Nonalcoholic fatty liver disease (NAFLD) is a term for accumulation of fat in the liver with no other cause, such as alcohol consumption or genetic disorder. It’s the most common liver disease in the United States, affecting 1 in 3 adults and 1 in 10 children. NAFLD can progress to nonalcoholic steatohepatitis (NASH), a serious disease that increases risk of liver cirrhosis and cancer. But the good news is that NAFLD can largely be addressed through diet and lifestyle changes, as long as you start early on.
Obesity, diabetes, and metabolic syndrome, a condition that includes increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels, all greatly increase the risk of developing NAFLD. In fact, 96 percent of significantly obese people have NAFLD. Some research suggests that as many as 70 percent of people with type 2 diabetes have fat accumulation in their livers. Older people with diabetes are at even greater risk, and NAFLD affects men at twice the rate as women.
Environmental and lifestyle factors can also contribute to NAFLD. Persistent organic pollutants (POPs) increase diabetes risk, and polychlorinated biphenyl (PCB), lead, and mercury exposure all have negative effects on the liver. Animal studies suggest a link between bisphenol A (BPA), found primarily in plastics, with fatty liver. Also, the herbicide glyphosate, commonly found in genetically modified foods, may also contribute to NAFLD. Alcohol and fructose, primarily as high fructose corn syrup, consumption both contribute to NAFLD as well.
NAFLD doesn’t usually cause any symptoms, except sometimes for pain in the upper right quadrant of the body. For that reason, people with metabolic syndrome, type 2 diabetes, dyslipidemia, or obesity need to be screened for fatty liver. Identifying NAFLD allows you to make changes that can keep the disease from progressing to NASH, cirrhosis, or cancer.
Diet, exercise, and weight loss are the main ways to address NAFLD. Significant weight loss—a minimum of 10 percent of one’s body weight, is essential for people with NASH. Don’t try to lose weight too quickly, though—aim for 1 to 2 pounds per week, because rapid weight loss can cause liver damage. Regular exercise at a moderate intensity level will support weight loss and also reduces NAFLD. The best diet for liver health is the Mediterranean diet, which focuses on fiber, vegetables, fruits, whole grains, olive oil, nuts, fish, and modest amounts of pasture-fed meat. Avoid Paleo-type diets and diets high in saturated fat. Limit high fructose corn syrup and alcohol consumption (if you have NASH, eliminate alcohol altogether).
Maintenance: choose organic foods to minimize your exposure to pesticides, glyphosate, and other environmental toxins. In addition to diet, certain supplements may also help promote liver health. These include vitamin E, dimethylglycine, omega-3 fatty acids, magnesium, vitamin D and vitamin C.
While NAFLD can lead to serious health concerns, the good news is that it can be addressed through diet, exercise, and lifestyle changes.