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Fatty Liver Disease

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It’s thought one in three of us suffers from fatty liver disease – and most of us don’t even know it. Could you be at risk? Specialist liver disease researcher and clinical nurse Nicole Tresize explains

Unfortunately, liver health doesn’t spend much time in the spotlight. But it should. According to the Australian Bureau of Statistics, liver disease is one of the leading causes of death in Australia, and incredibly, experts now estimate that approximately one in three people in the Western world suffers from a form of liver disease called fatty liver disease (FLD) – a precursor to diabetes, heart disease and other types of liver disease. So how do you know if your liver is healthy – and what can you do to look after it?

Your liver

After your skin, the liver is the second largest organ in your body. It plays a vital role in metabolising all the food you eat, producing hormones, storing essential vitamins and minerals and creating the chemicals, such as bile, which aid in digestion. It’s also what the Gastroenterology Society of Australia (GESA) refers to as the body’s ‘detoxifier’; processing any substances or ‘toxins’ you consume, such as medicines and alcohol.
But sometimes your liver begins to accumulate a build-up of fats, which then replace healthy tissue and trigger enlargement of the rest of the liver cells.

This condition, known as fatty liver disease, often shows no signs of symptoms – but it’s a known risk factor associated with diabetes, heart disease and cirrhosis of the liver, so knowing if you’ve got it could make all the difference to your health.

What Causes FLD?

The specifics of what causes FLD are not known, but according to GESA, the most common causes are obesity, type 2 diabetes and heavy alcohol use. However, you don’t need to drink alcohol to have an unhealthy liver. In fact, non-alcoholic fatty liver disease (NAFLDLD) is by far the most common version of FLDLD in Australia, and it needs to be properly managed, says Dr Marno Ryan, a gastroenterologist at the University of Melbourne, who has recently returned from conducting research into the disease in the US.

“Non-alcoholic fatty liver disease can lead to non-alcoholic steatohepatitis, where the enlarged liver cells caused by NAFLD ‘irritate’ the liver, causing inflammation,” she explains. “Over time, this inflammation can lead to scarring of the liver, which causes the functions of the liver to be adversely affected. This can
result in liver disease and can even lead to liver failure.

So How do I know if i have fld?

People who are developing or already have FLD commonly experience no symptoms at all, although fatigue and pain above the right side of the torso (on top of the liver) may be experienced in some cases.

A blood test is the best way to confirm whether you have FLD, so if you lead an inactive lifestyle, suffer from obesity or diabetes, or have a high-fat diet or a high alcohol intake, make an appointment to see your doctor. To keep your liver healthy (or to improve your liver’s health), it’s also important to follow these guidelines.

Could you have Fatty Liver Disease?

Most people with fatty liver disease won’t experience any symptoms whatsoever until the disease progresses to something more serious. To find out whether you could have FLD, use the following checklist:
* Do you lead an inactive lifestyle?
*Are you obese?
*Do you have a high-fat diet?
*Do you have a high alcohol intake?
*Do you have diabetes?

If you answered ‘yes’ twice or more, see your doctor – you’re
at a higher risk than average. A routine blood test can provide
a conclusive diagnosis.

Weight loss

Approximately 20 per cent of people regarded as obese have FLDLD. However, losing weight (and for those with diabetes, improving your blood sugar control) can significantly reduce the amount of fat in the liver, and therefore decrease the risk of liver inflammation and damage, says

DR Ryan. “It should be emphasised that people with FLDLD who aim to lose weight, only need to lose between one and five per cent of their body weight to achieve a significant reduction in liver fat,” she says.
If you’re overweight, it is suggested you follow a weight management program geared toward a steady weight loss goal of 0.25kg to 0.5kg per week.

Healthy diet

Contrary to popular belief, there is no specific diet that is ‘liver cleansing’. However, a well-balanced diet can lower your risk of FLD, and can also help you manage the condition if you already have it, explains Dr Ryan.
“I was involved in some diet studies in the US that examined the types of diet best for subjects with cardiovascular risk factors and fatty liver [disease]. The results of those studies are yet to be published, but preliminary data suggests that a diet that involved a moderate reduction in carbohydrates, together with a switch from saturated to monounsaturated fat, was associated with a reduction
of liver fat,” she says. If you have questions about how to improve
your diet, seek the advice of an Accredited Practising Dietitian.

Exercise

One of the many benefits of exercise is protection against FLD. And if you already have the disease, “the best thing [you] can do is exercise,” says Dr Ryan. “Regular exercise, even a 40-minute walk three times a week, improves the uptake of sugars into muscles, helping insulin to do its job, and ultimately helping fat to move out of the liver.”

Alcohol

For general health, current Australian guidelines recommend a maximum of two standard drinks per day and several alcohol-free days each week. For those with confirmed FLD, however, it’s recommended that alcohol be avoided entirely.