Fatty Liver & Diet
Nutrition and lifestyle management in fatty liver disease due to insulin resistance and metabolic syndrome
Learning the Concept of Treatment
How do we treat fatty liver?
Lifestyle intervention remains the backbone of entire spectrum of fatty liver disease; simple fatty liver disease to non-alcoholic steatohepatitis related advanced cirrhosis
Does lifestyle intervention help regenerate liver structure and improve functions?
Nutritional therapy in combination with physical activity/exercise improves liver fat, inflammation, and fibrosis. Up to 7% to 10% of weight loss is associated with improvements in all the parameters of disease. However, if lifestyle change is achieved and sustained, the benefits to liver, cardiac and metabolic health can surpass the efficacy of the drugs currently being evaluated in phase III trials. Thus, lifestyle modification should remain the primary focus for all patients with NAFLD.
What is a lifestyle intervention?
1. Energy Restriction
o Calorie Restriction (500-1,000 per day)
o 7-10% weight loss target
o Long-term maintenance approach
2. Meal Timing
o Consume most calories during the day
o Light and Early dinner
3. Healthy Fat Intake
o Low-to-moderate amount of vegetarian fat (polyunsaturated)
o Avoid saturated fat (animal fat sources including cheese)
4. Low Glycemic Carbohydrates
o Avoid foods and drinks containing fructose
o Avoid white flour and corn products
5. No Alcohol Intake
6. Minimum 7 Hours of Sleep
7. Coffee Consumption
o No liver-related limitations
8. Physical Activity
o 10,000 steps per day
o 150-200 min/moderate intensity in 3-5 sessions
o Resistance training to promote musculoskeletal fitness and improve metabolic factors
What are the dietary goals?
· Sugars: 0 grams per day
· Protein: 1.2 grams per kg of body weight per day
· No saturated or trans fats
· Minimum 80% compliance
· 10% weight loss in the first year
Improved vigilance or self-education
How do we differentiate good carbohydrate from bad carbohydrate?
Carbohydrate quality has a major influence on risk for numerous chronic diseases. Replacing processed carbohydrates with unprocessed carbohydrates or healthy fats would greatly benefit public health. Glycemic index is the good measure to differentiate good from bad carbohydrate.
Glycemic Index of Foods: The glycemic index of foods measures how quickly or slowly the food can increase blood glucose levels. Low glycemic foods cause blood sugar levels to rise slowly and high glycemic foods cause blood sugar levels to spike rapidly.
What is the difference between saturated and unsaturated fats?
Saturated fats are solid at room temperature and are derived from animal sources such as red meat, whole milk, dairy foods, cheese, coconut oil, and are found in many processed foods. Saturated fats can increase total and LDL cholesterol which can lead to blockages in the arteries. Unsaturated fats are liquid at room temperature and are sourced from vegetable oils, nuts, seeds, and fish. Unlike saturated fats, unsaturated fats increase the levels of HDL cholesterol which removes other forms of cholesterol from the bloodstream and lowers the risk of heart disease.
Sources of Healthy Fats:
· Walnuts, cashews, almonds
· Olive oil
· Chia seeds