The facts of fatty liver you need to know

The liver plays a key role in metabolising lipids. So, what if it contains and accumulates some extra fat? In a sense, it is true. However, if the fat content is more than 5% of the weight of the liver, then we have a problem. This is what we call a fatty liver or steatosis. 

Fatty liver is usually asymptomatic. That is why it is also known as silent liver disease. Detection is accidental. It pops up when we are doing abdominal imaging for some other reason. 

Fatty liver is one of the most common liver conditions worldwide. In Bangladesh, about one-third of the population is estimated to suffer from this. This is not unusual considering the rapid rise in obesity and type 2 diabetes, two leading risk factors for steatosis. 

The perception that overweight people are the only ones to have this condition or that all overweight people suffer from fatty liver may not be necessarily true. 

There are many other factors which could precipitate it, like prediabetes, high blood pressure, hyperlipidemia, metabolic syndromes and family history of liver disease. Many of these people may not be overweight or obese. 

There are other, less common risk factors, for example, hepatitis C infection, medication (e.g., corticosteroids) and polycystic ovarian syndrome (PCOS). 

If there are no symptoms, why are we concerned about fatty liver disease? Because it could give rise to complications like cardiovascular problems or insulin resistance. 

Some can suffer from significant inflammation and injury to liver cells, causing a condition known as nonalcoholic steatohepatitis (NASH), which is symptomatic. This could eventually give rise to cirrhosis or even cancer.

In case the disease progresses to NASH, all we can do is manage it since there are no curative medications available so far. This includes avoiding any foods detrimental to the liver, e.g., sugar, sugary beverages, fast foods, and saturated fats. 

If the patient drinks alcohol, this should be stopped. Weight loss is advisable in cases of obesity or overweight. The target should be gradually reducing at least 5% of excess weight. Vaccination against hepatitis A and B is beneficial. 

If there are underlying diseases, such as diabetes, hypertension, etc., these must be properly managed in consultation with the physician. Regular screening for liver cirrhosis/cancer is also recommended. 

We can adopt positive lifestyle changes to minimise the risk of fatty liver. Keeping our body weight within normal limits is a good start. So, if we have extra weight, let’s shed it. This will be advantageous for many reasons, not only liver disease. Exercise will always help, particularly aerobic exercise. 

Regular and proper aerobic exercise, e.g., walking, running, swimming, cycling, can reduce unnecessary fat and inflammation in the liver. 

Eating a healthy and balanced diet is crucial. We should stop or at least cut down our intake of fast foods, sugary drinks, and alcohol as much as possible. Our diet should consist of fruits, vegetables, whole grains, poultry, and finish. Red meat should be consumed only in moderation, and canola or olive oil are preferable to other types of oil. 

Last but not least, there is a belief that eating rice may harm our liver. This has yet to be conclusively proven. Rather, a study by the Korea Food Research Institute demonstrated that cooked rice may play a role in preventing fatty liver. 

However, that does not mean we must fill our plates with rice. It should be part of a balanced diet, no more, no less. 
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