Fatty Liver Disease

Hepatic Steatosis is a medical term for a fatty liver, a condition in which there is an abnormal and excessive build up of fat in the cells of the liver. When the fat in the liver accounts for more than 10% of the liver’s weight, then it is called "hepatic steatosis" and this condition could lead to more serious complications for the patient.

Most people know that alcoholics develop liver damage as a consequence of chronic alcohol consumption. But not all fatty, inflamed livers are caused by excessive alcohol consumption. It’s estimated that over one third of Americans suffer from fatty liver disease that is unrelated to alcohol consumption. That’s over 60 million people.

This type of liver disease is called non-alcoholic fatty liver disease (NAFLD) and it’s a concern because just like the type that alcoholics get, NAFLD can lead to an inflamed liver, a disease called nonalcoholic steatohepatitis, or NASH, and set the sufferer up for a higher risk of liver cancer.

Worse, a fatty liver produces no symptoms on its own, so people often only learn about their fatty liver when they have medical tests for other reasons.

What Does Your Liver Do For You?

The liver is the largest organ in the body. It is found high in the right upper abdomen, behind the ribs. It is a very complex organ and it has a serious impact on your health because if performs many important functions, such as:

  • Storing energy in the form of glycogen
  • Storing vitamins, iron, and other minerals needed for good health
  • Making proteins, including blood clotting factors, which help with growth and body health
  • Breaking down worn out red blood cells and cleansing the blood
  • Making bile needed for the digestion of fats from the diet
  • Metabolizing medications and alcohol
  • Killing germs that enter the body through the intestines.

The liver takes on the majority of body maintenance tasks and it even has a remarkable power to regenerate itself. Keeping your liver healthy is a very important goal!


What Causes Non-alcoholic Fatty Liver Disease?

There are many different causes for NAFLD. Most sites, including the American Liver Foundation, mention elevated triglycerides, but they don't tell you what to do.

So then, what causes elevated triglycerides? As it turns out, a diet high in carbohydrates, especially a diet high in fructose, has been shown to elevate triglyceride levels, and as a consequence, worsen NAFLD. Here's a study which demonstrates the effect of fructose.

On average, Americans eat about 75 pounds of fructose per year, mostly in the form of high fructose corn syrup (HFCS). HFCS is added to just about every processed food, and it’s in foods that you wouldn’t suspect, including artificial crabmeat, soups, and other supposedly non-sweet foods.

Study after study has shown that fructose elevates blood pressure, triglyceride levels and increases inflammation in the liver. Fructose is metabolized exclusively in the liver, and a diet high in fructose damages the liver and makes it insulin resistant. This includes the fructose found natural foods such as fruit and honey.

Here’s a video from an expert on the dangers of fructose:


Other Causes of NAFLD

In addition, a high consumption of omega-6 polyunsaturated fats also contributes to fatty liver disease. Omega-6 fats include vegetable oils such as corn, canola, and soybean oils (see the ingredients in mayonnaise and commercial salad dressing). Omega-6 oils do not include olive oil, and nut oils; these are monounsaturated oils.

In addition to contributing to NAFLD, many studies (see below) have shown that omega-6 polyunsaturated oils are highly inflammatory, and can cause liver inflammation and scarring. This includes fish oil if taken in excess!

In fact, linoleic acid, the main fatty acid found in vegetable oil, has a suppressive effect on the immune system and on thyroid function. See this article for more details.


Choline is Critical

A deficiency of choline, one of the B vitamins, has been shown in several studies to be the root cause of a fatty liver. In one study, men and women fed intravenously (IV) with solutions that lacked choline developed signs of liver damage consistent with a fatty liver. When they were given choline, the damage was alleviated.

These blog posts discuss this in more detail:


Treating NAFLD

At least two studies, one from Duke University, and one from Cambridge in London, have shown that reducing carbohydrate consumption and increasing saturated fat intake helps the liver shed excess fat in as little as three days. CAVEAT: Chris Masterjohn, in his posts on this subject notes that sufficient choline needs to be available for cleansing.

Read the Duke Study here.

Read the Cambridge study here.

In a third study here, the authors write: "Several lines of investigation indicate that dietary fat can modulate the severity of alcoholic liver injury.... In experimental animals, for example, diets enriched with saturated fatty acids protect against alcohol-induced liver injury, whereas diets containing polyunsaturated fatty acids promote liver injury. Saturated fatty acids have also been reported to reverse established alcoholic liver injury."


Building a Healthy Liver

For a healthy liver, you should:
  • Cut your overall carbohydrate intake (see this paper)
  • Avoid consuming fructose, especially high fructose corn syrup, white sugar (50% fructose), honey (40% fructose), and agave syrup, which can be up to 90% fructose
  • Avoid consuming refined vegetable oil (oils from corn, canola, and soybeans) which are rich in inflammatory polyunsaturated fatty acids
  • Avoid excess intake of fish oils
  • Eat more egg yolks and liver from clean, grass fed animals. These foods are high in choline.
  • Eat other foods rich in choline such as beef, cod, shrimp, broccoli, dairy products, and almonds.
  • Eat foods rich in an amino acid called methionine. The body can make choline from methionine. Meat, fish, sesame seeds and Brazil nuts are rich in methionine.


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