Most People with Diabetes Have Fatty Liver Disease

Hugo Rosen, MD, a liver disease specialist and chair at the Keck School of Medicine of USC, has witnessed a startling shift in his practice. There are less individuals coming in for hepatitis C and a lot more people seeking treatment for fatty liver disease.

It is estimated that a quarter of the global population has nonalcoholic fatty liver disease (NAFLD). Results from a Mayo Clinic study and other studies suggests NAFLD is linked to increased risk of liver cancer, and susceptibility to other forms of cancer.

60% of people with type 2 diabetes also have nonalcoholic fatty liver disease. NAFLD is often considered as a manifestation of the metabolic syndrome, especially in those with elevated BMIs and diabetes.

Dr. Rosen says he’s most worried about fad diets like Keto that are attractive to people because they can eat lots of tasty foods like butter, cheese, and red meat, but it encourages a high increase in fat. Rosen says 80% of your calories will generally come from fat on the keto diet.

Studies on mice suggest the uptake in fat in the diet can lead to nonalcoholic fatty liver disease. The hardest part about NAFLD is that most people don’t know they have it and don’t start exhibiting signs of it until it has progressed to cirrhosis or nonalcoholic steatohepatitis (NASH).

What action can people take?

The current recommended treatment includes weight loss (because it helps reduce fat and inflammation in the liver) and eating a well-balanced diet with fiber, and lessening fat intake particularly from processed foods.

Don’t overdo it on fats, Rosen recommends, especially from processed foods. Fructose and other sugars are a major concern as well, especially in sodas, candy, sugary cereals, sweetened juices and fast food. Those kinds of refined foods can increase cholesterol and cause inflammation in the liver.

Vitamin E and Pioglitazone have helped some with NAFLD, but results are inconsistent and there is no FDA-approved drug to specifically treat it yet.

For the full study details and nutrition and lifestyle recommendations for NAFLD, see USC’s article on Rosen here.

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