What is fatty liver disease & what can I do?

What is non-alcoholic fatty liver disease?

Metabolic-associated steatotic liver disease (fatty liver disease), often called MASLD, is a liver problem that affects people who drink little to no alcohol. In MASLD, too much fat builds up in the liver. It is seen most often in people who are overweight or obese.

MASLD ranges in severity from hepatic steatosis, called fatty liver, to a more severe form of the disease called nonalcoholic steatohepatitis (MASH).

MASH causes the liver to swell and become damaged due to the fat deposits in the liver. MASH may get worse and may lead to serious liver scarring, called cirrhosis, and even liver cancer. 

Is fatty liver disease serious?

In most cases, the fat buildup doesn’t cause serious problems or prevent the liver from functioning normally.

In some cases, however, the condition progresses to liver disease. It usually progresses in stages:

Hepatitis (liver inflammation):

Your liver goes from fatty to inflamed. The inflammation causes damage to the liver tissue. This happens when the normal fatty liver disease (MASLD) progresses to steatohepatitis (MASH).

Fibrosis:

Bands of scar tissue form where the inflammation damages the liver causing the liver to stiffen.

Cirrhosis:

Extensive scar tissue replaces healthy tissue and now there is cirrhosis of the liver. Without treatment, cirrhosis can be fatal.

Therefore it is important to get treatment for the fat buildup on your liver before it progresses to more severe scarring and other conditions.

Symptoms:

MASLD often has no symptoms, when it does it may include:

• Fatigue

• Not feeling well, general flu-like symptoms

• Pain or discomfort in the upper right belly area

More commonly people will experience symptoms when the disease has progressed. Symptoms of MASH and cirrhosis or severe liver scarring can include:

• itchy skin

• Nausea

• Loss of appetite

• Abdominal swelling

• Shortness of breath

• Swelling in legs

• Spider-like blood vessels beneath the skin's surface

• Enlarged spleen

• Red palms

• Yellowing of skin and eyes

What Causes Fatty Liver Disease:

MASLD and MASH are both linked to the following:

• Genetics.

• Overweight or obesity.

• Insulin resistance.

• Type 2 diabetes

• High levels of fats, especially triglycerides, in the blood.

You have a greater chance of developing fatty liver disease if you:

• Have alcohol use disorder (frequent or heavy alcohol use).

• Have metabolic syndrome (insulin resistance, high blood pressure, high cholesterol, and high triglyceride levels).

• Have Type 2 diabetes.

• Have overweight (BMI 25 to 29.9 kilograms kg/m2).

• Have obesity (BMI 30 kg/m2 and above).

• Have polycystic ovary syndrome (PCOS).

• Have obstructive sleep apnea.

• Have hypothyroidism (low thyroid hormones).

• Have hypopituitarism (low pituitary gland hormones).

• Have hypogonadism (low sex hormones).

• Take certain prescription medications

Prevention/reduce the risk:

To reduce your risk of MASLD:

• Eat a healthy diet. Eat a healthy diet of fruits, vegetables, whole grains, and healthy fats.

• Limit alcohol, simple sugars, and portion sizes. Avoid sugary drinks like soda, sports drinks, juices, and sweet tea. Drinking alcohol can damage your liver and should be avoided or minimized.

• Keep a healthy weight. If you are overweight or obese, work with your healthcare team to gradually lose weight. If you are a healthy weight, work to keep it by eating a healthy diet and exercising.

• Get vaccinated against Hepatitis A and B. These viral infections are dangerous if you already have liver disease.

• Exercise. Be active most days of the week. Get an OK from your healthcare team first if you haven't been exercising regularly.

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At least 150 to 300 minutes a week of moderate-intensity or,	75 to 150 minutes a week of vigorous-intensity aerobic physical activity,	Muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on 2 or more days a week
As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training and aerobic and muscle-strengthening activities—at least 150 minutes per week of exercise.

150 minutes a week = 30 minutes of moderate walking a day from Monday to Friday.

300 minutes a week = 60 minutes of moderate walking a day from Monday to Friday.

Healthy diet tips:

High fibre starch:

Starch (carbohydrates) should make up one-third of the food you eat. They include potatoes, bread, rice, pasta and cereals.

Choose higher fiber or whole grain starch items, such as wholewheat pasta, brown rice, and wholewheat bread.

Include 1 starchy food with each meal.

Lots of fruit and vegetables:

It is recommended to eat 5 portions of fruit and veg every day. They can be fresh, canned, frozen, drier, or juiced.

Include vegetables in at least one of your meals every day if you do not like vegetables and progress from there on.

Eat more fish:

Fish is a good source of protein and contains many vitamins and minerals.

Eat at least 2 portions of fish a week including 1 portion of oily fish such as pilchards/sardines.

Sugar:

Eat less sugary items. Regular consumption of sugar increases the risk of obesity and tooth decay.

Eat less salt:

It is recommended that we eat less than 6g of salt daily.

When food is being cooked there is already salt added through different spices and when we add extra salt when eating the food we most likely are ingesting too much salt.

Drink a lot of water:

Do not go dehydrated. Drink enough water. It is recommended to drink 6-8 glasses of water a day.

Try to avoid sugary soft and fizzy drinks as they are high in calories.

Switch high-sugar drinks with unsweetened drinks/juices.

Do not skip breakfast:

Some people skip breakfast because they think it’ll help them lose weight.

But a healthy breakfast, high in fiber and low in fat and sugar can help you get the nutrients you need.

Studies also show eating a healthy high-fiber fiber and protein breakfast will reduce hunger throughout the day.

Good Foods for Fatty Livers:

• broccoli

• Avo

• Olive oil

• Oats

• Garlic

• Green tea

• Fruit and veggies

• Beets

Food to avoid:

• red meat

• Soda

• White bread

• Salt

• Alcohol

• Sugar

Fatty liver disease doesn’t cause major health problems for most people unless they develop advanced cirrhosis.

Untreated cirrhosis can eventually lead to liver failure and liver cancer. You can not survive without your liver, therefore it is extremely important to protect your liver.

If you have a fatty liver, it is still possible with some changes and treatment to improve the outcome of the disease and potentially save your life.

Make good choices.