3/30/2017 0 Comments Diet Plan For Fatty Liver DiseaseNonalcoholic Fatty Liver Disease. January 2. 01. 4 Issue. Nonalcoholic Fatty Liver Disease. By Erin Mc. Carthy, MS, RD, CSSDToday’s Dietitian Vol. Suggested CDR Learning Codes: 5. Level 3. Take this course and earn 2 CEUs on our Continuing Education Learning Library. Dietary factors contribute to fat accumulation in the liver, and early intervention is key to helping patients. Nonalcoholic fatty liver disease (NAFLD) is characterized by the accumulation of triglycerides in the hepatocytes of patients who don’t abuse alcohol. It ranges in severity from simple steatosis (excessive fat accumulation) to steatohepatitis (liver cell injury and inflammation). NASH can progress to cirrhosis and hepatocellular carcinoma. NAFLD is associated with cardiometabolic risk factors and the metabolic syndrome, and it’s the most common chronic liver disease among adults in developed countries; 3. United States have NAFLD. Individuals with the disease have a higher risk of all causes of mortality, largely because of the coexistence of the metabolic syndrome. Despite considerable research in this area, NAFLD’s pathogenesis isn’t fully understood. Most patients with a fatty liver have excess body weight; obesity is a common and well- documented risk factor for NAFLD and a predictor of advanced disease. Both BMI and visceral obesity are risk factors for NAFLD. Given the close relationship between obesity, the metabolic syndrome, and the development of NAFLD, it isn’t surprising that many NAFLD patients have multiple components of the metabolic syndrome, whether or not they’re overweight or obese. No specific medications are approved for treating NAFLD. The current standard of care for treating patients with NAFLD focuses on lifestyle interventions, particularly diet and exercise. Sustained weight loss is the most effective treatment and should be the foundation of any treatment plan. Sufficient weight reduction can be an effective treatment to improve the histology of NASH. A 5% weight loss is believed to improve steatosis, whereas a 1. RDs are the cornerstone of NAFLD treatment and should be up- to- date on the current recommendations for medical nutrition therapy. Nutrition professionals should work with patients’ health care team members, including primary care physicians, hepatologists, exercise physiologists, and health psychologists, to provide the best care. Nonalcoholic fatty liver disease occurs in every age group but especially in people in their 40s and. Health Plan Administration. Pritikin Diet; Exercise Plan. Diet Can Help Control NAFLD (Fatty Liver). This potentially life threatening disease that causes fatty. A fatty liver diet plan can be. Along with a fatty liver diet, other fatty liver disease. They also should monitor patients’ dietary intake and physical activity (both daily and structured), obtain food logs, and monitor patients’ glucose levels. A nonpharmacological intervention based on personalized diet, physical activity, and behavior therapy should aim to encourage lifestyle change, the only therapy proven to effectively treat NAFLD. This continuing education course reviews the dietary factors associated with NAFLD as well as the lifestyle and nutrition options for treating the disease. Lifestyle and Dietary Factors Dietary factors may contribute to liver fat accumulation through multiple pathways, such as the following: Obesity. Obesity, combined with host factors such as diet, sedentary lifestyle, and genetic predisposition, has been directly associated with increases in the prevalence of insulin resistance, type 2 diabetes, metabolic syndrome, and NAFLD among adults. There is an excellent diet plan in Dr Cabot. They also prevent fatty buildup and damage to the liver cells. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. New Website Offers Special Treatments and Diet Plans for Fatty Liver Disease Launched on the. Choosing the Best Fatty Liver Diet Plan for Fatty Liver Disease. Non-alcoholic fatty liver disease (NAFLD). Following a healthy NAFLD diet plan can help reduce the liver damage and slow down the progression of NAFLD. Fatty liver, or hepatic steatosis. Fatty liver disease should not make it harder for you to lose weight. Estimates suggest that about 8. NAFLD, with 3. 6% having the more aggressive form of fatty liver, NASH. Obesity itself is a chronic inflammatory condition resulting from the failure of normal homeostatic regulation of energy intake, storage, and utilization. With obesity, particularly central obesity, there’s an expansion of visceral adipose tissue. Weight loss can change the activity of adipose tissue and reverse many negative consequences of the condition, including NAFLD, as can dietary macronutrient content. Energy balance is a major factor in liver fat accumulation. NAFLD can be a precursor to developing the metabolic syndrome or a “hepatic manifestation” of insulin resistance. Although the liver isn’t meant to store fat, caloric excess coupled with and unmatched caloric expenditure can result in fat accumulation in this organ. NASH patients have been shown to have higher energy intake compared with healthy controls. Overfeeding studies have clearly shown that an increased intake of fat,1. In addition, several mechanisms may play a role in the pathogenesis of NAFLD, including insulin resistance, oxidative stress, and cytokine toxicity. These factors likely are present in those with severe obesity and NAFLD and at a significantly increased prevalence than in their normal- weight counterparts. An increasing number of patients with NAFLD have been described as having a normal BMI, although these individuals tend to have central adiposity and insulin resistance. Clinical and epidemiologic studies suggest a direct association between hepatic fat content and visceral adiposity. Total Fat. Aside from weight gain and obesity, dietary composition can influence the development of NAFLD. The amount and type of dietary fat may directly affect liver fat content, with high- fat diets being potentially harmful. Research participants with NAFLD who were fed a three- day isoenergetic diet containing 3. A higher dietary fat intake with an increased ratio of omega- 6 to omega- 3 polyunsaturated fatty acids (PUFAs) and an increased intake of saturated and trans fatty acids is associated with liver inflammation and NAFLD. In contrast, 7. 4 severely obese patients undergoing bariatric surgery demonstrated that a higher total fat intake was associated with lower odds of hepatic inflammation. It appears that the type of fat rather than the amount of fat makes the most difference in NAFLD patients. Saturated Fatty Acids. Diets high in saturated fat have been shown to induce insulin resistance. In epidemiologic studies, both total fat and saturated fat in the diet have been correlated with liver triglyceride content and the presence of NASH. Patients with NAFLD ingested a higher percentage of their calories from fat (2. While no human studies have linked NAFLD and diets high in saturated fat, evidence from experimental animal studies demonstrates that high dietary saturated fatty acid consumption worsens insulin resistance, NAFLD, and cardiovascular disease in rodents. In a double- blind randomized controlled trial of two reduced- fat diets, one containing 3. LDL cholesterol in healthy male test subjects. HDL cholesterol also decreased, and triglyceride levels increased with the reduced- fat diets. This suggests that while reduced saturated fat intake (below 1. NAFLD, intake of less than 6% may have counterproductive effects on plasma lipids, specifically triglycerides. Another study suggested that a low total fat and low saturated fat diet (2. HDL, and LDL cholesterol) but not liver fat. Trans Fatty Acids. Trans fatty acids are implicated in the metabolic syndrome, as they’re strongly associated with an increase in inflammatory processes, plasma triglycerides, and cholesterol as well as a reduction in HDL cholesterol. While there are no human studies on trans fatty acids and NAFLD/NASH, animal studies have shown positive relationships between the increased consumption of trans fatty acids from oxidized oils and liver inflammation. Little is known about how lipids and trans fatty acids affect hepatic functions and oxidative stress. PUFAs. Individuals with NASH have a lower intake of PUFAs and, in particular, omega- 3 PUFAs. Omega- 3 PUFA levels also are decreased in the hepatic tissue of patients with NAFLD. In addition, a higher omega- 6 to omega- 3 PUFA ratio within the liver of NAFLD patients may contribute to the development of a fatty liver because of a decreased capacity to regulate liver lipid metabolism. High Carbohydrate Intake. Extrapolating from the diabetes literature and available data about NAFLD, the amount and type of carbohydrate in the diet likely have an important impact on NAFLD. NASH patients have been found to consume more sweets and simple carbohydrates. Diets rich in carbohydrate sources lead to increased circulating insulin concentrations, which contribute to elevated fasting triglyceride concentrations even under isocaloric conditions. A low- fat, high- carbohydrate diet promotes the development of a fatty liver through increased de novo fatty acid synthesis (fatty acid and triglyceride synthesis). A higher carbohydrate intake (more than 5. Excess High- Fructose Corn Syrup Intake Growing evidence suggests that the epidemic of NAFLD is closely related to the Western dietary pattern and an increased intake of simple sugars, especially fructose. Whether there’s a link between fructose or high- fructose corn syrup and an increased risk of fatty infiltration of the liver or muscle is uncertain. Researchers have hypothesized that fructose can be linked to NAFLD through both indirect and direct mechanisms. Indirectly, fructose can lead to adverse metabolic effects that can increase the risk of developing NAFLD. Fructose may indirectly predispose someone to fatty liver infiltration by creating an adverse metabolic profile. Studies have indicated that increased fructose consumption boosts fat mass, de novo lipogenesis, and inflammation. It also induces insulin resistance and fasting and postprandial triglycerides, which can, in turn, result in liver steatosis. In case- controlled studies, sugar- sweetened beverage consumption was associated with hepatic steatosis independent of the degree of obesity. In other studies, total fructose consumption was associated with NAFLD, and NASH in particular. In a cross- sectional analysis of 4. Inactivity Patients with NAFLD generally engage in less than one- half the amount of exercise performed by age- and sex- matched controls, and in one study, less than 2. In a large- scale study of 3. NAFLD group engaged in less reported leisure time physical activity, including total, aerobic, and resistance, although only the association with resistance physical activity remained significant when adjusted for BMI. In a small study of 3. Do You Have a Fatty Liver? Million Americans Do! The most common disease in America is something you probably never heard of, but it affects 9. Americans and is a major risk factor for diabetes, heart attacks, and even cancer. It is called NALFD (non- alcoholic fatty liver disease) or fatty liver, for short, and is caused by the 1. How do you know if you have it? And how do you fix it? Do you exercise, take drugs, change your diet, or take supplements to fix it? Many of you are probably wondering, “What is a fatty liver?” Some of you may have heard of foie gras. Foie gras is the French term for fatty liver that is used to describe a delicacy made from duck or goose liver. What happens to the livers of these animals as a result of the controversial practice of overfeeding is what you could be doing to your own liver, unknowingly. For those people who have this disease, essentially what they have is a liver that is full of fat, and that is a major cause of chronic disease and inflammation in the body. How is it that we live in a country where fatty liver is the single most common disease, but most people have never even heard of it? Americans have a fatty liver and almost none of them know they have it. In fact, you might have it, as well, and not even know it. What causes it? In order to make foie gras, ducks or geese are force- fed sugar in the form of corn and starch—a sad practice. In the body, this sugar turns on a fat- production factory in the liver, a process known as lipogenesis, which is the body’s normal response to sugar. Fructose actually ramps up the lipogenesis response. The high fructose corn syrup found in our processed foods is the single biggest cause of fatty liver. Soda, which, frighteningly, is the number one source of calories in the American diet, is, then, the biggest cause of fatty liver. How do you know if you have it? There are blood tests available that can detect a fatty liver. You can also see it on an ultrasound. And if your test comes back abnormal, you are in trouble. But even if your test comes back normal, you might not be out of the woods. It’s important to know that a liver function test doesn’t always detect a fatty liver. An ultrasound can be more sensitive. The bottom line is, if you eat a lot of sugar and flour, if you have a little bit of belly fat, or if you crave carbs, starch, and sugar, you probably have this. Why is this a problem? Fatty liver creates a whole cascade of issues. It causes inflammation in your body. This inflammation creates insulin resistance and pre- diabetes, which causes your body to deposit fat not just in your liver but also all around your organs and in your belly. That dangerous belly fat caused by the sugar and starch in your diet then creates even more problems. It causes you to have high triglycerides and low HDL, the good cholesterol. It causes you to have small LDL, the dangerous cholesterol particles that cause heart attacks. In fact, having a fatty liver puts you at great risk for having a heart attack, and most people have no idea they have it. Certain populations like Latin Americans have a much higher risk of having a fatty liver. And shockingly, now, we see 1. That’s pretty scary, and we really need to think about what we are doing to our children by feeding them these toxic substances. When you have a fatty liver, you need to think about the damage it’s causing. You don’t want to end up with a liver transplant. You don’t want to end up needing to be on medications to fix the complications of a fatty liver like high blood pressure, diabetes, heart disease, and abnormal cholesterol. You want to get to the root of the problem. How to fix your fatty liver. There are some really simple things you can do with diet, exercise, and supplements to help heal your fatty liver. Cut out all high fructose corn syrup from your diet. If you see it on any label for any product—whether it’s a salad dressing or ketchup or tomato sauce—don’t eat it. Think about it: most servings of tomato sauce that you buy in a jar have more sugar than a serving of Oreo cookies. Get rid of all that high fructose corn syrup from your diet, 1. Reduce or eliminate starch. Get rid of white, processed flour. Even whole grain flours can be a problem. It’s common to find too much of these starchy foods in the classic American diet, or what we call the SAD (Standard American Diet). All of those things will promote a fatty liver. You may be surprised to learn that it’s actually not fat that causes a fatty liver. To learn more about why this is true, check out my book, The Blood Sugar Solution. Add some good things to your diet to help heal your fatty liver. Add plenty of fruit, vegetables, nuts, and seeds. Add lean animal protein like chicken and fish. Add good oils like olive oil, macadamia nut oil, avocados, coconut butter, and fish oil. Good fats like these are anti- inflammatory, and they help repair your liver. Improve your metabolism through exercise. This is a fabulous way to improve insulin resistance and reduce fatty liver. Use the right supplements. I do a lot of this with my patients, and I find it very effective. We give them herbs like Milk Thistle. We use things like Lipoic Acid, a powerful antioxidant, and N- Acetyl- l- Cysteine. These things help boost something in your liver called glutathione. I encourage you to read my blog on glutathione, which talks about how this wonderful detox substance in your liver can be regenerated with certain supplements. And we use other things like B vitamins and magnesium. All these things will help your liver repair and heal. Eat detoxifying liver- repairing super foods. Focus on the broccoli family. I love this family of foods, and I try to have at least a cup or two every day. Kale, collards, cabbage, Brussels sprouts, broccoli, arugula, daikon radish—all wonderful foods that help repair and heal your liver. Garlic and onions, also, are full of sulfur, which is a great detoxifier. I promise you, you don’t want a fatty liver. You need a healthy liver to help you deal with all the junk and chemicals in our environment. When you have a healthy liver, your body stays healthy, you don’t get sick, and you can feel good, which is what I want for everybody. So, now I’d like to hear from you? Or what hasn’t worked? Share your questions and experiences in the comments section below, so that you may help others or others may help you. Share this House Call with your friends and family, and subscribe to receive one every week. Join me on Facebook and Twitter, and submit your questions, so that next week, I may make a House Call to you.
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