease.
Vitamin E is a fat soluble vitamin and an antioxidant that can help protect liver cells from damage. Studies have shown that vitamin E supplements can help reduce liver fat and inflammation in individuals with NAFLD.
One study found that individuals with NAFLD who took vitamin E supplements for 24 weeks had a significant reduction in liver fat compared to those who received a placebo. Another study found that vitamin E supplements improved liver function and reduced liver inflammation in individuals with NAFLD and type 2 diabetes.
The exact mechanism by which vitamin E improves NAFLD is not entirely clear. One possibility is that vitamin E reduces oxidative stress in the liver, which can help reduce inflammation and liver damage. Vitamin E may also improve insulin sensitivity, which can help reduce liver fat accumulation.
It's important to note that while vitamin E supplements may be beneficial for some individuals with NAFLD, high doses of vitamin E can have negative effects, so it's important to keep intake at safe levels, or under the supervision of a medical pro.
There is growing evidence to suggest that probiotics may be beneficial in preventing and treating NAFLD, or non-alcoholic fatty liver disease.
One possible mechanism by which probiotics may help prevent and treat NAFLD is by reducing gut permeability. Gut permeability refers to the ability of substances to pass through the intestinal lining into the bloodstream. When gut permeability is increased, toxins and other harmful substances can enter the bloodstream, leading to inflammation and liver damage. Probiotics can help improve gut barrier function, reducing the risk of toxins entering the bloodstream and contributing to liver damage.
Probiotics may also help improve liver function by reducing inflammation. Inflammation is a key factor in the development and progression of NAFLD. Studies have shown that probiotics can help reduce inflammatory markers in the blood and improve liver function in individuals with NAFLD.
Furthermore, probiotics may help improve insulin sensitivity, which is an important factor in preventing and treating NAFLD. Insulin resistance is a hallmark of metabolic syndrome, a cluster of conditions that includes obesity, high blood pressure, high cholesterol, and insulin resistance. Metabolic syndrome is a significant risk factor for NAFLD. Studies have shown that probiotics can improve insulin sensitivity and reduce the risk of developing metabolic syndrome.
Magnesium is a mineral that is essential for many biological processes, including energy production and proper insulin function and sensitivity. Studies have shown that magnesium may play a beneficial role in preventing and treatment of the disease by helping improve insulin sensitivity, in turn reducing the accumulation of fat in the liver and preventing the development of NAFLD.
In addition to its effects on insulin sensitivity, magnesium may also help reduce inflammation in the liver. NAFLD is associated with chronic low-grade inflammation in the liver, which can contribute to liver damage and the progression of the disease. Studies have shown that magnesium supplements may help reduce liver inflammation and damage, which can help prevent the development of NAFLD and slow/reverse its progression in individuals with existing disease.
Milk thistle is a plant related to the daisy, whose extract has been used for ages to keep livers healthy.
There's a flavonoid in milk thistle called silymarin, which has some pretty interesting properties. It's an antioxidant and anti-inflammatory, which means it can help protect your liver cells from damage and reduce inflammation in your liver. This inflammation is a big part of NAFLD, so anything that can keep it down is worth checking out.
Studies have shown that milk thistle supplements can be effective in reducing liver inflammation and damage in folks with NAFLD. One study found that people with NAFLD who took milk thistle supplements for six months had better liver function and less inflammation than those who didn't.
Milk thistle might also help your lipid metabolism, which is how your body processes fats. If your lipid metabolism is out of whack, it can contribute to the development of NAFLD. Luckily, silymarin might help reduce liver fat accumulation and improve lipid metabolism in one fell swoop.
Weight Loss/ Management
Not surprisingly, if you carry more fat around, you are immediately at higher risk of developing NAFLD.
NAFLD is strongly associated with obesity, and losing weight can help reduce fat accumulation in the liver and improve liver function.
When you lose weight, you reduce the amount of fat stored in your body, including in your liver. This can help reduce the likelihood of fat being accumulated in the liver, which is a major risk factor for NAFLD.
Losing weight can also improve insulin sensitivity, which has the net effect of reducing lipogenesis (formation of new fat).
In addition to reducing fat accumulation in the liver, weight loss can also improve other risk factors associated with NAFLD. For example, losing weight can help lower blood pressure, improve cholesterol levels, and reduce the risk of developing type 2 diabetes, all of which are significant risk factors for NAFLD.
Ideal weight management is also important in preventing NAFLD from developing in the first place., or once you have achieved a level you are comfortable with.
However, in that same vein, it is critical to not become a yo-yo dieter, as the rollercoaster of weight loss and then gain sometimes leads to your body becoming resistant to utilizing the stored fat.
It goes without saying that exercise should be part of your strategy in preventing and treating NAFLD, or non-alcoholic fatty liver disease. Exercise has been shown to have a beneficial effect on liver function and can help reduce the risk of developing NAFLD and other health problems associated with obesity and metabolic syndrome.
Both aerobic and resistance-type activity has been shown to have beneficial effects on liver function in individuals with NAFLD.
Aerobic exercises, such as jogging, cycling, or swimming, can help improve insulin sensitivity and reduce the accumulation of fat in the liver. Resistance training, such as weightlifting or bodyweight exercises, can help improve muscle mass and strength, which can help improve insulin sensitivity and reduce the risk of developing NAFLD.
In reality, a combination of the two is the best recipe for success, as they bring advantages to the table that are synergistic together.
Exercise also has other health benefits that can be beneficial for individuals with NAFLD. Regular exercise can help reduce blood pressure, improve cholesterol levels, and reduce the risk of developing type 2 diabetes, all of which are significant risk factors for NAFLD.
If you have NAFLD, or non-alcoholic fatty liver disease, it's important to avoid alcohol altogether. Even small amounts of alcohol can contribute to liver damage and exacerbate NAFLD.
Alcohol is processed by the liver, and excess alcohol consumption can lead to inflammation, scarring, and damage to liver cells.
This damage can make it more difficult for the liver to perform its normal functions, such as removing toxins from the body and regulating metabolism- and make it much more difficult for recovery to occur.
In individuals with NAFLD, the liver is already on its way to being damaged and may not function as well as it should. Consuming alcohol can exacerbate this damage and lead to more severe liver disease, such as alcoholic fatty liver disease or alcoholic hepatitis.
In addition to exacerbating liver damage, alcohol consumption can also contribute to other metabolic health problems associated with NAFLD, such as high blood pressure, high cholesterol, and type 2 diabetes. These health problems can further damage the liver and increase the risk of developing more severe liver disease.
Medication as Prescribed
Medication prescribed by a healthcare provider can be an important part of the strategy for treating NAFLD. Some of the medications that may be prescribed for NAFLD include cholesterol-lowering medications such as statins and anti-diabetic medications.
Cholesterol-lowering medications such as statins can be beneficial in treating NAFLD by reducing inflammation in the liver and improving lipid metabolism.
Statins work by blocking the enzyme responsible for producing cholesterol in the liver, which can help reduce the accumulation of fat in the liver and improve liver function. Some studies have shown that statins can reduce liver fat accumulation and improve liver function as well.
Anti-diabetic medications sometimes work by improving insulin sensitivity and reducing insulin resistance, which can help reduce the accumulation of fat in the liver and improve liver function.
They might also enhance the usage of glucose by the body, decreasing the likelihood of excesses being present in the blood.
Some studies have shown that these medications can assist with reducing liver fat accumulation and improve liver function in people diagnosed with NAFLD.
While it may sound attractive to just employ natural strategies and "hope for the best", oftentimes the best approach is to have regular checkups. These may include blood tests, imaging scans and biopsies to monitor the progression of the disease.
Regular check-ups can help your healthcare provider track any changes in your liver health over time, as well as any potential complications.
You would want to know that the treatment plan you are following is working the way it should, after all, so this is a critical step you should not opt out of.
Getting Enough Sleep
Sleep plays a critical role in regulating metabolism, hormone levels, and immune function, all of which are important for maintaining liver health.
Studies have shown that individuals who get less than six hours of sleep per night are at an increased risk of developing NAFLD. This may be because lack of sleep can lead to metabolic disturbances, including insulin resistance and changes in hormone levels, which can contribute to the development of NAFLD.
In addition to increasing the risk of developing NAFLD, lack of sleep can also exacerbate existing liver damage and increase the risk of developing more severe liver disease. Studies have shown that individuals with NAFLD who have poor sleep quality or sleep disturbances are more likely to have more severe liver disease and poorer liver function.
Getting enough quality sleep is important for maintaining liver health and reducing the risk of developing NAFLD or worsening existing liver damage. Aim for at least seven hours of sleep per night and prioritize healthy sleep habits, such as maintaining a regular sleep schedule, avoiding electronic devices before bed, and creating a comfortable sleep environment.
Dreamzzz can help you get better quality rest if this an area you are struggling with.
Limit Exposure to Toxins
Environmental toxins such as heavy metals, pesticides, and industrial chemicals can contribute to the development of NAFLD. These toxins can accumulate in the liver and other organs, leading to inflammation and damage to liver cells.
Although complete avoidance might not be possible, minimizing the time spent in direct contact can help reduce your chances of it developing.
NAFLD might not seem serious at first glance, but it is one of those things that "leaving to chance" is not a good approach.
It is very easy to craft a treatment plan if you have it, and with a little effort, you can be good to go, so don't wait until it's too late.