Non-Alcoholic Fatty Liver Disease (NAFLD)

What is NAFLD?

Non-alcoholic fatty liver illness (NAFLD) is the most common form of fatty liver disease with a staggering 30% of Americans being affected. NAFLD has many stages that range from steatosis, which is the least harmful state, to non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis (permanent scarring of the liver) and eventually liver failure. Patients with NAFLD have a buildup of fat around the liver wall. A healthy liver should have little to no fat.

What are the stages of NAFLD?

NAFLD has the following stages:

1. Simple fatty liver (hepatic steatosis). A healthy liver has very little fat. Simple fatty liver is when fat builds up in the liver, creating a wall of fat cells. Usually, simple fatty liver does not severely harm the liver. With radical lifestyle and diet changes, this condition can be reversible.
2. Non-alcoholic steatohepatitis. As fatty liver disease progresses into NASH, the fat built up in the liver starts causing the inflammation. This condition can be still reversible, however through adopting the liver-healthy diet and lifestyle.
3. Fibrosis. is when scar tissue builds up in the liver, creating chronic hepatitis and damage to the liver. When fibrosis first develops, the liver can still function, but will begin to slow down in terms of efficiency.
4. Cirrhosis. is characterized by permanent liver damage and scarring when the healthy liver cells get replaced by scared tissues. This disease is irreversible and life-threatening. Long-term injury to the liver can create serious complications for the liver and can even lead to liver cancer. Long- term damage may lead to the need of a liver transplant.

Causes of NAFLD

As opposed to alcohol-related liver disease, NAFLD is not caused by alcohol consumption though their symptoms and complications can be very similar. The main causes and risk factors of non-alcoholic fatty liver disease include:

• Obesity
• Poor diet (excessive consumption of fat food and food high in carbs, sugary beverages, processed foods, etc.)
• Diabetes (mainly type 2)
• Insulin resistance
• High blood sugar
• High levels of fats in the blood
• High cholesterol
• Metabolic syndrome

Early Signs & Symptoms of NAFLD

NAFLD often remains asymptomatic in the beginning which makes it hard to detect at an early stage. Most people with NAFLD remain unaware that they even have a liver disease until it progresses into a more advanced stage and more symptoms arise. This is why it is important to use measures of preventative care, such as maintaining a healthy diet and regular exercise, as well as scheduling regular check-ups with your doctor.

The early symptoms of NAFLD may include:

• Weakness
• Rapid weight loss
• Abdomen pain or swelling
• Exhaustion
• Jaundice
• Poor appetite
• Red palms
• Nausea and vomiting

If you are diagnosed with NAFLD early, altering your lifestyle habits can often reverse the effects of NAFLD.

Diagnosis of NAFLD

To diagnose NAFLD doctors use:

• Patient´s medical history (individuals with obesity, type 2 diabetes or metabolic syndrome are especially at risk of developing NAFLD)
• Physical examination
• Blood test (liver function test)
• Imaging tests (ultrasound, MRI, CT)
• Liver biopsy

Treatment of NAFLD

Currently, implementing lifestyle and diet changes are the first and main steps in the treatment of non-alcoholic liver disease, since there is no specific medication available for treating NAFLD. Such lifestyle and diet changes usually mean:

• Start eating liver-healthy. Avoid foods high in salt, refined sugar, fat, starch, and simple carbs, processed foods as well as sugary drinks such as soda and juices. Instead, incorporate fruits and vegetables, complex carbs, fiber, whole grains, and drink more water.
• Implementing regular movement and exercise.
• Losing weight, if recommended by your doctor.

Make sure to schedule regular check-ups with your doctor to check your liver function for any signs of progression. Next time you get your blood tested, make sure you ask your doctor to include the liver enzyme tests as well.

Can NAFLD be reversed?

Yes, in some cases adopting liver-healthy lifestyle and diet can help stop the progression or even reverse non-alcoholic fatty liver disease. If these lifestyle and diet changes are not successfully met, NAFLD can progress into a more advanced form — non-alcoholic steatohepatitis (NASH) which over time may develop into fibrosis, and eventually cirrhosis.

Why is nutrition so important for liver health?

According to a survey, 97% of liver health experts consider nutrition the most important factor for liver health. Alongside with regular exercise, a liver-healthy diet is one of the cornerstones of non-alcoholic fatty liver disease treatment and prevention. On the other hand, poor nutrition will cause further damage to the liver as well as serious medical complications. But why is a liver-healthy diet so important for the liver?

Healthy nutrition can:

• Help the liver regenerate itself.
• Reduce risk of diabetes, metabolic syndrome, obesity, and fatty liver disease.
• In some cases, stop further progression of liver disease.
• Support the liver´s metabolism function.
• Decrease inflammation in the liver, normalize body weight and blood sugar.
• Avoid nutritional imbalances and deficiencies.

What is a liver-healthy diet?

A liver-healthy diet is a balanced diet. It should include an adequate amount of lean proteins, complex carbs, fiber, and vitamins & minerals. It should also be low in salt, sugar, starch, and fat.

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