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These two common conditions present many overlapping risk factors, but both respond to healthy lifestyle changes.
The largest organ of your body, your liver, is just below and to the right of your heart. This body organ plays many vital roles in the body, including the treatment of cholesterol and the making of proteins that help your blood clot. But nearly one in four Americans has a potentially dangerous accumulation of fat in the liver. This disease, known as non-alcoholic fatty liver (NAFL), often goes hand in hand with obesity and diabetes. Both of these conditions increase the risk of heart disease, and more and more evidence links NAFL to cardiovascular problems.
"The link between fatty liver and the earliest signs of plaque in the coronary arteries is becoming more obvious," said Dr. Tracey Simon, a Harvard-affiliated Mbadachusetts General Hospital (MGH) hepatologist. Excess fat around the liver and other organs of the abdomen, called abdominal obesity, is another problem probably related. In fact, abdominal obesity seems to accelerate the progression of fatty liver to a more serious form of the problem, nonalcoholic steatohepatitis or NASH (see "The many faces of fatty liver disease").
However, even people of normal weight can develop NAFL, although this is not common. "About 7% of people with fatty liver have what we call a" lean NAFL, "says Dr. Simon, who treats patients at the MGH fatty liver clinic. The percentage can reach 20% among Asians. For these people, it is likely that genetic or environmental factors still unknown contribute to the disease, she adds.
Many faces of foie grasExcessive consumption of alcohol can lead to accumulation of fat cells in the liver. Known as alcoholic fatty liver, this condition affects about 5% of adults in the United States. But non-alcoholic fatty liver disease, which is not badociated with excessive alcohol consumption, is much more prevalent, affecting at least 25% of American adults. There are two types of this disease. The sweetest form, non-alcoholic fatty liver (NAFL), is also called simple fatty liver. But it can progress to a more serious condition called NASH, in which liver cells are inflamed and injured. In the United States, between 3% and 7% of adults have NASH. NASH may continue to progress to fibrosis (scarring) of the liver, cirrhosis and liver cancer. |
Diagnose fatty liver disease
People with simple hepatic steatosis rarely show symptoms, which is why they are most often discovered at random during an imaging test (abdominal ultrasound, MRI or CT scan, for example) performed for another reason. Sometimes a blood test reveals slightly elevated liver enzyme levels, prompting to look for other liver problems, such as hepatitis C. However, between 60% and 70% of sufferers NAFL have normal liver function results, says Dr. Simon.
An ultrasound of the liver can quantify the amount of fat in the liver and reveal changes in its texture, but it takes a biopsy to diagnose NASH. Doctors usually practice biopsies only when they are unsure whether a person has fatty liver or some other rare form of chronic liver disease, says Dr. Simon.
Treat fatty liver disease
Contrary to what you might badume, people with a fatty liver do not need to avoid fat. Recent research suggests that the Mediterranean diet, the diet shown to reduce the risk of heart disease, is also beneficial to liver health. "A Mediterranean diet seems to reduce the risk of progression of fatty liver and long-term liver-related complications," says Dr. Simon. This style of restoration focuses on fruits, vegetables, whole grains, legumes, nuts, butter replacement with olive or canola oil, and increased consumption of fish. and lean poultry instead of red meat.
Refueling with fresh and healthy plant foods instead of processed foods (which tend to be full of fat, salt and sugar) can also help people lose weight, which may be the most important treatment for hepatic steatosis. And you do not need to lose a lot of weight – only 5% to 10% of your body weight can make a difference. Aerobic exercises such as brisk walking also help eliminate excess fat from the liver, even if you are not getting thinner.
There is currently no FDA-approved drug for treating fatty liver diseases. Although many people can benefit from a cholesterol-lowering statin, some people avoid these drugs because they fear liver damage. However, liver damage caused by statins is not only rare, they are easily diagnosed and reversible, says Dr. Simon. There is therefore no reason to avoid statins, especially since heart disease is the leading cause of death in people with fatty liver, she adds.
Image: © Nerthuz / Getty Images
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