Healthy Eating and Increased Physical Activity Paramount to Treatment of Non-Alcoholic Fatty Liver Disease

Date
January 31, 2020
Topics
Diet, Exercise, NASH, Liver

Oxford 31st January 2020. The burden of diseases related to obesity and fatty liver disease can be reduced using a simple structured approach to diet and physical activity — as demonstrated in a Gastroenterology Clinics paper co-authored by Perspectum employee, Thomas Waddell, and CEO, Rajarshi Banerjee. In fact, only a small reduction in body weight was enough to improve liver health significantly.   

Complications including non-alcoholic fatty liver disease (NAFLD), metabolic syndrome, type 2 diabetes, and cardiovascular disease are becoming more common and are closely linked to the global rise in obesity prevalence. In most cases, the leading cause of obesity is excessive calorie intake. Analysis of 24-hour diet questionnaires from over 200,000 participants from the UK Biobank showed that 32% of men and 42% of women were consuming more energy than the recommended daily amount.    

Whilst the deleterious effect of obesity on health has long been recognised, recent technological advancements in non-invasive imaging have allowed researchers to investigate the effects of obesity on multiple organs and in large study populations,” author Thomas Waddell remarked. “This greater understanding of obesity pathophysiology and its association with clinical outcomes has greatly advanced our ability to provide tailored intervention plans.”  

Evidence in the paper clearly shows that healthy eating habits, weight loss, and increased physical activity are all critical in the prevention and management of fatty liver disease and obesity. Additionally, it shows both macronutrients and micronutrients also play a role in slowing or preventing NAFLD progression. Notably, the type of carbohydrate was found to be critical — it's easy to eat a lot of highly-processed carbohydrates, and a high-calorie diet of refined carbohydrates increases liver fat. Similarly, excessive amounts of saturated fat induce inflammation. On the other hand, monounsaturated and polyunsaturated fatty acids, like those commonly found in nuts, olive oil, and avocados, reduced liver fat and inflammation. Specific dietary amino acids were also shown to control aspects of fatty liver disease progression, including fibro-inflammation. Although high-protein diets do look promising for reducing liver fat, it should be considered that they may also contribute to insulin resistance.   

A diet that has proven to be consistently successful in improving health is the Mediterranean diet of low simple sugars, high fibre, fresh fruit and vegetables, olives, avocados, nuts, and fish, especially when paired with 2.5-5 hours of moderate to vigorous activity per week. Incredibly, this has been shown to reduce liver fat accumulation by about 28% in patients with NAFLD.     

The most difficult part of this treatment is convincing patients to change their lifestyles long term. When asked about how medical professionals should go about helping patients to do so, author Nicola Guess responded The good news is that even small lifestyle changes are possible to help reduce liver fat - such as walking 30 minutes a day or replacing red meat and butter with white meats, pulses, and olive oil. While any weight loss can help reduce liver fat, it's exciting to know that some dietary switches can lower liver fat even if you don't lose weight.”  

Read the full paper here: https://www.gastro.theclinics.com/article/S0889-8553(19)30068-8/fulltext