I suppose the term “non-alcoholic fatty liver disease” isn’t a day to day component of most people’s conversation.  It is, however, the single most common progressive liver disease in this country.  There is a spectrum ranging from simple fatty liver that has no symptoms all the way to cirrhosis.  Why would this be the topic of a column relating to food?  Because diet appears to be the main instigator of the disease.  It is strongly associated with diabetes, metabolic syndrome and obesity, including in children.

It appears to work like this:  when you eat, glucose levels rise in the blood stream and these glucose molecules are supposed to be taken up by fat cells or burned off right away.  If this does not happen, then the glucose is turned into free fatty acids in the liver, where it is deposited as fat.  High levels of insulin, as found in Type II diabetes and metabolic syndrome, inhibits the oxidation of these fats (which helps to break them down), further adding to the fat accumulation.  These fat stores lead to inflammation and oxidative stress, which both damage liver cells directly and cause inflammatory damage elsewhere in the body.

Adding to the picture can be an imbalance of normal bacteria in the intestines.  A large amount of abnormal bacteria in the small intestines (common in the face of certain processed foods and high fructose corn syrup) leads to toxin formation that increases the amount of inflammation produced in the liver.  Ultimately, this increases the chance of liver damage.  Abnormal microbe growth in the gut, including yeast, has been documented to turn dietary sugars into ethanol and its byproducts.  These can directly lead to damage of liver cells as well (and help explain part of the drowsiness some people feel after eating starches).

Non-alcoholic fatty liver disease is extremely difficult to diagnose, mostly because in the early stages it either shows no symptoms at all or ones that are very vague and not apparently related to the liver.  Many cases of what initially appeared to be early-onset dementia have been seen to actually stem from the memory loss and confusion common with hepatorenal disease.  If your doctor tells you that your liver enzymes are “normal”, that’s great, but you should be aware that these tests don’t become abnormal until a large amount of damage has already occurred in the liver.  (Fatty liver can usually be noticed on ultrasounds of the liver, but this isn’t a common test to run).

As is usually the case, prevention is always better than treatment.  Not surprisingly, the diet advice here is what you already know:  eat your vegetables, cut back on processed foods and sugars.  Stop the fast food, stop soda.  Make sure that you get lots of various kinds of antioxidants in your diet by eating produce from every color of the rainbow every few days.  Help out your colon by eating plenty of soluble and insoluble fiber (apples, oats, salad greens, beans).  It’s really that easy, and in the process, you’ll be decreasing your chances of developing heart disease and diabetes as well.

If this whole thing sounds impossible, just remember the movie “SuperSize Me”, in which Morgan Spurlock ate entirely from the menu at McDonald’s for a month.  After only 2 weeks, his doctor was concerned with the rise in his liver enzymes….an indication of a large amount of damage.  Good news is that Morgan’s girlfriend is a macrobiotic and raw foods chef, so she pumped him full of healthy, liver – cleansing foods after his experiment, and he did fine.  So sure, his was an extreme example, but remember:  it only took 2 weeks.  What happens if you eat fast food several times a week for years???