Nonalcoholic fatty liver disease risk increases in non-obese patients with a large waist circumference

By: Dr. Victor Marchione | Liver | Monday, May 09, 2016 - 03:49 AM

NAFLDNonalcoholic fatty liver disease – or NAFLD – is the accumulation of fat in liver cells that is not caused by alcohol. These types of fat, called triglycerides, are naturally stored in your body and are created from food calories that your body doesn’t need straightaway.

It’s normal for your liver to contain some fat, but if more than five to 10 percent of the liver’s weight is fat, you’re in for trouble. It’s a fatty liver, setting you up for serious illness.

Knowing the signs of nonalcoholic fatty liver disease

How does it happen? If the triglycerides are never released into your system and get stuck in your liver, they can bring about NAFLD, causing the liver to swell. This can lead to scarring, inflammation, liver dysfunction and failure, as well as acute liver cancer.

Often, there aren’t symptoms to let you know you have it or direct causes to pinpoint. You might experience vomiting, stomach pain or jaundice, the slight yellowing of the skin and the whites of your eyes.

But it tends to occur in people who are obese, and those with diabetes and high cholesterol.

NAFLD usually is suspected if blood tests show high levels of liver enzymes, and an ultrasound may be used to confirm a diagnosis.

Unhealthy liver can increase your risk for NAFLD

Today, nearly a quarter of Americans are living with NAFLD, according to the American Liver Foundation. This liver disease, as I mentioned, is linked to a wide range of diseases and conditions that you don’t want to have. These include obesity, high cholesterol, metabolic syndrome, polycystic ovary syndrome, sleep apnea and type 2 diabetes, as well as an underactive thyroid (hypothyroidism) and underactive pituitary gland (hypopituitarism).

As a result, NAFLD will likely become the No. 1 cause of liver transplants in the coming years, putting a strain on the existing supply of livers for transplant. As it stands, as many as 16,000 people are on the waiting list for a liver transplant in the United States, but only about 6,000 transplants are performed each year. Prevention is key.

Pain reliever acetaminophen and liver damage

Another example of the daily stress we place on our livers is the use of pain relievers. For instance, millions of Americans use acetaminophen each year. That’s an active ingredient in Tylenol, which is often used by obese individuals to ease their short-term joint pain but, ironically, leads to long-term liver damage.

If used on a regular basis, acetaminophen gradually builds up in the liver, blocking the very pathways it uses to get rid of toxins. And just like alcohol, it affects a person with NAFLD even more.

That’s not all. Certain groups of people may also have an increased risk of NAFLD. For example, Hispanics are at least two times as likely as Caucasians to carry what’s called PNPLA3, which is a gene that causes the liver to produce excess triglycerides. Remember those?

Prevention and treatment options for NAFLD

Taken together, rising NAFLD rates certainly present a large-scale health challenge. Nevertheless, the prevention of liver disease is possible if we better understand the things that put people at risk in the first place.

And if prevention isn’t on the table, we better make sure that we’re prepared to address the liver transplant demand that’s likely to rise drastically in the coming decade.

Prevention tips of NAFLD include healthy lifestyle changes such as maintaining a healthy weight, regular exercise, eating well, not smoking, minimizing alcohol intake and reducing overall fat in the body. There is currently no medication available to prevent NAFLD but medications may be prescribed in order to control other conditions which can contribute to NAFLD such as blood pressure, diabetes, and cholesterol.

Ultimately the only form of treatment available if NAFLD worsens is a liver transplant so it is in your best interest to make the necessary lifestyle changes in order to prevent NAFLD from becoming that severe.

Don’t take your liver for granted

Your liver performs a variety of functions that protect you from the toxins that you consume in food, water and medicines. But its resilience is often taken for granted, with many people placing a great deal of pressure on their liver without thinking about the risk and prevention of metabolic shutdown. That means excessive overeating and lack of physical activity.

Alarmingly, roughly one-third of all Americans remain obese, and without prevention, the rates are expected to rise to 60 percent in 13 states by 2030, according to the Trust for America’s Health and the Robert Wood Johnson Foundation. That’s bad news for your liver.

If you’re at risk, you need to make activity a priority and take a good look at what you’re eating. Portion control and including whole, fresh foods in your diet can make a huge impact. Eating certain foods – onions, eggs, avocadoes, artichokes, ginger, beans and fish oil – can help cleanse your liver and give it a healing boost. With the right intervention, a clogged, unhealthy liver can heal and regenerate.

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