There are a number of diseases and conditions which increase the chances of developing non alcoholic fatty liver disease, as well as some at-risk groups for non alcoholic steatohepatitis. Those who are obese or overweight, have type 2 diabetes or metabolic syndrome, suffer from polycystic ovary syndrome or sleep apnea, have an underactive thyroid or an underactive pituitary gland, are over the age of 50, have high blood pressure or high cholesterol, or smoke are all at an increased risk of NAFLD. In addition, elderly people, individuals with diabetes, and those with body fat concentrated in the abdomen are more likely to develop non alcoholic steatohepatitis.
Obesity is perhaps the most obvious risk factor for non alcoholic fatty liver disease, and it becomes even more of a risk when the excess fat is carried in the abdomen. In fact, 70 to 90 percent of obese adults have NAFLD, compared to 10 percent of those with a normal body weight, and approximately 50 percent of obese children also have simple fatty liver. Since type 2 diabetes is very closely related to obesity, there is a similar link between diabetes and non alcoholic fatty liver disease. More specifically, research suggests that 40 to 80 percent of people with type 2 diabetes also suffer from NAFLD.
Having abnormal levels of fats in the blood is another common risk factor for NAFLD. This includes both high levels of triglycerides as well as abnormal levels of cholesterol, the latter of which could be high total cholesterol, high LDL cholesterol (the ‘bad’ cholesterol), or low HDL cholesterol (the ‘good’ cholesterol). Triglycerides are a type of fat that is found in the blood, while cholesterol is a type of fat that is produced by the liver, found in the blood, or even found in some foods. LDL cholesterol, or low-density lipoprotein cholesterol, is responsible for carrying cholesterol through the body for cell repair, whereas HDL cholesterol, or high-density lipoprotein cholesterol, helps remove extra cholesterol from the body. When any of these levels become so-called ‘abnormal’, NAFLD is more likely to develop.
Metabolic syndrome is an umbrella term for a group of conditions that increase the chance of developing heart disease, stroke, and diabetes. It is sometimes called insulin resistance syndrome and experts believe that it may be closely linked to NAFLD. Medically speaking, doctors define the term as the presence of three or more of the following: a large waist size, high levels of triglycerides in the blood, low levels of HDL cholesterol in the blood, high blood pressure, and higher than normal blood glucose levels. In sum, people are more likely to develop NAFLD if they have metabolic syndrome, or if they have one or more of the traits that are associated with the condition.
Given these risk factors for non alcoholic fatty liver disease, the most effective treatment for sufferers involves lifestyle changes like weight loss, aerobic exercise, and eating a well balanced diet. This is because losing roughly 5 percent of your body weight can already decrease some of the fat in the liver and improve abnormal liver tests. Furthermore, losing 7 to 10 percent can decrease the amount of inflammation in the liver and help repair some of the damaged liver cells. In terms of nutrition, it is best to focus on whole foods such as fruits, vegetables, legumes, and nuts. Given that cardiovascular disease is the greatest risk for people with fatty liver, lifestyle changes such as these will not only improve the liver, but will also help with heart health.
Resources:
- https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/
- https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/all-content
- https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567