An alarming rate of Americans have this "new" disease.
You've probably never heard of it. But up to 46% of you reading this likely have it. It's called nonalcoholic fatty liver disease, or NAFLD.
This isn't some dummy disease drummed up by drug companies like ones we've warned you about before.
It's a problem that's been around, but it's expanding along with our waistbands. Worse, NAFLD can cause everything from liver failure to cancer. Researchers warn we could see a big jump in liver-cancer deaths if we continue to ignore this problem.
And we think they're right. So we wanted to take this issue to explain a bit more about what it does and how to protect yourself starting today.
What does your liver do?
Your liver is the workhorse in your body. It filters our blood to remove hormones and toxins from what we ingest, like alcohol. It also works in the blood-clotting process and immune system function, and it produces key hormones and proteins needed to keep several other bodily systems running.
Your liver also plays a major role in digestion. It produces bile, which helps your small intestine break down fats and proteins so you can absorb vitamins and cholesterol.
What is fatty liver disease?
Over time, your liver may develop fat deposits. This happens if the body makes too much fat or if you have problems breaking down fats in your body. The clinical definition is when fat in the liver contributes to 10% or more of the liver's total weight.
Who gets fatty liver disease?
Only about 10% to 15% of people of normal weight get it, but 70% of obese folks get it. Many people don't experience symptoms. So undiagnosed cases could put that number higher.
And it's only rising. About 38% of all Americans are now obese, with middle-aged Americans (40-59 years old) and those over 60 having the two highest rates of obesity at 41% and 38.5%, respectively.
Worse, our kids are starting to show signs. A study from the International Journal of Molecular Sciences found that 10% to 20% of pediatric patients have NAFLD. That just sets them up for a lifetime of liver problems, including liver cancer.
Here's the scary part, according to that same study...
"Within the next 10 years, it is expected to become the leading cause of liver pathology, liver failure, and indication for liver transplantation in childhood and adolescence in the Western world."
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What causes fatty liver disease?
We don't know exactly why certain people's livers wouldn't break down fat as effectively, but we do know some common risk factors for fatty liver disease.
Risk factors include:
- Type 2 diabetes
- High cholesterol
- High blood pressure
- High triglycerides
More recent research points to other contributors like genetics, rapid weight loss, liver diseases like hepatitis, and certain medications such as steroids.
What are the symptoms?
Symptoms include a loss of appetite along with nausea and vomiting. You may experience pain, particularly in the upper right of your abdomen (just under your ribs). Some folks might also appear jaundiced, or yellow in the skin or eyes.
Your doctor will likely order blood tests to check your liver enzymes first. That might lead to an ultrasound and a possible biopsy to confirm your diagnosis.
Does fatty liver really cause cancer?
Fatty liver can cause inflammation, which we know damages tissue and may lead to cancer. But fatty liver also leads to scarring in the liver tissue called cirrhosis, which causes an increased risk of cancer.
NAFLD may not develop into anything. Or it could develop into nonalcoholic steatohepatitis, called NASH. NASH means there's inflammation in your liver, which may lead to scarring (cirrhosis) and cancer. Up to 12% of Americans have NASH.
Here's the thing... we read about a study presented at the European Association for the Study of the Liver (EASL) International Liver Congress in 2015. The study demonstrated that over a five-year period, researchers saw an increase in the number of liver cancer patients. The annual increase was 5% each year. Worse, the percentage of cases caused by fatty liver also increased, more so than the number of cases due to hepatitis.
Remember, liver cancer is the third deadliest cancer you can get. It has just a 17.2% five-year survival rate.
What can I do to prevent fatty liver?
The numbers are against us. Leading liver journal Hepatology forecasts that the number of NAFLD cases will reach 100.9 million by 2030. It also predicts an increase in NASH cases from 16.5 million in 2015 to 27 million in 2030 – that's a 63% increase.
We have to fight back. Keeping a healthy weight is crucial to preventing this disease. Following my guidelines for a Mediterranean diet and getting plenty of exercise will help. Replace trans fats with healthy ones, like olive oil.
A few studies point to a connection between monosodium glutamate (MSG) and fatty liver. It's a common flavoring added to food. Many folks know it's common in Chinese take-out, but it's also present in pre-made bottled sauces (like hot sauce), protein powder, croutons, salad dressings, and pre-mixed spice rubs.
I already have fatty liver. Can I reverse it?
Yes and no. The scarring and damage done by NASH is permanent. However, if you have NAFLD, you may be able to reverse the fat buildup with simple lifestyle choices. That includes things like losing weight and exercising. For NASH, you may be able to stop the damage from progressing if you also make the same adjustments. You might consider adding vitamin E to your diet.
Don't forget, coffee helps prevent liver cancer as well. If you don't already enjoy a cup or two in the morning, now is a perfect time to start.
A few supplements out there claim to "detox" your liver and reverse fatty liver. Unfortunately, there are few studies to support this. The ones we saw look promising for things like curcumin (found in turmeric) and milk thistle. Doctors sometimes prescribe milk thistle for alcoholic liver disease, but we haven't seen anything on nonalcoholic disease yet. Make sure for any supplement you do your due diligence with research from sites like the Medical Reference Guide at University of Maryland (see the entry on milk thistle here) and talking with your doctor about possible interactions.
Both NAFLD and NASH are growing problems in the U.S. As we continue our sedentary, ultra-processed-food lifestyles, we're slowly killing our livers. Cut out trans fats, start fasting, and get up and exercise every day. No matter what else you do in 2018, make sure taking care of your liver is a top priority.
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Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
February 27, 2018