Keep fat out of your liver

Fatty liver disease occurs when extra fat molecules accumulate inside liver cells. The presence of those fattened cells can then lead to inflammation in the liver and consequent fibrosis. This condition can progressively worsen leading to cirrhosis and eventually end up with chronic liver failure. At present, the second most common cause of end stage liver disease after alcohol is fatty liver. In the near future, with the alarming rise of obesity epidemic, fatty liver will soon become the most common cause of liver disease. Fatty liver is also an important cause of liver cancer.

Fatty liver not only leads to liver disease, but more importantly, it is a precursor for diabetes, hypertension, heart problems and so on. In simple words, ‘diabetes is only tip of the iceberg, fatty liver is the entire iceberg’. Risk of dying from cardiovascular disease is twice as high as compared to people that do not have an associated fatty liver.

Most people with fatty liver disease do not exhibit symptoms of liver disease early on. Rarely, fatigue or occasional pain in the upper right side of the abdomen, where the liver is located, can occur. So, more often than not, fatty liver disease is discovered incidentally, either by a routine blood test indicating high liver enzyme levels or a simple ultrasound scan showing fatty liver. The gold standard test to assess the degree of liver damage and ongoing inflammation is liver biopsy. However, with the advent of new technologies namely fibroscan, we can assess the quantity of fat and damage in the liver and since it is a dynamic test, treatment response also can be assessed by fibroscan if done on periodic intervals. Only in rare situations when diagnosis is in doubt, is a diagnostic liver biopsy warranted.

So, what can be done to prevent fatty liver? The foundation of treatment is strict diet and regular exercise. There is enough evidence showing that low carbohydrate diet is essential for improving fatty liver and its consequences. Secondly small frequent meal is another way to restrict calories and sudden rise in sugar levels which gets deposited as fat in the liver. Regular physical activity in form of walking or jogging and so on should also be adopted strictly. An exercise schedule of 30–60 minutes five days per week has a reported 10% decrease in liver fat.

Crash diets harm the liver, so gradual weight loss over a period of time is usually recommended. Suggested lifestyle changes include eating pulses and vegetables with a high fibre content, and drinking green tea.

Therefore, early identification and prevention of fatty liver is like a life insurance policy for a safe and secure future.

Dr Chandan Kumar KN

Senior Consultant - Hepatology & Lead Transplant Physician

Gleneagles Global Hospital Lakdikapul

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