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How to Treat Non-Alcoholic Fatty Liver Disease?
Non-alcoholic fatty liver disease (NAFLD), also known as non-alcoholic steatohepatitis (NASH) or “fatty liver disease”, is characterized by an excessive accumulation of fat in the liver. It affects about 25% of the world’s population, 65% of obese people and 85% of morbidly obese people. Often, it does not show any noticeable symptoms. It is diagnosed by blood tests indicating abnormal liver enzymes (AST, ALT and GGT) and an ultrasound of the liver that shows that the size of the liver is increased. If the fatty liver is not treated, it can have serious health consequences and lead to liver cirrhosis and cancer.
What are the causes?
In the absence of secondary causes such as excessive alcohol consumption, hereditary causes or the use of certain drugs, hepatic steatosis can be caused by excessive consumption of fat, sugar or calories, leading to an accumulation of lipids in the liver. The most common cause of NAFLD is obesity. Fatty liver is also associated with insulin resistance, type 2 diabetes, hyperlipidemia (high cholesterol or triglyceride levels), high blood pressure, abdominal obesity and metabolic syndrome.
How to treat it?
Currently, gradual and long-term weight loss is the main recommendation for treating non-alcoholic fatty liver disease. A weight loss of 5 to 10% of the total body weight is recommended. Thus, changes in eating habits and increased physical activity to promote weight loss is a very effective treatment. The amount of weight loss seems to be more important than the macronutrient composition (carbohydrate, fat, protein) of the diet when treating fatty liver. According to scientific studies available to date, several types of diets can be effective for treating fatty liver, including caloric restriction, a low fat or a low carbohydrate diet. SOSCuisine’s weight loss menu, based on the Mediterranean diet, has been designed for weight loss and can be a good choice for treating a fatty liver. It can also be helpful to get help from a Registered Dietitian and a kinesiologist to help make lifestyle changes that will be sustainable over the long term.
The ketogenic diet to treat non-alcoholic fatty liver disease?
To date, very few studies have examined the effects of the ketogenic diet in treating NAFLD. Thus, there is not enough evidence to recommend the ketogenic diet in people with fatty liver. A recent meta-analysis suggests that low carbohydrate diets (less than 40% of total calories) and moderate carbohydrates diets (40 to 50% of total calories) combined with regular physical activity may be beneficial to improve the risk factors of metabolic syndrome, promote weight loss, improve liver function and treat fatty liver. In general, a moderate carbohydrate restriction can be achieved by limiting sugars that have a poor nutritional value such as sugary drinks, sweets, added sugars and refined grains (white bread, white rice, white pasta, etc.).
References
- Fondation canadienne du foie (2017) Fatty Liver Disease. https://www.liver.ca/patients-caregivers/liver-diseases/fatty-liver-disease/
- York, Puthalapattu et Wu (2009) Nonalcoholic Fatty Liver Disease and Low-Carbohydrate Diets. Annu. Rev. Nutr; 29:365–79.
- Katsagoni et coll. (2017) Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: A meta-analysis. Metabolism Clinical and experimental; 68: 119-132.
- Haghighatdoost et coll. (2016) The effects of low carbohydrate diets on liver function tests in nonalcoholic fatty liver disease: A systematic review and meta-analysis of clinical trials. Journal of research in medical sciences 21(1):53.
- Schugar et Crawford (2012) Low-carbohydrate ketogenic diets, glucose homeostasis, and nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care; 15(4): 374–380.
- Paul et Davis (2018) Diagnosis and Management of Nonalcoholic Fatty Liver Disease. JAMA;320(23):2474-2475.
- Chalasani et coll. (2018) The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance From the American Association for the Study of Liver Diseases. Hepatology; 67 :1.
Author
Kathryn holds a Bachelor Degree in Nutrition as well as a Bachelor and a Master Degree in Kinesiology, all from Laval University. She is a Registered Dietitian and active member of the Ordre professionnel des Diététistes Nutritionnistes du Québec (ODNQ) and of the American Academy of Nutrition and Dietetics. She holds the Monash University's certification for the FODMAP diet and IBS, and has considerable clinical experience in that area. She is also an accomplished athlete, having ran track and cross-country at a national level. Kathryn specializes in sports nutrition, weight loss, diabetes, as well as heart and gastrointestinal health.
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