Nutrition. Education. Transformation.

Non-Alcoholic Fatty Liver Disease (NAFLD)

February 21, 2012

Nearly 70 percent of the American population is overweight. Over seventy million Americans may have Non-Alchoholic Fatty Liver Disease (NAFLD), which is one of the complications of obesity.1 Evidence suggests that the environmental background for the development of non-alcoholic fatty liver disease may be established in early life, and that the duration of the disease affects probably the likelihood of progression to more severe disease, such as cirrhosis. NAFLD associates with abdominal obesity, insulin resistance and features of metabolic syndrome. In genetically prone individuals, excessive consumption of trans-fats and refined sugars leads to insulin resistance and a chronic, low-grade inflammation that often precedes liver damage and disease.

Many other nutritional, metabolic, and lifestyle factors are likely to play a role in fatty liver as well, by influencing the liver’s ability to store carbohydrates as glycogen and to burn fats and carbohydrates for fuel. Excess nutrients cannot be stored in the adipose tissue and overflow elsewhere, mainly to the liver and muscle tissue. Fat deposition in both sites further contributes to insulin resistance. 2

How does Non-Alchoholic Fatty Liver Disease happen?

Fatty liver disease occurs in two stages:

  • Simple steatosis, fat accumulates within the cells of the liver.
  • Inflammation, the proliferation of fibrous connective tissue (fibrosis), which eventually the formation of scar tissue (cirrhosis).

NAFLD refers to the full range of these disease states, while “NASH” (non-alcoholic steatohepatitis) refers only to the inflammatory stage. Several experimental diets are currently used to study nonalcoholic fatty liver disease in laboratory animals, including diets high in fat, high in fructose, or deficient in choline and methionine. While animal studies cannot completely replicate a human model, the evidence in its totality suggests that the initial accumulation of fat in the liver is triggered by nutritional imbalance.

Fatty liver seems to occur as a result of too much energy flowing through the liver without sufficient nutrients to process it. The accumulation of delicate fats, especially polyunsaturated fatty acids, increases the vulnerability of the liver to oxidative and inflammatory damage in the form of toxins, poor metabolism or infections. The first stage of simple fat accumulation can ultimately lead to the second stage of inflammation and thereby disease.3

The primary suspects are nutrient-poor refined foods, choline deficiency and polyunsaturated oils.4 

Fatty Liver Disease can begin in childhood

Obesity is characterized not only by excess fat near the surface of your body, but also excess fat in and around your internal organs. NAFLD is becoming more common as American waistlines are growing, and the segment of our population most at risk is our children. According torecent research published in the Journal of the American College of Nutrition, the longer you have NAFLD, the more likely it is to progress into more serious disease like liver fibrosis (accumulation of abnormal fibrous tissue), cirrhosis (accumulation of scar tissue), and NASH.

The following facts about pediatricNon-Alchoholic Fatty Liver Disease :

  • NAFLD is strongly associated with insulin resistance and other classic symptoms of metabolic syndrome
  • Children with high abdominal fat have the highest risk for NAFLD.  If your child develops NAFLD, his risk for developing NASH and cirrhosis is much higher. NASH is usually progressive and virtually untreatable. It is vital to intervene before permanent liver damage ensues. Preventing obesity is key, as it is the excess liver fat promotes the development of more serious disease over time.
  • Cases of pediatric NAFLD have been reported in children as young as three years old.
  • Among obese children and adolescents, NAFLD has been identified in 20 percent of American children and adolescents, 44 percent of Italian, and 74 percent of Chinese.5

What are the culprits in Non-Alchoholic Fatty Liver Disease?

Fructose. Fructose, typically derived from corn, is a cheap form of sugar used in thousands of food products and soft drinks, which can damage your metabolism. More than any other form of sugar, heavy fructose consumption can cause dangerous growths of fat cells around vital organs and can trigger the early stages of diabetes, heart and liver disease. High-fructose corn syrup (HFCS) and crystalline fructose are the primary sweeteners in soft drinks, and also are in many processed foods, including –surprisingly — salad dressing, ketchup, soup, salad dressing, crackers, and bread. Fructose in converted into fat, which gets stored in your body tissues and you liver as body fat; it is metabolized more quickly than any other sugar.

Low, nonfat and sugar-free diet foods are often those that contain the most fructose. Studies confirm that consuming large amounts of HFCS may contribute to the development of Non-Alchoholic Fatty Liver Disease.6

Low Choline: Choline is responsible for shuttling stored fat out of the liver. When choline is too low, this leads to NAFLD. Choline is highest in eggs, liver, fish eggs, fish and bone marrow.

How to eat right and (safely) detoxify your liver

As nonalcoholic fatty liver disease has emerged over the last several decades, refined foods have become the norm.  Meanwhile, our total fructose intake has increased 30 percent, and intakes of omega-6 polyunsaturated fatty acids have doubled.

Principal sources of choline (which helps vacuum fat out of the liver) such as eggs and organ meats have been demonized or largely disappeared from the table. All of these trends have contributed to the rise in Non-Alchoholic Fatty Liver Disease.

We highly recommend ancestral diets, ingesting only foods that our body recognizes, that are eaten as close to how nature made them as possible. Packaged foods, even those labeled “natural,” should be avoided. Grassfed animal proteins in 4-6 oz portions, abundant organic vegetables, bone broths and small amounts of low-glycemic fruits are optimal. Gluten and grains should be minimized or avoided unless soaked or sprouted. Refined sugars and fructose must be removed from the diet.

A common component of Non-Alchoholic Fatty Liver Disease is a combined deficiency of choline and methionine (an amino acid precursor to choline), which critically impairs the body’s ability to package up the fats in the liver and to send them out into the bloodstream. Choline is necessary to produce a phospholipid called phosphatidylcholine. This is a vital component of the VLDL particle, which the body needs to make in order to export fats from the liver.8

Choline-rich foods include (pastured and organic- for all meats and eggs) organ meats, beef, egg yolks, chicken, salmon and shrimp; nuts such as pine nuts, almonds, and macadamia nuts; organic vegetables such as cauliflower, broccoli and Brussels sprouts.

Healthy fats such as virgin coconut oil, olive oil and grass-fed butter should replace any butter substitutes, corn oil, and other polyunsaturated/trans fats in the diet.

Stay hydrated with filtered water and lemon. Warm water and lemon is a wonderful beverage to have first thing in the morning.

Gentle Detoxification through the digestive system, the liver, the kidneys and the skin

Digestion

  • Keeping a healthy digestion full of good bacteria is one of your strongest allies in proper detoxification. If you have a high amount of bad bacteria your stomach like Candida, toxins will re-circulate in your body increasing your full toxic load each day. Constipation in the strongest indicator that your body is recycling toxins in the your blood stream. This can result from low fiber, excessive feedlot-raised red meat, coffee and sugar, processed food, and allergens.

How do I keep my digestion healthy?

  • Probiotics found in yogurt, kombucha, non-pasteurized sauerkraut and other fermented foods build your good bacteria colony. Keeping your body full of fresh fruit, vegetables and whole grains also contribute to their growth, where as coffee, alcohol, sugar and fried foods can all contribute to an unhealthy digestive system, and in turn your immune system. 70-80% of your immune system is in your digestive tract, so you can see how important good digestion is.

Supporting the Liver

  • The important concept to remember about the liver is that it has a huge job. To do that job well, it doesn’t like to be given inadequate time to do the work. A good way to remember this is to make sure you eat a substantial breakfast between 7:00 and 9:00 in the morning, and that you eat your last meal before 6:00 pm. Digestion is at its strongest at noon, and at its slowest at 7:00pm and later.
  • The spring is a wonderful time to support your liver because nature assists with the food that is available. Dandelion greens, artichokes and beets are some of the best foods for your liver, along with garlic, onions, celery, seaweed, miso, kale, alfalfa, mushrooms and watercress. Spices like cinnamon, cardamom and turmeric are also incredibly beneficial. Check out our recipe for Detox Salad!

Recommended Supplementation

1. Optimal PC

If you cannot get enough choline due to dietary restrictions, supplementation is highly recommended.

2. Cordyceps CS4

In multiple studies, Cordyceps have helped normalize liver enzymes, inhibit steatohepatits derived from nonalcoholic fatty liver disease by lowering serum and tissue TNFa, reducing the over-expression of UCP2, and inhibit hepatic fibrogenesis derived from chronic liver injury as well as retard the growth of cirrhosis.

Sources

1. Angulo P. Obesity and nonalcoholic fatty liver disease. Nutr Rev. Jun 2007;65(6 Pt 2):S57-63.
2., 3 http://www.westonaprice.org/health-issues/nonalcoholic-fatty-liver-disease
4. Ibid
5.  http://www.jacn.org/content/27/6/667.long
6. http://www.greenmedinfo.com/toxic-article/high-fructose-corn-syrup-may-contribute-pathogenesis-nonalcoholic-fatty-liver-disease-.
7. Bray GA, Nielsen SJ, Popkin BM. Consumption of highfructose corn syrup in beverages may play a role in the epidemic of obesity. AJ Clin Nutr. Apr 2004;79(4):537- 543.
8. Yao ZM, Vance DE. The active synthesis of phosphatidylcholine is required for very low density lipoprotein secretion from rat hepatocytes. J Biol Chem. Feb 25 1988;263(6):2998- 3004.

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