Don't fatten your liver

The liver is the largest, heaviest and most complex internal organ in the body with many important functions.

It makes bile for breaking down dietary fats, it absorbs and converts blood glucose into glycogen, produces urea (the main impurity in urine), makes certain important proteins like albumin, filters out and neutralises harmful substances like alcohol and drugs from the blood, stores vitamins like vitamin A, D, K and B12. The liver is also responsible for producing about 80 per cent of the cholesterol in your body.

FATTY LIVER

Normally, the liver can handle a lot of abuse and has a tremendous ability to regenerate itself after damage and stress. Unfortunately, most people, including many doctors, are unaware of a liver problem that researchers say is now the commonest liver disorder in developed countries. It is estimated to affect almost a quarter of the American population. It is called Non-alcoholic Fatty Liver Disease (NAFLD). The name speaks for itself: an accumulation of fat in the liver, occupying over 10 per cent of the organ, in people who drink little or no alcohol. This latter distinction is important as, in the past, a fatty liver was typically associated with alcohol abuse. As the obesity epidemic accelerates, medical experts are realising that we are facing an epidemic of NAFLD.

WHO IS AT RISK?

The disease can strike anyone, but certain groups are at high risk:

THE OBESE: Ninety per cent of obese individuals are at risk of damaging their liver with fat, especially where the excess fat is stored around the waistline. Fat around the waist (truncal obesity) is not just stored under the skin. It surrounds and infiltrates the abdominal organs, particularly the liver where fat globules actually enter the liver cells and damage them.

THE DIABETIC: Fifty per cent of diabetics have NAFLD, and just about all obese diabetics will have this problem. Elevated levels of insulin in the blood and insulin-resistance are strongly associated with Type 2 diabetes and obesity and seem to play a major role in fatty liver disease.

HIGH CHOLESTEROL LEVELS: A very high percentage of individuals with elevated levels of bad (LDL) cholesterol and triglycerides have excess fats damaging their livers.

THE ELDERLY: The prevalence of this condition rises with age and recent studies show that over 65 per cent of persons over age 80 have NAFLD. Unfortunately, obese children may already have fatty livers.

WHAT TO LOOK OUT FOR: Like diabetes and high blood pressure, this liver condition is often initially silent, only to cause life-threatening problems many years later.

In some cases, patients may have only non-specific complaints, like low energy, fatigue, malaise and mild upper abdominal pain. Laboratory tests for liver function may or may not reveal any abnormality. Later in the progression of the disease, signs of inflammation of the liver (hepatitis), cirrhosis, liver failure or liver cancer may develop.

TREATMENT AND PREVENTION

Conventional medicine does not have a specific drug or treatment for this problem. However, the condition can be largely prevented and sometimes reversed by nutritional and lifestyle modification. This includes:

Weight loss. Losing weight with a nutritionally sound weight loss programme will result in a significant reduction of excess fat in the liver. I have found a low carbohydrate, cellular nutrition type programme, effective in this regard. Correcting truncal obesity is an essential part of any treatment plan.

Controlling high blood sugar levels is also very important in managing this problem. A diet low in simple carbohydrates, along with supplements like chromium and the omega 3 fatty acids, greatly improves blood sugar control.

Antioxidant supplementation with vitamins A, C, E, selenium, alpha lipoic acid, coenzymeQ10, green tea and glutathione is important in protecting the liver cells.

Detoxification programmes will help relieve the toxic burden on an already compromised liver. The herb, milk thistle, is particularly useful in this regard. Alcohol and other liver toxins must be absolutely avoided.

Soy products. Soy-beans contain a form of phosphatidylcholine, which has been shown in some studies to halt the progress of liver damage in NAFLD.

So, if you have a spare tire, a love handle or a beer belly, this may be a warning sign that you are on your way to developing a fatty liver. Remember, your life depends on your liver!

You may email Dr Tony Vendryes at vendryes@mac.com or listen to An Ounce of Prevention on POWER106FM on Fridays at 8 p.m.