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Non Alcoholic FATTY LIVER Disease
The term fatty liver disease is used to describe a range of conditions where the liver cells build up more fat then usual. As the liver is one of the most important organs of the body, controlling many of our body’s essential processes ,it is serious when the liver starts accumulating abnormal amounts of fat.
Fatty liver is not just a disease of alcoholics. To distinguish between the two, the term non-alcoholic fatty liver disease (NAFLD) is used. NAFLD is the accumulation of excessive amounts of fat in the liver cells without a known history of excessive alcohol intake. It seems to occur in about 14-30% of the general population. NAFLD is related to the term insulin resistance and normally occurs as part of the metabolic changes that accompany obesity, diabetes, and high levels of fats in the blood.
Insulin resistance. Normally, insulin acts on the liver to stop the liver’s cells from making glucose from its stores of glucose. If the liver no longer recognises the job of insulin then the liver releases uncontrolled glucose into the blood stream even when the blood sugar levels are
already high. Insulin resistance also increases the amount of fat that is broken down from fat storage and therefore gives an influx of fat into the liver. This leads to a further increase in insulin resistance and the cycle continues.
There is a strong link between obesity, diabetes and NAFLD. In fact NAFLD is considered the liver’s manifestation of the metabolic syndrome which increases risk of heart disease. The abnormalities include a large waist circumference, raised blood fats, high blood pressure and raised blood glucose levels.
NAFLD is an condition that can progress to liver failure. Those at greatest risk of developing non
alcoholic steatohepatitis, or inflammation of the fatty liver cells, and progressing to liver failure include those with a BMI>28, >50 years old, high liver enzymes, and raised fasting triglycerides. The greater the number of features present, the greater the likelihood of severe liver disease.
Your dietitian with the help of your doctor and or specialist will support and recommend dietary change.
The most successful treatment of NAFLD is through lifestyle changes where weight loss by dietary restriction and exercise achieves a goal of 0.5kg per week.
We also know that exercise decreases insulin resistance and promotes weight loss, so it s a logical part of any treatment.
Recent studies have explored the benefits of using drugs to treat the condition. These include insulin sensitising drugs such as those used to manage Type 2 diabetes, large doses of the antioxidant Vitamin E, and lipid lowering drugs. To date none of these modes of treatment have been recommended for use outside of clinical trials due to possible side effects and questions regarding their effectiveness.
Treatment recommendations for NAFLD:
Firstly exclude other possible causes of fat accumulation in the liver. Your doctor will advise you.
Have your GP screen you for the other risk factors associated with the condition, such as being overweight, diabetes, high cholesterol and high blood pressure.
Avoid substances which can harm your liver, such as alcohol. Get your GP to review current medications and advise them of any herbal supplements you might be taking as these can also be toxic to the liver.
Discuss with your doctor commencing regular physical activity of at least 45 minutes most days of the week. This will improve insulin resistance and promote weight loss.
Improve your diet. Focus on improving your nutritional status through reducing intake of saturated fat and sugars, weight loss, diabetes control Prognosis Appropriate treatment can reduce the amount of fat in the liver cells. For many people this will require ongoing weight management. The less damage to the liver before diagnosis, the better the long term picture can be. If untreated, deterioration of the liver cells will continue . Added to site on : Tuesday, 28 December 2010