How can NAFLD be reversed?
Published 18 Jan 2022 • By Candice Salomé
NAFLD, or non-alcoholic fatty liver disease, is a liver disease, often linked to obesity, diabetes or hypertension. This serious condition may progress to cirrhosis. But the good news is that it can be reversed!
So what is NAFLD? What are its manifestations? How can it be reversed?
We explain it all in our article!
Non-alcoholic fatty liver disease (NAFLD) is characterised by an accumulation of fat in the liver cells, and affects up to 5% of the adult population in the UK. In 20% of cases, NAFLD can lead to liver inflammation, which can result in cirrhosis or liver cancer.
What is NAFLD and what are its symptoms?
Fatty liver disease is becoming increasingly common as it is directly linked to excess weight. Thus, it is estimated that in the UK nearly 1 in 3 people are affected with early stages of NAFLD, without even knowing it. 20% of them will develop inflammation of the liver, called NASH. NASH stands for "Non-Alcoholic Steatohepatitis".
This condition can be defined as a hepatic manifestation of metabolic dysfunction and can progress to fibrosis: the liver becomes scarred and does not work correctly. Patients with an advanced stage of fibrosis (2 to 5% of NASH patients), develop cirrhosis, especially if other factors are present, such as alcohol consumption, even moderate. And cirrhosis in its turn can later progress to liver cancer.
NAFLD is very often linked to the triple epidemic of obesity, pre-diabetes and diabetes.
The symptoms of NAFLD are mostly silent and non-specific to the disease, which makes the diagnosis difficult. Thus, patients affected by NAFLD may not know about their condition until the disease reaches the advanced stages.
NAFLD is linked to unhealthy diet of fatty and sugary foods and sedentary lifestyle, which both lead to an overloaded liver. As the reserves become too significant, the liver transforms the excess sugar into fat, and starts to accumulate it. The liver can end up weighing up to 5% of the body's weight, whereas it normally weighs only 2%.
The deterioration of the liver is gradual and silent and patients do not experience any specific symptoms. Only a special blood test can lead to the discovery of the disease: a blood test for gamma GT, transaminases and alkaline phosphatases, which reflect the health of the liver cells.
As of today, there are no drugs that can cure NAFLD. Only a healthy lifestyle can prevent and reverse the early stages of NAFLD.
How can NAFLD be reversed?
All stages of the disease, from fatty liver to cirrhosis, take time to develop and it is possible to interrupt the process naturally.
Although some risk factors cannot be changed, such as age or gender, other factors, which determine our lifestyle, can be corrected.
It is possible to improve the situation and reverse NAFLD by following these tips:
The first goal for people with NAFLD is to lose weight because the benefits are indeed significant.
Losing 3 to 5% of one's initial weight reduces the presence of fat in the liver. However, to reverse visible damage to the liver, weight loss must be more substantial.
In a study conducted in Cuba, 293 patients with NAFLD were given nutritional advice and tried to lose weight for 52 weeks.
NAFLD symptoms were reduced in all participants who were able to lose weight. The best results, however, were observed when patients managed to reduce their starting weight by 10%. In 90% of the participants, the tests revealed that NFLD had been reversed.
Abnormalities present in the hepatocytes had disappeared and the inflammation of the liver had subsided. In 45% of the participants, even fibrosis had regressed.
Physical activity is the second most important lever for reversing NAFLD. Cardio exercises combined with resistance training, at a rate of 3 sessions of 40 to 45 minutes per week, are effective in stopping the accumulation of fat in the liver.
Moreover, exercise helps fight against NAFLD even if there is no weight loss. In fact, physical activity has a direct impact on the liver since it burns an increased quantity of fatty acids, reduces their production and prevents damage to the liver cells.
Review your diet
Fat accounts for only 10% of free fatty acids in the liver. Nevertheless, the nature of the fat consumed could play a decisive role in the development of NAFLD .
It has been shown that people with NAFLD tend to have an unbalanced fat intake, characterized by:
- excess of saturated fats found in animal products and omega-6 found in sunflower and corn oil and industrial foods,
- deficiency in omega-3 found in oily fish or rapeseed oil.
Saturated fatty acids are more toxic for the liver because they are more difficult to transform into triglycerides (a less dangerous storage form). It is therefore recommended to rebalance your intake but also to supplement with omega-3.
Consumption of sugary drinks seems to be a determining factor in the development of NAFLD.
A large amount of fructose contained in sweetened soft drinks promotes the production of fat in the liver. It increases the concentration of uric acid in the blood, which is a risk factor for the disease.
In a study of 271 obese children and teenagers with fatty liver in the United States, those who developed NAFLD had been consuming larger amounts of soft drinks than the other participants.
But fizzy drinks are not the only source of fructose. In fact, many industrial foods are also rich in fructose because they are sweetened with corn syrup or glucose, for example.
Although there is no treatment for NAFLD, the disease may be reversed. Losing more than 10% of one's original weight, exercising regularly and having a balanced diet can reverse the phenomenon.
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Stéatose hépatique non alcoolique (NAFLD/NASH), SNFGE
Qu'est-ce que la NASH ?, The NASH Education Program