Fatty liver: what you need to know

We have an emerging liver problem. Better you hear from me first.

Fatty liver, or non-alcohol fatty liver disease (NAFLD), is the main reason I encounter mildly abnormal liver blood tests these days. Obesity is the most common risk factor.

Worldwide, 25% of people have fatty liver; in the overweight population, it's three in four. Another scary thing: It doesn’t spare children. In the general pediatric population, 3% to 10% of children have fatty liver; the incidence increases to 80% in overweight children.

What’s fatty liver?

Our liver filters blood – detoxifies bad stuff and synthesizes good stuff – and does everything under the sun to keep us out of trouble. Plus, it stores fat.

The excessive calories we consume are converted to fat and stored in many places, including our liver. But fat goblets, to liver, are tenants from hell. The liver swells and scars, predisposing it to cancer.

NAFLD-related liver cancer increased ten-fold from 2000 to 2010. Fatty liver is expected to surpass alcohol as the leading cause of liver transplants.  

Treatments

We don’t have drugs that can burn fat in liver cells. But you can – by eating right and exercising.

Reader to me: "You say that often."

Me to reader: "It’s what works."

Think of food as a medicine. Given the prevalence of calorie-dense, fiber-poor processed food, today's food choice is more important than ever.

Stop drinking sugary drinks like soda and juice. Just stop. Like the benefits of apples? Eat the fruit.

Exercise and weight loss improve fatty liver independently (and immediately – blood tests improve in weeks).

Experts suggest 5% to 10% weight loss. I suggest that you not think in absolute terms: “I have to lose 20 pounds to be healthy.” Think, instead, in relative terms: “I’m definitely healthier at 180 lbs than 185 lbs.”

And get your vaccines (Hepatitis A and B, in this case).

Moderate your alcohol consumption. Caffeine is not a problem for fatty liver, but alcohol is. A compromised liver is vulnerable to even low-dose alcohol.  

One of my favorite foods is foie gras, which literally means “fat liver” in French. I loved, loved it until I found out how it was made. For two weeks before slaughter, a duck or goose is forced-fed corn through a feeding tube so the liver swells and develops that silky consistency.

With age, I’ve lost my appetite for any food with a sad narrative. And yes, I buy free-range eggs.

Let me share a wonderful and healthy recipe from my sister-in-law. The most wonderful part: I never suspected I was eating the green-which-shall-not-be-named until she said something.

Brussels sprouts salad with apple and walnuts

Combine 1-1/2 lb Brussels sprouts, shredded (until you can’t tell what it is!); one large red apple, cubed; 3 tbsp minced shallots; 4 tbsp olive oil; 4 tbsp vegetable oil; 6 tbsp apple cider vinegar; 3 tbsp honey; a pinch of salt/pepper.

Refrigerate covered for half to a few hours. Toss 3/4 cup toasted walnuts (crushed) and 3/4 cup Parmesan (crumbled) before serving.

My daughter throws in dried cranberries, pomegranate seeds, feta or blue cheese. I say whatever it takes to hide that “green.”