Sedentary lifestyles, nutrient-poor diets, chemical exposure, and an excess of sugar and refined foods are wreaking havoc on and in our bodies more than ever before. And the effects aren’t just cosmetic – beyond bulging waistlines, the incidence of high blood pressure, high blood sugar, and high cholesterol associated with metabolic syndrome are all on the rise, along with the rate of nonalcoholic fatty liver disease (NAFLD).
As the name implies, NAFLD (casually pronounced “naffled”) is a condition in which the liver stores excess fat occurring in those who drink little to no alcohol. Over time NAFLD can not only increase the risk of cardiovascular disease, but can also lead to further ailments of the liver like cirrhosis and liver cancer – conditions also seen in heavy alcohol consumers, but now more commonly seen in non-drinkers. In fact, NAFLD is the leading cause of liver disease in the West, often concurrent with other metabolic conditions: approximately 40 to 80% of people with the disease also have type 2 diabetes, and 30 to 90% are obese. As with metabolic syndrome, the incidence of NAFLD is also on the rise among children, affecting an estimated 3 to 12% of children with normal body mass and an alarming 40 to 80% of obese children.
The umbrella term NAFLD encompasses two sub-categories: nonalcoholic fatty liver (NAFL), which is characterized by fatty liver with little to no inflammation; and nonalcoholic steatohepatitis (NASH), which is the more harmful of the two and is defined as fatty liver with inflammation. It’s estimated that 30 to 40% of American adults have NAFL and about 3 to 12% have NASH.
The causes of NAFLD are not fully known, but a large piece of the puzzle has to do with the liver holding onto excess triglycerides. Triglycerides (TGs) are a form of fat that the body produces from excess calories, such as those that come from carbohydrates and sugar. Insulin resistance and blood sugar levels clearly play a role in the progression of NAFLD, which may very well explain why so many individuals with the disease are also diabetic. It has also been demonstrated that oxidative damage further exacerbates the situation, contributing to the progression of NASH.
But what causes that oxidative injury? It’s still being researched, but some explanations include iron overload conditions (like hemochromatosis), low antioxidant defenses, and an over-abundance of opportunistic or pathogenic bacteria in the gut (also known as dysbiosis), which contributes to inflammation and “leaky gut.”
I think NAFLD should be considered another aspect of metabolic syndrome. Clinically, I suspect NAFLD when a patient has a slightly elevated fasting glucose, but their gycohemoglobin A1c is normal. One or more of their liver enzymes (SGOT, SGPT, GGT) may also be elevated.
Elevated triglycerides are typically elevated when patients consume a lot of refined carbohydrates, but if triglycerides remain high after cleaning up their diet, NAFLD must be considered.
The diagnosis is confirmed with an ultrasound of the liver, demonstrating fatty infiltration. As long as there is no evidence of scar tissue (cirrhosis), then the condition is reversible. However, traditional medicine has not yet developed any drug therapy for NAFLD.
Diet, exercise and nutritional supplementation are the keystones to reversal of NAFLD. Silymarin, phosphatidal choline, oil soluble chlorophyll, and support for any other aspects of metabolic syndrome are effective adjuncts.
If you have high triglycerides, any aspects of metabolic syndrome (high blood pressure, obesity, high serum lipids, insulin resistance, or hypothyroidism), or elevated liver enzymes please consult your PCP to test for NAFLD. However, if you suffer from NAFLD seek qualified nutritional evaluation and treatment.
Source: June 13, 2019 Allery Research Corporation