Fatty liver is exactly what it sounds like.
Fat is supposed to be carried in fat cells (adipocytes) not liver cells, says Dr. Jason Fung, a nephrologist at Scarborough Health Network in Toronto.
“When the liver has too much fat, it may cause inflammation and over many years, usually decades, it may destroy the liver and cause cirrhosis.”
A fatty liver can look different for different patients, but Fung says it is closely related to people who are obese or have Type 2 diabetes. It can also have a variety of symptoms including fatigue, loss of appetite or elevated insulin, Healthline reported.
“People with too much fat overall may also have too much fat in the liver.”
What does it mean to have a fatty liver?
But Dr. Joseph K. Lim, professor of medicine at Yale Liver Center and Section of Digestive Diseases in New Haven, Conn., told Global News the term fatty liver is also seen as an umbrella term in the medical community. He adds fatty liver is rapidly emerging as one of the most common causes of liver cirrhosis requiring liver transplantation.
“Fatty liver is used to describe a spectrum of liver disease in which there is an excess of fat within hepatocytes or liver cells,” he said.
He added an estimated one in five Canadians (approximately 7 million) have fatty liver.
“Although this condition can be benign without medical complications, a subset of patients will have an associated pattern of chronic inflammation which is injury or irritation to liver cells.”
This can lead to progressive liver fibrosis (hardening and scarring of the liver) and eventually liver cirrhosis and its complications. “This can include liver failure and liver cancer.”
What causes fatty liver?
Fung says like obesity and Type 2 diabetes, fatty liver is predominantly a dietary disease caused by high levels of insulin and high intakes of sugar and refined carbohydrates.
“When we eat sugar and refined carbs, the hormone insulin is produced, which tells the body to store food energy (or calories),” he explained.
“If we are eating mostly sugar and refined carbohydrates, then the liver will turn those carbohydrates into fat. If we eat too much sugar and refined carbohydrates, then too much fat is produced by the liver which builds up and becomes fatty liver.”
Lim says increased alcohol consumption can also be a cause.
“It is worth noting that there are genetic mutations which may predispose some individuals to fatty liver, as well as several commonly used medications which are well known to cause fatty liver as a side effect.”
Prevention and treatment
If you want to avoid a fatty liver, change your diet.
“Since fatty liver is caused by excessive sugar and refined carbohydrate intake, the key to prevention is to lower the intake of sugar and refined carbohydrates,” Fund said.
Lim says this also means cutting back on alcohol, as well as controlling metabolic diseases like diabetes, hypertension and hyperlipidemia.
Fortunately, the disease is completely reversible in the early stages, Fung says.
“Intermittent fasting is an option,” he continued. “During fasting, the body is forced to use its stores of energy (body fat). The first place it will take the fat from is the liver, so fatty liver may reverse long before significant weight loss occurs. ”
He says because this is a dietary disease, a patient must work to fix their diet.
“As little as 10 per cent weight loss can actually reverse not only fatty liver, but also the associated inflammation and liver fibrosis as well,” Lim added.
Awareness of liver disease as a whole
Fung says we still have a long way to go when it comes to awareness around liver disease.
The disease was practically unknown before 1980, he says, so the public isn’t as aware as other diseases like cancer.
“Fatty liver was originally thought to be exclusively due to alcohol until the first few cases of non-alcoholic fatty liver were described,” he said. “One of the first patients reported in the medical literature was drinking approximately 20 Cokes a day.”
Lim adds the vast majority of Canadians are not aware of fatty liver disease and its consequences.
“The Canadian Liver Foundation has reported that 89 per cent of Canadians have little or no knowledge regarding fatty liver and that most are not aware that fatty liver disease can cause liver cirrhosis, require liver transplantation, and death.”
He adds more work is needed to raise awareness.
“Both among the general public and general practitioners to improve screening and identification of patients with fatty liver so appropriate evaluation and management can be pursued.”