The liver is the body’s second-largest organ.It is also known as the regenerative organ. The liver performs more than 500 important functions in the human body. It removes waste products, foreign substances, regulates blood sugar levels, and produces bile for digestion and absorption.
Inflammation arises when there is too much accumulation of fat in the liver. This causes scarring to the liver, if left untreated these scarring of the liver can lead to liver failure.
In this blog, Let’s explore the concept of fatty liver and how to reverse it for a healthy life.
What is fatty liver?
Fatty liver or hepatic steatosis, is a condition that occurs when excess fat accumulates in the liver. It is mostly seen in obese and overweight individuals.
It is a growing epidemic side by side to obesity worldwide in adults and children. According to a study, it is projected that over half of the adult population globally will have Non-Alcoholic Fatty Liver Disease by 2040.
This represents a 43.2% increase from the prevalence of 39.8% in 2020. It also reports that NAFLD is expected to occur in women, smokers and those who are not diagnosed with any metabolic syndrome.
Types of fatty liver
- Non-alcoholic fatty liver disease – This is a condition where there is little to no inflammation but the presence of accumulation of fat. This condition is not due to the heavy alcohol use.
- Alcoholic fatty liver – This condition occurs due to the accumulation of heavy alcohol use. Normally, your liver breaks down alcohol to remove it from your body. However these substances can damage your liver cells, cause inflammation, and weaken the immune system. The early stage of alcoholic liver disease is alcoholic fatty liver. It can advance to alcoholic hepatitis and cirrhosis.
- Non-alcoholic steatohepatitis – It is a more serious form of NAFLD. In this condition, the liver is inflamed in addition to fat accumulation. In this state, the liver may be damaged and this damage can cause scarring of the liver. When NASH is left untreated, it can progress into cirrhosis and may lead to hepatocarcinoma (liver cancer).
Grades of fatty liver
Fatty liver is graded into 3 based on the visual changes observed in the ultrasound.
- Grade 1 – The fatty liver is the mildest form. Fat accumulation is on the outside of the organ, and the functions of the liver are not affected.
- Grade 2 – The condition is moderately severe and medical intervention is needed to prevent the worsening of the condition.
- Grade 3 – This is the severe stage when the fat accumulation percentage is more than 66%. The inflammation of the liver is severe and in some cases, patients may need transplants.
Fatty liver can progress through four stages: fatty liver, steatohepatitis, fibrosis and cirrhosis.
Symptoms of fatty liver
Fatty liver is asymptomatic unless the condition progresses to cirrhosis. In some conditions, people may experience discomfort or pain in the right upper abdomen.
Diagnosis of fatty liver
As fatty liver is asymptomatic, it is difficult to easily diagnose the condition.
- Blood tests
- Imaging like abdominal ultrasound, Magnetic resonance imaging (MRI) or computerised tomography scanning, transient elastography, magnetic resonance elastography
- Liver biopsy
Causes of fatty liver
- Consuming a diet high in refined carbohydrates, and high-fat food. Not eating enough protein and vegetables.
- It can be due to anti-inflammatory medications, immunosuppressants and other medications.
- Exposure to environmental toxins.
- Family history of diabetes, fatty liver or cryptogenic cirrhosis.
- Obese or being overweight can also cause fatty liver.
- Fatty liver can also be caused by gastric bypass surgery for the treatment of morbid obesity.
Can fatty liver be reversed?
Fatty liver can be reversed when it is in the early stages by making some lifestyle changes. Studies show that inflammation,fat and scarring can be reversed.
Weight Loss
Weight loss is a good treatment for fatty liver. About 10% of weight loss improves liver health. Weight loss methods include dieting, exercising, medications and in extreme cases weight loss surgery.
Dietary pattern
An underlying condition of fatty liver is often obesity. To lose weight, following a balanced and healthy life helps.
- Include complex carbohydrates like whole grains, millet, pulses, legumes, and vegetables.
- Add lean protein like chicken, fish, eggs, paneer, tofu, legumes and pulses.
- Include healthy fats like nuts, seeds, olive oil, and avocados as they are high in omega 3 and omega 6 fatty acids.
- Avoid any excess simple carbohydrate intake like candies, desserts, cakes, pastries, sodas, and sweetened beverages.
It is not the extra fat that you eat that accumulates in the liver but the extra simple carbohydrates that you eat convert into fat and accumulate.
Physical activity
The inflammation can be lowered by physicalactivity. Aerobic exercise and resistance training can help reduce NAFLD.
A study showed that engaging in moderate exercise for at least 20 to 60 minutes for 4 to 7 days each week helps improve liver health.
A study revealed that exercise and diet intervention in people with NAFLD resulted in remission of fatty liver in 64% of the participants.
Vitamin E as a treatment
Vitamin E is a fat-soluble vitamin. It has antioxidant properties and anti-inflammatory properties. Vitamin E includes four tocopherols and four tocotrienols. Tocopherols are saturated forms and tocotrienols are unsaturated.
Oxidative stress plays an important role in causing hepatic injury associated with NAFLD.
Vitamin E is commonly found in oils like corn, and peanut, and the latest amount of ɑ-Tocopherol is found in soybean oil. Rice bran, barley, oats and palm oil contain high amounts of tocotrienols.
Vitamin E along with vitamin C as a combined treatment resulted in being effective after 4 years
of active therapy in reducing the odds of having hepatic steatosis in
individuals with computed tomography diagnosed with NAFLD.
Multiple clinical trial studies reported that there was an improvement in NAFLD or NASH when a dose of 100-1200 IU/day of vitamin E was used as monotherapy.
Foods to improve fatty liver
- Grapefruit – It contains antioxidants, the main ones are naringenin
and naringin. These antioxidants reduce inflammation and protect the
cells.
- Blueberries and Cranberries – Berries are rich in antioxidants. Antioxidants give the berries their distinct colours.Extracts of blueberry inhibit the growth of human liver cancer cells and cranberry supplements improve hepatic steatosis or fatty liver.
- Grapes – Red and purple grapes have benefits on liver health. It helps in lowering the inflammation, prevents cell damage and increases the antioxidant levels.
- Beetroot juices – Beetroots are a rich source of nitrates and antioxidants – betalains. The compounds help reduce oxidative damage and inflammation in the liver.
- Cruciferous vegetables – Cruciferous vegetables like broccoli, brussels sprouts, cabbage, kale and cauliflower are rich in fibre. These vegetables contain certain compounds which make a change in the detoxification process and protect against harmful compounds.
- Fatty fish – Fatty fish like mackerel, salmon, and sardines are rich in omega-3 fatty acids. These omega-3 fatty acids help reduce inflammation. A study found that omega-3 fatty acids helped lower liver fat and triglycerides in those with NAFLD or non-alcoholic steatohepatitis.
- Olive oil – The Mediterranean diet is rich in olive oil. According to one study, following a Mediterranean diet rich in olive oil had an effect in lowering the risk of fatty liver in older adults. It also showed improved blood levels of liver enzymes.
Conclusion
Fatty liver can be reversed in the initial stage. It is important to have regular health checkups and screening for early detection of fatty liver. Following a healthy and balanced diet and regular exercise will help in reversing the condition. Make sure that your diet contains all the necessary nutrients that your body needs.
Kripa N,
Senior Clinical Dietitian, Simplyweight
