The Enid News and Eagle, Enid, OK

September 12, 2013

Don’t let liver get too fat

By Judy Rupp, columnist
Enid News and Eagle

— You probably haven’t spent much time worrying about the accumulation of fat in your liver. But maybe you should.    

Alcoholics often get a fatty liver on their way to more serious events such as cirrhosis and liver failure. But even people who don’t drink are vulnerable to fatty liver disease, and it can have the same effect — leading to cirrhosis and liver failure.    

Non-alcoholic fatty liver disease (NAFLD) has been increasing in this country and around the world. Its prevalence among American adolescents has more than doubled over the last three decades.    

If you have excess fat in your liver, you probably don’t know it. A definitive diagnosis can be made only with a liver biopsy, which is too invasive for screening use. For patients with elevated liver enzymes, however, an ultrasound scan of the liver can give doctors a pretty good idea.    

Although a fatty liver has no effect on your weight or waist line, most persons with non-alcoholic fatty liver disease are overweight. Many have abdominal obesity and metabolic syndrome — often a precursor of type 2 diabetes and you’re highly likely to have other medical conditions such as high cholesterol, hypertension and metabolic syndrome that increase your risk of serious disorders and early death.    

The increased incidence of non-alcoholic fatty liver disease is frequently linked to the obesity epidemic that has occurred. Obesity-related NAFLD has become an increasingly common reason for liver transplantation.    

The problem occurs when the liver, for some reason, has difficulty breaking down fats. This may be due to changes in levels of liver enzymes. At first, this fatty buildup may cause no harm, and it’s believed that a large percentage of the population has some degree of fatty buildup.

In a small number of people, the fat causes an inflammatory reaction in the liver, impairing its ability to function properly. The next stage occurs when the inflammation causes scarring of the liver, known as cirrhosis. Cirrhosis is a well-known consequence of alcohol abuse, but it is a common and life-threatening occurrence in non-drinkers or moderate drinkers, as well.

According to one intriguing theory, non-alcoholic fatty liver can be attributed in part to changes in the bacterial flora of the intestines. One study found distinctly different flora in obese patients with non-alcoholic fatty liver disease compared to non-obese subjects.    

NAFLD is completely reversible — but only if treated early enough. The key is treating associated problems such as diabetes, the metabolic syndrome and high cholesterol while making meaningful changes in lifestyle.    

WEIGHT LOSS is nearly always the first step. Weight loss of 10 percent or more of body weight is recommended. Several studies have found weight loss to be effective in reducing or eliminating the inflammation caused by fatty liver disease.    

A BETTER DIET: Even those who have trouble losing weight can be successful in preventing or treating fatty liver disease through improvements in their diet.     

EXERCISE is recommended — for weight control and for management of associated problems such as diabetes, high cholesterol and high blood pressure. Aim for at least 30 minutes a day of moderate or vigorous physical activity.    

DRINK WINE, COFFEE: One study found that persons who reported drinking up to one glass of wine a day had half the risk of NAFLD as those drinking no alcoholic beverages. This benefit did not apply to subjects drinking other alcoholic beverages.

Coffee drinkers also seem to have a reduced risk. A large population study in Norway found coffee consumption associated with a lower risk of liver cirrhosis.    

BE WARY OF DRUGS: You can protect your liver by avoiding unnecessary use of over-the-counter or prescription medications. Drugs associated with an increased risk of NAFLD include amiodarine, methotrexate, tamoxifen and HAART.    

Whether as a cause or an effect, excess fat in the liver is associated with some serious, even life-threatening, medical conditions. Fatty liver affects a significant and growing portion of the population. If you’re one of them, it’s time to start taking action.

Rupp is a certified information and referral specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.