Posted on May 27 2022
The liver is one of the most vital organs in the human body, which performs over 500 functions. Unfortunately, 35% of the Indian population suffers from fatty liver. As this disease can start off being painless, most people don't take it very seriously.
The fatty liver's grade depends on subjective examination of fat in the organ.
Grade 1 fatty liver occurs in the primary stages, where the fat accumulates outside the liver and doesn't affect the functioning. People tend to learn about this disease through frequent health checkups and ultrasounds.
Grade 2 fatty liver means a change in the liver texture. It is at this stage that developing a healthy nutrition and lifestyle regimen can prevent further spread of the disease.
If your liver has fat but no tissue damage or inflammation, the disease is Simple Fatty Liver. In case fat causes inflation and liver damage (not the subject refrains from drinking alcohol), the diagnosis is Non-alcoholic Steatohepatitis (NASH).
Often times, a fatty liver diagnosis might be anxiety causing and the information you find online is very over- whelming. Thus, I have tried to simplify terms and help you understand disease management and even reversal better through this article.
Fatty liver is tricky because the diagnosis for the same can either be via a liver test or scan. Because patients do not present with any other symptoms, diagnosis via scans are often caught accidentally when other organs are being tested.
Liver tests too can fails to diagnose one with fatty liver in over 50% of cases unless the patient is in an advanced stage. Thus fatty liver can most definitely be a silent killer.
Let's dive in.
What is Fatty Liver Disease?
Liver is the bodies detox machine. It helps flush out excess hormones and toxins from the body. However, it is also very sensitive to a bad lifestyle and nutrition. Fatty liver disease (steatosis) is a health issue caused due to excessive fat accumulation in your liver. You may have your doctor call the disease, "hepatic steatosis".
You are more likely to get a fatty liver if you are a heavy drinker. Excessive alcohol consumption builds up fat in your liver cells, which ruins this organ's functioning. However, your liver can get fatty even if you don't drink alcohol a lot.
A healthy liver has a small amount of fat. The problem starts when the liver comprises of over 5- 10% fat cells.
Unless the cause is linked to alcohol consumption, fatty liver is more often than not reversed with a drop in body fat percentage. It is said that with every 10% drop in body fat, you reduce one grade of scaring in the liver. So if you were to drop your body fat% from 40%- 30%, you would move from a grade 2 to grade 1 fatty liver.
Thus, treatment begins with a change in nutritional and lifestyle habits. Here is an example of lifestyle changes that help with obesity:
Why is Fatty Liver Disease Bad?
Fatty liver disease does not cause any critical issues or affect the normal functioning of the organ. However, this disease gets worse gradually, and for 7% to 30% of people, the disease goes through the following three stages:
- Steatohepatitis - Your liver gets swollen or inflamed that damages its tissues. This also reduces the livers detox functions, affecting other organs of the body.
- Fibrosis - Scar tissue builds up where your liver gets damaged
Cirrhosis - Extended scar tissue replaces healthy tissue. At this point, disease reversal might be impossible.
The three stages mentioned above reflect why fatty liver disease is bad and how it gets worse over time. Cirrhosis is the outcome of severe liver damage. The hard scar tissue, which replaces healthy liver tissue, deteriorates, and even liver functions go downhill. Cirrhosis can also lead to liver failure and cancer.
According to an Epidemiology study on obesity on a group of Netherland researchers, fatty liver is also associated with heart diseases and heart attacks. The study follow 714 participants and demonstrated that an increase in fatty liver was also associated with reduced blood flow to the heart, leading to coronary diseases.
This is not surprising as obesity, the root cause of fatty liver is also associated with multiple other metabolic diseases, including heart attacks.
If you are also struggling with obesity and cholesterol, read this to understand more:
What are the Forms of Fatty Liver Disease?
Fatty liver disease is of two forms below:
- Nonalcoholic fatty liver disease (NAFLD)
- Alcoholic fatty liver disease (AFLD)
How is Fatty Liver Disease Diagnosed?
As fatty liver disease tends to have no symptoms, the doctor may spot it while scanning the abdomen for other problems such as ovarian cysts. A high level of elevated liver enzymes may also indicate that your liver is injured.
A doctor may do the following things to diagnose your fatty liver disease:
- Liver biopsy (tissue sample) to determine the level of progress in your advanced liver disease
- FibroScan, a special ultrasound, which is conducted rather than an over biopsy sometimes to detect the amount of scar tissue and fat in your liver
Ultrasound or Computed Tomography (CT scan) to check your liver condition
What is a Nonalcoholic Fatty Liver Disease (NAFLD)?
NAFLD occurs in people who are not alcoholic's. 9 to 53% of people in India suffer from NAFLD. Many factors, such as diabetes and obesity, increase the risk of developing this health disorder.
Some people suffer from a much more critical form known as Nonalcoholic Steatohepatitis (NASH). People suffering from NASH should be careful and seek treatment to prevent liver scarring and cirrhosis. This occurs when the liver gets damaged and the scar tissue gradually replaces scar tissue.
What is Alcoholic Fatty Liver Disease?
Alcohol fatty liver is fat accumulation in the liver caused due to excess drinking. Moderate drinking is one drink per day for women and approximately two drinks per day for women.
The liver is the most complex organ in your body, which filters toxins from the blood, promotes food digestion, controls sugar and cholesterol, and fights diseases and infections. As the liver is very resilient, it can often fix itself. But every time this organ filters alcohol, it gets scarred a little.
To prevent the scarring, the liver accumulates fat cells around itself as a defence mechanism.
If you have alcoholic fatty liver disease, stop drinking, this combats the risk of further liver damage and helps in recovery. The end stage to a fatty liver might also be a liver transplant.
Alcohol addiction, high blood pressure, and smoking are some of the common causes of death worldwide.
The major life-threatening complications of alcoholic fatty liver disease are internal (variceal) bleeding, toxins build-up in your brain (encephalopathy), fluid accumulation in the abdomen (ascites), kidney failure, and liver cancer.
What Causes Fatty Liver Disease?
You may get fatty liver diseases even without having any preceding issues.
However, these are the common causes of this disease:
- Obesity or being overweight
- Metabolic syndrome (high triglyceride levels, high cholesterol, high blood pressure, and insulin resistance)
- Type 2 diabetes
Medications, such as diltiazem (Cardizem®), amiodarone (Cordarone®), and tamoxifen (Nolvadex®) or long term steroid use.
The key risk factor for AFLD (Alcohol Fatty Liver Disease) is excessive alcohol drinking, 15 or more drinks/week for men and 8 or more drinks/week for women. According to research, men who have 40 to 80 grams of alcohol per day and women who consume 20 to 40 grams of alcohol per day over a decade have a higher risk of critical alcohol-related liver disease.
A standard drink contains approximately 14 grams of alcohol.
Besides heavy alcohol consumption, the other risk factors are as below:
- Older age
History of specific infections, like Hepatitis C
The big risk factors for NAFLD are below:
- High cholesterol
- Insulin resistance
- High cholesterol
- High triglycerides
- Metabolic syndrome
- Type 2 diabetes
- Polycystic Ovary Syndrome (PCOS)
- Medications, such as Tamoxifen (Nolvadex), Methotrexate (Trexall), and Amiodarone
- Rapid weight loss
- Obstructive sleep apnea
Rare genetic complications
Do you have one or more of these risk factors for fatty liver disease? Consult a doctor to learn the prevention strategies.
Can Fatty Liver Disease Be Reversed?
Yes, you can reverse and even cure fatty liver disease with a 10% sustained drop in body fat percentage. The liver is capable of repairing itself.
Follow these tips below to decrease liver fat and reverse early damage:
Losing weight can be the most effective step to reversing and curing fatty liver disease. Aim to lose 10% of your body fat percentage. Consult an experienced nutritionist about how to lose weight safely.
Treat Other Health Issues
A fatty liver leads to many other health issues. If you treat them, you can reverse fatty liver disease. Such health issues are diabetes, cholesterol, triglycerides, sleep apnea, Polycystic Ovary Syndrome (PCOS), hypothyroidism/underactive thyroid, and hypopituitarism/underactive pituitary gland.
Change Your Diet
A whole food plant- based diet is the most effective way to manage fatty liver. Lifestyle changes with a nutrias diet can go a long way in terms of managing liver health. We will discuss about a whole food plant- based diet in length later in this article.
Alcohol consumption is associated with a fat built- up int he liver, as a way for the liver to protect itself. Needless to say, if you are diagnosed with Alcoholic Fatty liver disease, you want to stop alcohol consumption at the earliest.
Take Proper Medicines
There is no specific drug, which can cure fatty liver disease. However, certain medications and supplements can always help. You can take vaccines to protect yourself against Hepatitis A and B, liver-damaging viruses.
B12 and D3 supplements can also go a long way. Work with a nutritionist to understand wha you require. Avoid taking a multi- vitamin without first testing yourself to see if you need them. Multi- vitamins are often associated with reduced lifespan or simply no improvements markers at all.
Does a vegan diet improve liver function?
The effects of a vegan diet on liver function depends largely on the quality of a diet. Regardless of the diet you follow, it is obvious that the quality of foods in your diet matters. But a plant- centric diet overall does have some benefits over a meat centric diet.
As per a published study in the Journal of Gastrointestinal and Liver Diseases, vegan diets improve liver function proactively in patients who have nonalcoholic fatty liver disease (NAFLD).
In one study, over a span of six months, researchers studied body weight, calorie intake, and liver function in 26 people with NAFLD who were on a vegan diet. Dietitians assisted participants in adhering to their dietary plans. They observed weight loss and improvements in liver enzymes approaching normal levels. The increased plant-based food consumption boosted antioxidant intake and gut microbiome. These are favourable to liver enzymes.
These findings lend support to plant-based dietary approaches for treating liver illness. They also support the prevention of associated chronic disorders such as hepatitis, fibrosis, cirrhosis, and hepatocellular cancer.
Another study with 3400 participants published by the Tzu Chi medical journal proposed to show that vegetarians have a lower risk and reduced severity of fatty liver disease compared to meat eaters. Even among vegetarians, the quality of food impacted disease progression. Consumption of whole grains and soy products was linked to better liver health and disease risk.
Red and processed meats also are high in choline, which is converted to TMAO int he liver. TMAO is associated with an elevated risk of fatty liver disease. Plant- based diets are naturally lower in saturated fats, TMAO and inflammation, thus, is associated with prevention of fatty liver disease.
Will a vegan diet help with reversing fatty liver?
A vegan diet is usually near the top of the list when most people think of a healthy diet. Being naturally high in micro- nutrients and low in calories, it does support weight loss, without the need to restrict the amount of food you are eating.
Losing weight through a plant-based diet and exercise benefits/cure's NAFLD or NASH.
In other words, we can state that there is substantial evidence to support the idea of following a plant-based diet as a cure.
However, again, simply changing to a vegan diet will not work for everyone. After all, there are lots of obese vegans. So thinking of a whole- food plant- based diet, that minimises the consumption of processed vegan foods, such as mock meat, oil's and sugars should be your goal.
A significant amount of alcohol is still vegan. Likewise, carbohydrates that have been refined are still vegan. There's also a lot of vegan fast food. So, not just any vegan diet will help you improve your fatty liver disease. You should do the following:
- Ensure the diet is truly healthy and focused on reduction in saturated fats. The goal is often accomplished by limiting, if not eliminating, junk food and lowering or eliminating refined carbs, which are easy to overeat.
Secondly, you must be able to persist with it. If you have fatty liver disease, changing your diet simply for a short period until symptoms improve will not work. It's a long-term lifestyle adjustment. Thus, lifestyle modification is of utmost importance. Here is what I mean by lifestyle changes:
Is fatty liver linked to heart diseases?
According to one Netherlands Epidemiology study of Obesity, researchers analysed data from 714 participants. They compared liver function, cardiac function and BMI.
Despite any pre-existing signs of metabolic syndrome, a rise in liver fat decreased coronary blood flow in obese patients. These findings imply that nonalcoholic fatty liver disease may increase the risk of heart failure.
Also, the risk factors previously linked with metabolic syndrome emphasizes the relevance of dietary treatments as a means of prevention.
How to prevent NAFLD?
NAFLD is becoming more frequent worldwide, particularly among the South Asian population. Anywhere between 9- 23% of the Indian population is estimated to be suffering from NAFLD.
Nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease characterised by liver inflammation, can occur in people with NAFLD and progress to severe scarring (cirrhosis) and liver failure. This is analogous to the damage produced by excessive alcohol consumption.
NAFLD generally has no visible signs and symptoms. However, when this occurs, they may include:
- Upper right abdominal pain or discomfort
To lower your chances of developing NAFLD, do the following:
- Choose a nutritious diet. Choose a plant-based diet high in fruits and vegetables, whole grains, and healthy fats. Avoid fruit juices (not the fruit, just the juices), sugars, artificial sweeteners and refined carbs.
- Maintain a healthy weight. If you are overweight or obese, you should shift to an increased daily physical activity routine. Additionally, it is essential to check and reduce your daily calorie intake. If you are a person with a healthy weight, work to keep it that way by eating well and exercise often.
The liver has an incredible capacity for self-repair. Therefore, minimising liver fat and inflammation and reversing early liver damage is feasible if you avoid alcohol or lose weight.
Important foods for fatty liver disease?
Ginger is a popular cultivation and has been in use for medicinal and culinary purposes. The high antioxidant value of ginger is effective in scavenging various free radicals.
Research has established a consensus that ginger and its principal ingredients have positive benefits against several conditions. These include 'obesity, diabetes, cardiovascular diseases, and associated conditions,’ as stated by scientists from China Agricultural University.
There has been a lot of interest in non-pharmaceutical ways of treating and preventing metabolic syndrome. But because big pharmaceutical companies would not sponsor studies with kitchen herbs and spices, most of these superfoods go unnoticed.
But owing to its diverse phytochemicals and antioxidant profile, ginger- one of the world's most extensively eaten spices, has a long history as herbal medicine to treat several diseases.
Ginger also helps reduce oxidative stress (a type of cellular ageing). It is anti-inflammatory, and improves cholesterol and blood pressure. It may even help prevent atherosclerosis, which is the buildup of harmful fat in the arteries. But authors presume that the evidence for these benefits is stronger in animal and test-tube studies than in human investigations.
There has been one study, however, comparing the consumption of just a tsp of ginger powder daily to placebo and its effect on NAFLD. Both groups in this study were asked to follow a low cholesterol, healthy diet and both groups showed improvements at the ned of 12 weeks. The ginger group however performed better.
Now this is one study, but what could be the harm by consuming just a tsp of ginger powder daily. If anything, it adds flavour to your food, thus, must be considered.
Not oatmeal alone, but whole grains in general like brown rice, quinoa and whole wheat, seem to have a protective effect against metabolic diseases.
The moment we think about losing weight, we thing about dropping 'carbs' and inevitably, grains happen to be the first thing we strike out the list of food's to avoid.
But the very opposite seems to be true. Whole grain consumption has been liked to a lower BMI and even a lower waist to hip ratio. I talk about whole grains in details here:
Oats are high in soluble fiber, the kind of fiber that boosts your satiety hormone, making you feel fuller for a long time. Thus, cutting down the risk of over eating. The soluble fiber in oats particularly help in the growth go good gut microbiome too. The kind of gut bacteria that help support immune function. But have oats directly been tested for liver function? Well, yes!
Flaxseed powder is a part of every single one of my clients meal plan. These magical seeds are not only high in essential fatty acids and fiber, but have been shown to reduce cholesterol levels in a number of studies.
Flaxseed consumption has also been linked to better weight management and BMI. Meaning, studies have shown that participants asked to consume flaxseed's additionally to their diet end up losing more weight that participants who dont eat flaxseeds.
Thus, but naturally, it would be interesting to see the effects of flaxseeds on liver health. And indeed, there is a study that checked for just that. Participants in this study were asked to make lifestyle modifications and either take 30 grams of flaxseed powder (2 tbsp worth) or not. Both groups performed well at the end of this 12 weeks study (thanks to the lifestyle modifications), but the flaxseed group showed improved results with an additional drop in body weight, liver inflammation and liver scarring.
NAFLD or not, I insist you include flaxseed meal to your daily meal plan.
Sample One- day Meal Plan:
It is important to understand that meal plan's MUST be customised for your specific condition. There is no one- plan- fit's- all, however, a plant- centric diet proves to be the most beneficial.
Besides the above dishes, I also highly insist my clients include three cups of whole fruits, a serving of salad, adequate water and cruciferous vegetables to their diet. Besides this, lifestyle changes that specifically target circadian health, reduces stress levels and increased physical activity are of utmost importance.
The Bottom Line
Are you suffering from fatty liver disease? It doesn't have to be a life sentence unless you choose for the same. Fatty liver disease is often manageable and even reversible with the right lifestyle and nutrition habits.
Hopefully, this post helped you to learn the most important things about fatty liver disease and the Indian diet for a healthy liver. Now, it's time to start working out and eat the right foods to treat this disease and gain your health back!
Fill this form below if you are looking help in structuring a diet plan for fatty liver.
Let's Just Talk. No Obligations.
I do free consultations every Tuesday's and Thursday's. Either way you will get some actionable tips to reach your fitness goals faster.