In today’s fast-paced world, it’s not unusual for us to make snap decisions based on what we do and even what we eat. Whilst it’s easy to opt for takeaways and fast food, it’s important to remember that not only may these types of foods be harmful to our waistlines, but concerns regarding the potential risks to our liver, and other organs, are also often overlooked.
An alarming development in recent years is the increasing prevalence of fatty liver disease. In the UK alone, non-alcohol-related fatty liver disease (NAFLD) affects 1 in 5 people, as reported by the British Liver Trust. If left untreated, this condition can progress to more severe complications such as cirrhosis, liver failure or even a higher risk of liver cancer. However, the good news is that fatty liver disease in both preventable and reversible in most cases. In fact, 90% of liver disease is preventable.
What is fatty liver disease?
Fatty liver disease is a condition characterised by the excessive accumulation of fat in the liver. This condition can be classified into two types: non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (ARLD).
The liver plays a crucial role in our overall health. It serves as a vital organ responsible for over 500 essential functions, including detoxification, bile production for fat digestion, regulation of blood sugar levels, and support of the immune system etc.
In most cases, fatty liver disease does not cause any serious problems but for 7-30% of people with fatty liver disease it gets worse over time. It can progress into cirrhosis (when the liver becomes extensively scarred replacing the healthy tissue). Cirrhosis of the liver is a result of severe damage to the liver tissue. Scar tissues replace healthy tissue, resulting in a slowing down of the liver function. Eventually, it can block liver function entirely, which in turn can lead to liver failure and cancer of the liver.
What causes fatty liver disease?
Causes of fatty liver disease can vary depending on the type, with non-alcoholic fatty liver disease (NAFLD) and alcohol-related fatty liver disease (ARLD) being the most common forms.
- Non-alcoholic fatty liver disease
Although the exact cause of NAFLD is not fully understood, it is believed to develop when the body cannot metabolise fat efficiently or when there is an excess of fat production in the body.
Several factors contribute to the development of NAFLD, including:
- Obesity or being overweight.
- Having a condition that affects insulin production in the body such as type 2 diabetes or polycystic ovary syndrome (PCOS).
- High blood pressure.
- Underactive thyroid (hypothyroidism).
- Age over 50 years old.
It is estimated that around one-third of the population has early stages of NAFLD, often without being aware. Initially, the condition, known as simple fatty liver, is relatively harmless. However, if left untreated for many years, it can progress to cirrhosis, a more severe and potentially life-threatening form of liver disease.
- Alcohol-related fatty liver disease
Excessive alcohol consumption can lead to ARLD, whether it involves consuming a large amount of alcohol over a short period or prolonged excessive drinking.
The liver is capable of processing the alcohol we consume, but excessive alcohol intake can damage liver cells and result in the accumulation of fatty deposits.
Factors contributing to ARLD include:
- Being overweight or obese.
- Having a family history of ARLD.
- Having viral hepatitis, particularly Hepatitis C.
What are some symptoms of fatty liver disease?
The symptoms of fatty liver can be difficult to spot, especially in the earlier stages of the disease. Symptoms usually only visibly manifest once the liver has been significantly damaged.
Early-stage symptoms include:
- Stomach pain (usually in the upper right-hand side)
- Unexplained weight loss and/or loss of appetite
- Extreme fatigue
- Feeling extremely weak
Late-stage symptoms include:
- Yellowing of the skin and eyes (referred to as jaundice)
- Abdominal bloating
- Swollen legs and ankles
- Veins appearing on stomach
- Hair loss
- Red palms
- Confusion, memory, and sleep problems.
How do I tell if I have a fatty liver?
Often, a fatty liver disease diagnosis involves a combination of methods including a medical history assessment, physical examination and/or imaging techniques such as ultrasound and MRI, blood tests and in some cases biopsies. Diagnosing liver disease can prove challenging if relying solely on any single method, but blood tests are a good foundational step in providing valuable insights into liver health.
Liver function blood tests can be a helpful first step in assessing the function of the liver by measuring certain biomarkers in the blood. Albumin is a protein that is produced by the liver. Low levels of albumin can indicate decreased liver function. If a result comes back as reactive, this can be a sign to follow up further with more examinations.
What can I do to prevent fatty liver disease?
Diet can play a huge role in preventing and sometimes even reversing fatty liver disease.
Being overweight or obese is a common cause of NAFLD and ARLD but those who are not overweight or obese can still suffer from liver disease.
Tips for preventing liver disease:
- Avoid fast food – fast foods tend to be high in saturated fats, added sugars and other ingredients that can affect metabolic health. Since NAFLD and ARLD are closely tied to metabolic health, eating more healthfully can help to prevent or possibly reverse it.
- Use alcohol responsibly – it is estimated that ARLD develops in 90% of people who drink more than 4 units of alcohol a day. Even those diagnosed with NAFLD should avoid drinking alcohol excessively.
- Exercise regularly and eat a balanced diet – try to have a mix of fruit, vegetables, proteins and carbohydrates while reducing sugar and fat intake.
- Be careful with medication – supplements are often considered safe and effective however for those living with liver disease, dietary supplements may cause more damage. It is always recommended to seek medical advice from your doctor before you start taking medicines or dietary supplements.
- Prevent hepatitis A, B and C – it is important to get vaccinated and practice safe sex.
- Stop smoking.
Since 1970, deaths due to liver disease have increased by 400% (https://britishlivertrust.org.uk/about-us/media-centre/statistics/). With liver disease being preventable, we all need to ensure that we are taking the necessary steps to look after our liver health.