Fatty Liver is WAY More Dangerous Than You Realize. Here’s How to Fight It:

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Fatty Liver is WAY More Dangerous Than You Realize
Fatty Liver is WAY More Dangerous Than You Realize Graphic © healthpowerboost.com. Photo © AdobeStock 66298358 (under license)

While the words “fatty liver” might not sound as serious as other diseases, it is a dangerous condition that affects 17 to 33% of adults in Western countries. The numbers are even higher if you have co-morbidities — among diabetics, the prevalence of fatty liver is a whopping 34 to 74%! [1]

So much for Western countries – but the statistics are not much different worldwide, with a huge 25.24% of adults affected by non-alcoholic fatty liver disease (NAFLD). [2] So what is a fatty liver anyway?

Understanding Fatty Liver Disease

Fatty liver disease (FLD) is often categorized into (1) non-alcoholic fatty liver disease (NAFLD) and (2) alcoholic fatty liver disease (AFLD). As the name suggests, AFLD is caused by excessive alcohol consumption while NAFLD is often caused by an unhealthy diet and unhealthy lifestyle choices. [3][4] A third category is often used as well: NASH, which stands for Nonalcoholic Steatohepatitis. You can consider NASH as a subcategory of NAFLD, where there is now damage to your liver. [4]

Risk Factors For Fatty Liver Disease

Dr. Mark Hyman discusses fatty liver in one of his popular Youtube videos (see below our article), highlighting the risk factors and dietary adjustments needed to manage the condition. He mentions 1) a high fat diet, 2) diabetes and insulin resistance, 3) hypertension, and 4) dyslipidemia as risk factors, and he is absolutely correct. These risk factors all belong to an umbrella condition called metabolic syndrome, which is a major contributor to various noncommunicable (and potentially fatal) diseases like hypertension and diabetes.

According to Bang & Cho in a 2015 study [1], over 90% of people diagnosed with NAFLD have one or more components of metabolic syndrome. This is because the pathophysiology of NAFLD involves the build-up of fat in the liver due to high triglyceride levels and insulin resistance. Insulin resistance causes fatty acids to keep circulating in the blood, eventually being deposited in the liver. [5]

This is typically seen in diabetics or people with high blood sugar, and people who are overweight or obese. That being said, the more fat and sugar in your diet from fried food, fatty meat, and sugary desserts, the greater your risk in developing a fatty liver.

An analysis by Wu, et. al. in 2016 [6] found that NAFLD was associated with an increased prevalence of adverse cardiovascular events like coronary artery and vascular disease, atherosclerosis, and hypertension. Similarly, NASH was also associated with an increased incidence of cardiovascular disease. The same mechanisms underlying how fat gets deposited in the liver can also apply to the development of these cardiovascular conditions.

How To Fight Fatty Liver Disease (Top 4 Steps)

Because of this rising prevalence, one of the proposed amendments to the WHO Global Action Plan is to include fatty liver disease under the fourth objective, which is to prevent and control non-communicable diseases such as cardiovascular disease, diabetes, cancer, and chronic respiratory disease. [7][8] One of the specific interventions in the proposed amendment is early detection and weight management strategies, primarily through exercise and dietary adjustment.

Dr. Hyman makes this easy for us:

1. Reduce Or Eliminate Starchy Food

Instead, opt for vegetables, non-starchy nuts and seeds, and fruit. If you are unwilling to avoid meat, choose chicken, fish, and grass-fed meat instead. There are also healthier oil options, such as olive oil, macadamia nut oil, avocado, coconut butter, and even fish oil you can use when cooking or dressing a salad.

Dietary changes have been shown to improve liver health in people with NASH after a year of intense diet counseling. Increasing your omega-3 fatty acids from nuts and plant oils (just like Dr. Hyman suggested) can help improve insulin sensitivity and reduce triglyceride levels, slowing or reducing the damage caused by NASH. [9]

2. Exercise.

Exercising not only keeps your heart healthy, but it can also help manage your weight by improving metabolism and fighting insulin resistance. According to the AHA or the American Heart Association, at least 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic activity each week is a good way to stay in shape. [10] This kind of physical activity is an important lifestyle modification in helping with weight loss, leading to a reduced risk for NASH. Using a treadmill or step machine and resistance training are great options for moderate to high-intensity activity. [9]

3. Glutathione

Glutathione is an antioxidant that is naturally produced by the liver, helping with tissue repair and regeneration. It also helps in clearing free radicals and reducing oxidative stress in the body. Various studies on fatty liver disease have suggested that glutathione metabolism and production is one of the mechanisms that could be used in interventional therapy for FLD. [11][12]

Dr. Hyman mentions that you could boost your glutathione levels with milk thistle. According to a study by Jung, et. al. in 2017 [13], supplementation with Korean milk thistle (also known as silymarin in other parts of the world) helped reduce hepatotoxicity and improve glutathione levels. NAC or acetylcysteine is another glutathione precursor as well as being a direct antioxidant. [14] Different studies have also shown that supplementation with Vitamin B and Magnesium could be beneficial in raising glutathione levels as well. [15][16]

Note that glutathione can be taken as a supplement, but it is not very well absorbed via digestion (hardly worth it), however glutathione IV (intravenous) is a treatment commonly seen in detox clinics. You can also obtain liposomal glutathione as a supplement – and this is readily absorbed – however note that while milk thistle is very widely regarded as safe for ongoing (tonic) supplementation, glutathione supplementation may not be advised over long periods as it may slow down the mechanism that produces it naturally in the body from the precursors.

4. BEST Foods For Liver Health

Broccoli: Dr. Hyman highlights several foods that could help reduce your risk for fatty liver disease. The broccoli family is first on his list – did you know that an extract from broccoli called glucoraphanin [17] was able to reduce obesity-induced inflammation and insulin resistance in the body? This is not only great for diabetics, but also for people who are at risk for fatty liver disease.

Greens / Cruciverous Veg: Kale, collards, cabbage, brussel sprouts, and arugula are other superfoods that made it on his list. This is because green vegetables have been shown to help reduce systemic inflammation (by improving gut health) and improve liver fatty acid profiles, reducing the risk for NASH. [18][19] Brussels sprouts, and kale are high in fiber and beneficial plant compounds. Studies suggest they alter the detoxification process and protect against harmful compounds.

Radish, Garlic & Onion: Extracts from radish have also been studied in relation to liver disease, with results showing how they improved liver profiles in both non-alcoholic and alcoholic fatty liver disease. [20][21] Garlic and onions are both known for their significant anti-oxidant effects, with studies showing how beneficial they are in ameliorating NAFLD, insulin resistance, and the metabolic syndrome. [22][23][24][25]

Coffee: Coffee may be beneficial in protecting the liver from disease. Studies indicate that coffee consumption lowers the risk of cirrhosis in people with chronic liver disease and reduces the risk of liver cancer. Coffee’s benefits are attributed to its ability to prevent fat and collagen buildup in the liver and its high levels of the antioxidant glutathione.

Tea: Particularly green tea, has been found to reduce levels of liver enzymes in people with nonalcoholic fatty liver disease (NAFLD). Green tea drinkers also show a lower risk of developing liver cancer.

Grapefruit: Grapefruit contains antioxidants like naringenin and naringin, which protect the liver by reducing inflammation and protecting cells. These antioxidants have been shown to reduce the development of hepatic fibrosis.

Blueberries and Cranberries: These berries are rich in anthocyanins, antioxidants that have been linked to many health benefits, including improved liver health. They have been shown to inhibit the growth of human liver cancer cells in test-tube studies.

Grapes: Red and purple grapes contain various beneficial plant compounds that may benefit liver health, including lowering inflammation and preventing cell damage.

Prickly Pear: Commonly used in traditional medicine for liver disease, prickly pear has anti-inflammatory and antioxidant properties that may protect the liver from alcohol toxicity.

Beetroot Juice: Beetroot juice is a source of nitrates and antioxidants called betalains, which have been shown to reduce oxidative damage and inflammation in the liver in animal studies.

Nuts: Rich in healthy fats, antioxidants, and vitamin E, nuts have been associated with a reduced risk of NAFLD.

Fatty Fish: Containing omega-3 fatty acids, fatty fish help reduce inflammation and have been associated with a lower risk of heart disease and liver fat accumulation.

Olive Oil: A healthy fat with positive effects on the heart and metabolic health, olive oil has been shown to reduce fat accumulation in the liver and improve liver enzyme levels.

Vital Functions of the Liver for Human Health and Wellbeing

The liver plays a crucial role in numerous metabolic processes and maintaining liver health is crucial for the overall functioning of the body. Located mostly in the right upper portion of the abdomen, it weighs around 3 pounds in adulthood and is roughly the size of a football. The liver’s major functions are integral to the body’s metabolic, detoxification, and immune systems.

Metabolic Functions: The liver is central to the metabolic processes, including the breakdown or conversion of substances from food such as fats and proteins. It extracts energy, vitamins, and minerals from the food we consume. This process involves receiving blood with nutrients from the digestive organs via the portal vein, which the liver cells, or hepatocytes, filter and process.

Detoxification: One of the liver’s key roles is making toxins less harmful to the body and removing them from the bloodstream. It achieves this by producing bile, which helps in breaking down fats in the small intestine. The liver also converts ammonia, a toxic by-product of protein breakdown, into urea, which is then excreted in urine.

Regeneration Capacity: The liver is unique in its ability to regenerate. After an injury or surgery that removes tissue, the liver can grow back to a certain extent. This regeneration starts with the enlargement of existing cells, followed by the multiplication of new liver cells.

Further Diseases Affecting the Liver: Various diseases can affect the liver, impacting its functions. These include autoimmune hepatitis, biliary atresia, hemochromatosis, hepatitis A, B, and C, liver cancer and cirrhosis. Each of these conditions can significantly impair the liver’s ability to perform its vital functions.

WORST Foods For Liver Health / AFLD / NAFLD

1. High Fructose and Sugary Foods:
Excessive consumption of fructose, particularly from industrial sources like high-fructose corn syrup, is linked to liver damage. Foods high in simple sugars and sweetened beverages are associated with an increased risk of developing steatosis and non-alcoholic steatohepatitis (NASH), especially in overweight and obese individuals. Fructose can lead to hepatic ATP depletion and promote de novo lipogenesis, contributing to fatty liver disease.

2. Red and Processed Meats: High consumption of red and processed meats is related to insulin resistance and NAFLD. These foods, rich in saturated fats, can impair phospholipid metabolism and increase insulin resistance, promoting mitochondrial dysfunction and oxidative stress, leading to liver damage.

3. Saturated Fats: Diets high in saturated fats, often found in fast food and processed snacks, are detrimental to liver health. They contribute to the accumulation of liver fat, exacerbating conditions like NAFLD and NASH. Saturated fatty acids disrupt metabolic processes and can lead to inflammation and fibrosis in the liver.

4. Alcohol: While moderate alcohol consumption might have certain health benefits, excessive intake is one of the leading causes of liver damage. Alcohol can cause various forms of liver disease, including alcoholic hepatitis, fatty liver, and cirrhosis.

5. Salt-Heavy Foods: Excessive salt intake, often found in processed and fast foods, can lead to liver inflammation and fibrosis. High sodium levels can exacerbate liver damage, especially in individuals with existing liver conditions.

6. Deep-Fried and High-Calorie Foods: Foods that are deep-fried or high in calories can contribute to obesity, a significant risk factor for NAFLD. These foods often contain trans fats and unhealthy oils that can lead to the accumulation of fat in the liver.

7. Certain Types of Seafood: Seafood of the types higher in mercury, such as swordfish and tuna, can be harmful to the liver. Mercury is a toxic metal that can cause liver damage and exacerbate existing liver conditions.

References: [26][27][28]


[1] Bang, K. & Cho, Y. (2015). Comorbidities and Metabolic Derangement of NAFLD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608226/

[2] Rinella, M. & Charlton, M. (2016). The globalization of nonalcoholic fatty liver disease: Prevalence and impact on world health. https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.28524

[3] Kotronen, A., et. al. (2010). Non-alcoholic and alcoholic Fatty Liver Disease – two Diseases of Affluence associated with the Metabolic Syndrome and Type 2 Diabetes: the FIN-D2D Survey. https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-10-237

[4] Johns Hopkins Medicine. Nonalcoholic Fatty Liver Disease. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease

[5] Tolman, K., et. al. (2007). Spectrum of Liver Disease in Type 2 Diabetes and Management of Patients With Diabetes and Liver Disease. https://diabetesjournals.org/care/article/30/3/734/25518/Spectrum-of-Liver-Disease-in-Type-2-Diabetes-and

[6] Wu, S., et. al. (2016). Association of non-alcoholic fatty liver disease with major adverse cardiovascular events: A systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5026028/

[7] World Health Organization. Updating Appendix 3 of WHO Global NCD Action Plan 2013-2020. https://www.who.int/ncds/governance/appendix3-institute-of-liver-and-biliary-sciences.pdf

[8] World Health Organization. Global Action Plan. https://www.who.int/publications-detail-redirect/9789241506236

[9] Paredes, A., et. al. (2012). Treatment of nonalcoholic fatty liver disease: Role of dietary modification and exercise. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499276/

[10] American Heart Association. American Heart Association Recommendations for Physical Activity in Adults and Kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

[11] Mardinoglu, A., et. al. (2017). Personal model‐assisted identification of NAD+ and glutathione metabolism as intervention target in NAFLD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371732/

[12] Rom, O., et. al. (2020). Glycine-based treatment ameliorates NAFLD by modulating fatty acid oxidation, glutathione synthesis, and the gut microbiome. https://pubmed.ncbi.nlm.nih.gov/33268508/

[13] Jung, H., et. al. (2017). Protective effects of flavonoids isolated from Korean milk thistle Cirsium japonicum var. maackii (Maxim.) Matsum on tert-butyl hydroperoxide-induced hepatotoxicity in HepG2 cells. https://www.sciencedirect.com/science/article/abs/pii/S037887411632150X

[14] Aldini, G., et. al. (2018). N-Acetylcysteine as an antioxidant and disulphide breaking agent: the reasons why. https://pubmed.ncbi.nlm.nih.gov/29742938/

[15] Lai, C., et. al. (2020). Impact of Glutathione and Vitamin B-6 in Cirrhosis Patients: A Randomized Controlled Trial and Follow-Up Study. https://pubmed.ncbi.nlm.nih.gov/32635181/

[16] Mohammadi, H., et. al. (2020). Magnesium Sulfate Attenuates Lethality and Oxidative Damage Induced by Different Models of Hypoxia in Mice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765718/

[17] Xu, L., et. al. (2018). Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance. https://pubmed.ncbi.nlm.nih.gov/29898626/

[18] Yang, Y., et. al. (2021). Green Plant Pigment, Chlorophyllin, Ameliorates Non-alcoholic Fatty Liver Diseases (NAFLDs) Through Modulating Gut Microbiome in Mice. https://pubmed.ncbi.nlm.nih.gov/34764881/

[19] Johnson, M., et. al. (2013). Diets containing traditional and novel green leafy vegetables improve liver fatty acid profiles of spontaneously hypertensive rats. https://pubmed.ncbi.nlm.nih.gov/24192144/

[20] Ahn, M., et. al. (2019). Fermented black radish (Raphanus sativus L. var. niger) attenuates methionine and choline deficient diet-induced nonalcoholic fatty liver disease in mice. https://pubmed.ncbi.nlm.nih.gov/31660146/

[21] Park, W., et. al. (2021). Raphani Semen (Raphanus sativus L.) Ameliorates Alcoholic Fatty Liver Disease by Regulating De Novo Lipogenesis. https://pubmed.ncbi.nlm.nih.gov/34959999/

[22] Jiang, G., et. al. (2021). Synergistic effects of black ginseng and aged garlic extracts for the amelioration of nonalcoholic fatty liver disease (NAFLD) in mice. https://pubmed.ncbi.nlm.nih.gov/34136174/

[23] Sangouni, A., et. al. (2021). Effects of garlic powder supplementation on metabolic syndrome components, insulin resistance, fatty liver index, and appetite in subjects with metabolic syndrome: A randomized clinical trial. https://pubmed.ncbi.nlm.nih.gov/33974725/

[24] El-Din, S., et. al. (2014). Pharmacological and antioxidant actions of garlic and.or onion in non-alcoholic fatty liver disease (NAFLD) in rats. https://pubmed.ncbi.nlm.nih.gov/25597144/

[25] Emamat, H., et. al. (2018). The Effects of Onion Consumption on Prevention of Nonalcoholic Fatty Liver Disease. https://pubmed.ncbi.nlm.nih.gov/29371773/

[26] “Plant Consumption and Liver Health” (2015) – https://www.hindawi.com/journals/ecam/2015/824185/

[27] “Dietary factors in nonalcoholic fatty liver disease: impacts on human and animal health – a review” (2023) – https://sciendo.com/article/10.2478/aspr-2023-0007

[28] “Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review”(2023) – https://www.mdpi.com/2072-6643/15/18/3987

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