How much do you know about fatty liver? Check out these misconceptions and truths:

Myth: Fatty liver is a rare disease only found in alcoholics.

Truth: Fatty liver has been found in all age groups, even children as young as 2 years of age. It can develop in anyone with any of the following risk factors: a sedentary lifestyle, a diet high in processed foods, alcoholism, chronic hepatitis infection, insulin resistance/diabetes, polycystic ovarian syndrome (PCOS), metabolic syndrome, underactive thyroid or use of certain prescription medications.  

According to the Canadian Liver Foundation, about 20% of Canadians are living with NAFLD—Non-alcoholic Fatty Liver Disease.  The symptoms of NAFLD (such as fatigue) are so general that the disease is often overlooked.  The statistics are likely now higher since 2019 due to difficulties of accessing medical care in Canada over the past few years.

Myth: Fatty liver is only found in obese individuals.

Truth: You don’t have to look “fat” to have a fatty liver. I have had clients in my practice with ‘healthy’ BMI (body mass index) who were recently diagnosed with NAFLD. How could this be? One of them—an Asian woman—was also pre-diabetic. She didn’t drink alcohol, so initially, I was surprised. But then I looked at her diet journal and asked her to elaborate on her cooking methods. She ate white rice and fried foods daily—foods that are associated with developing NAFLD.  It’s also important to note that the threshold for healthy BMI is lower for those of Asian descent: a BMI of less than 22, compared to a BMI less than 25 in non-Asians.

Myth: A low-fat diet cures a fatty liver.

Truth: Replacing dietary fat for the wrong carbohydrates can be disastrous for health. In fact, it can lead to overeating due to the fact that carbs have a lower satiety than fat. This can lead to weight gain and increase risk of NAFLD.

Low-fat processed foods usually contain sugar to improve flavour. For example, low-fat or no-fat yogurts are usually loaded with sugar. Sauces like barbecue sauce may be fat-free, but sugar is often the first ingredient.  If you eat prepared foods, restaurant food and other ready-to-go meals, you may be ingesting a lot more sugars than you thought. What does the body due with unused carbohydrate calories? It stores it in the liver and muscles as glycogen, then converts it into fat if the energy isn’t needed.  

Myth: There are medications to treat fatty liver.

Truth: To date, there are no FDA-approved medications that treat fatty liver. Sometimes, if an individual is being treated with a medication for another pathology –such as diabetes type 2—NAFLD  may go into remission.  Meanwhile, consider that some medications are actually associated with a higher risk of developing NAFLD.

Myth: A fatty liver goes away on its own, so no lifestyle changes are needed.

Truth: Without lifestyle changes, NAFLD becomes NASH—non-alcoholic steato-hepatitis. This is an aggressive form of liver disease that can progress to cirrhosis (scarring) and liver failure. Even in a person who doesn’t consume alcohol, the liver of someone with chronic fatty liver can become as damaged as that of an alcoholic. That’s why weight management and lifestyle modifications are needed to experience improvements in liver health.

Don’t wait. A nutritionist can help you support your liver by teaching you how to eat a more liver-friendly diet and live a liver-friendly lifestyle that works for you.

June 8th is International NASH Day. Find out more about NASH here.

By Andrea

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