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What is Non-Alcoholic Fatty Liver Disease (NAFLD)?

Non-alcoholic fatty liver disease (NAFLD) is a liver disease affecting people who drink little to no alcohol. As the name implies, the main characteristics of NAFLD is too much fat stored in liver cells. NAFLD is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting about one-quarter of the population. NAFLD is the most common liver disease in Canada affecting about 20% of Canadians. It tends to develop in people who are overweight or obese, particularly if they have lot of fat around the middle of their body (waist). It can also develop in a person whose body weight is in the healthy weight range, but who typically eats a lot of sugary and fatty foods and who has extra fat around the waist. The most common cause of fatty liver disease in Canada is obesity. In 2018, almost 30% of Canadians 18 and older (roughly 7.3 million adults) reported height and weight that classified them as either overweight or obese. NAFLD has shown to be strongly associated with metabolic syndrome- a health disorder characterized by a group of risk factors (large waist circumference, high blood pressure, high blood sugar levels, high cholesterol, and abnormal amounts of lipids in the blood) that greatly increase the risk of many chronic illnesses. Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use. The main complication of NAFLD and NASH is cirrhosis, which is late-stage scarring in the liver. Cirrhosis occurs in response to liver injury, such as the inflammation in NASH. As the liver tries to halt inflammation, it produces areas of scarring (fibrosis). With continued inflammation, fibrosis spreads to take up more and more liver tissue. A wide range of diseases and conditions can increase your risk of NAFLD, including:

High cholesterol

High levels of triglycerides in the blood

Metabolic syndrome

Obesity, particularly when fat is concentrated in the abdomen

Polycystic ovary syndrome

Sleep apnea

Type 2 diabetes

Underactive thyroid (hypothyroidism)

Underactive pituitary gland (hypopituitarism)

These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and NASH, which may lead to a buildup of scar tissue in the liver.

To reduce your risk of NAFLD:

Choose a healthy diet. Choose a healthy plant-based diet that’s rich in fruits, vegetables, whole grains and healthy fats.

Maintain a healthy weight. If you are overweight or obese, reduce the number of calories you eat each day and get more exercise. If you have a healthy weight, work to maintain it by choosing a healthy diet and exercising.

Exercise. Exercise most days of the week. Get an OK from your doctor first if you haven’t been exercising regularly.

For individuals with NASH who are not overweight and not diabetic, a diet with lower fat foods without a lot of added sugars is often recommended.

Those with diabetes and high lipids in their blood have to improve their sugar         control and lower lipids levels. Usually, a lower fat, lower calorie diet with avoidance of sugary foods is recommended along with insulin or medications to lower blood sugar in people with diabetes. If you have diabetes, please see your healthcare provider who can advise you how to manage your diabetes.

People with fatty liver disease should see their primary healthcare providers on a regular basis and seek out the advice of a dietitian regarding their diet.

By adopting a healthy lifestyle, you may prevent obesity – the number one reason for fatty liver disease. Please remember that a healthy diet and exercise are important components of any weight-loss regimen. Introduce exercise into your routine, at least four times a week. You can enjoy walking, swimming, gardening, stretching.


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