John Myers
Widespread and rarely noticed: almost a quarter of all adults in this country suffer from fatty liver – and the number is constantly increasing. A healthy diet, fasting, and exercise can help.
Above all, diabetics and the very overweight have a fatty liver: Around 85 percent of them are affected by this chronic liver disease – and every third overweight child in Germany suffers from this disease. There are three stages of fatty liver:
- Stage 1: pure fatty liver with no inflammatory response
- Stage 2: Fatty liver with an inflammatory reaction (steatohepatitis, developing on average every second affected person)
- Stage 3: Cirrhosis of the liver (fatty cirrhosis, affects about ten percent of cases)
Unnoticed fatty liver harbors great risks
Anyone with a fatty liver increases the risk of liver inflammation and liver cancer. High blood pressure and heart and vascular diseases are also often associated with fatty liver. A fatty liver also accelerates the development of type 2 diabetes.
Symptoms of the fatty liver do not appear until very late
The disease can go completely unnoticed for years. The liver stores fat and swells – in severe cases it can double in size. But the organ suffers in secret. The stress on the liver shows up at most in the form of tiredness and problems concentrating. Even the so-called liver values (GOT, GPT) do not give any indication in a blood test in the first stage. Only when the fatty liver becomes inflamed do the liver values increase and symptoms of jaundice sometimes appear. Since a fatty liver can no longer properly carry out its metabolic control tasks, the blood sugar and blood lipid levels gradually become derailed.
In the case of fatty liver, there is a risk of inflammation, scarring, and cirrhosis
If the increased fat leads to inflammation of the liver over time, serious consequences are imminent: the liver tissue can harden, scar, and even eventually develop into cirrhosis – a proliferation that ultimately leads to scarring and loss of functional tissue. Then a liver transplant may be the only option.
But in the first stage everything can still be turned back: In order to decrease and heal a fatty liver, it is usually sufficient to lose five to seven percent of the body weight.
Diagnosis: How is fatty liver diagnosed?
The doctor can often feel an enlarged liver (hepatomegaly). The diagnosis of fatty liver can be confirmed by:
- Ultrasound (sonography) of the upper abdomen and
- Blood sampling with the determination of liver enzymes: increase in gamma GT (GGT) in pure fatty liver (stage 1), increase in GPT and GOT in the fatty liver that is already inflamed.
Fatty Liver Index (FLI): Indicator based on blood values and weight
The so-called fatty liver index (FLI) is calculated from the blood values for GGT and triglycerides with the data of BMI (height-to-weight ratio) and abdominal circumference (measured at waist height). There are numerous sites on the Internet with free FLI calculators where you can enter your own values. If the personal FLI is over 60, there is a high probability of fatty liver. If the liver is then enlarged in the ultrasound, the diagnosis of fatty liver is practically certain.
Only in rare cases is a puncture of the liver (liver biopsy) necessary – this is the removal of a small tissue sample under local anesthesia for microscopic examination. The doctor can use a fibroscan, a type of ultrasound, to examine whether the liver tissue has already been scarred by inflammation and whether there is a tendency to fibrosis – the pathological proliferation of connective tissue. He uses it to measure the elasticity of the liver.
Causes: poor diet and lack of exercise
The fatty liver is a disease of civilization, its causes are largely in the way of life: wrong diet – especially too many carbohydrates – and lack of exercise. Obesity, but also alcohol abuse, and certain medications promote the disease.
However, even slim people are not immune to fatty liver. Protein deficiency – for example due to malnutrition – can also make the liver fatty in the long run. The risk also increases during pregnancy, after a partial liver removal, or after surgery that shuts off parts of the small intestine.
Changing your diet is the only treatment approach
There are no medications for fatty liver. But changing your diet can make a big difference. As a rule, the storage of fat (mainly triglycerides) in the liver cells is reversible – i.e. it can be reversed. A balanced, healthy diet and abstinence from alcohol are often enough for the fat deposits to disappear completely. A diet with fewer carbohydrates – also known as “low carb” – is particularly successful.
Meal breaks and oat days for fatty liver
Important: The liver needs breaks between meals. The old rule of eating lots of small meals can overwhelm the liver cells. In order to relieve the liver and prevent type 2 diabetes, one oat day per week can also be useful.
Fasting for the Liver
If you have an advanced fatty liver or are very overweight (adiposity), you should also eat fewer calories. Intermittent fasting can help reduce weight and normalize metabolism.
The liver function is strengthened by the prebiotic nutrient inulin. It is one of the dietary fibers and is found in many root vegetables, among other things. As a powder, a heaped teaspoon a day can have a positive effect on
- intestinal flora
- liver function
- blood lipids
In some cases, the doctor will prescribe a short-term “liver fast” with special protein drinks before the actual diet change begins.
Exercise works against fatty liver
Not to forget is enough exercise – moderate is enough, and high-performance sports are not necessary. Exercise burns calories, which then no longer have to be converted into (liver) fat. It should be at least 10,000 steps a day.
