When fat accumulates in the cells of your liver and it's not due to excess alcohol consumption, the result is nonalcoholic fatty liver disease, or steatohepatitis. Obesity, diabetes or both is the underlying issue in most people with NAFLD, according to the University of California, San Francisco. In those who are not obese, a family history of diabetes and high cholesterol are other factors. Treatment is based on improving the underlying causes. If left untreated, NAFLD can progress to cirrhosis, a serious liver disease involving the development of scar tissue.
Most Consistent Underlying Cause
Fat accumulates in the liver when an imbalance exists between the amount of fat the liver takes in and the amount exported for energy and other purposes, according to a review published in the December 2007 edition of the journal, "Therapeutics and Clinical Risk Management." Insulin resistance, which promotes fat uptake by the liver, is the most consistent underlying factor, according to the review. Insulin is a glucose-regulating hormone. Resistance occurs when your body becomes insensitive to insulin, causing the pancreas to secrete more of it to compensate.
Weight loss is the cornerstone in treating NAFLD, according to the results of clinical research, as published in the June 2010 edition of the journal "Minerva Gastroenterology and Dietology." Data from a randomized controlled trial showed that lifestyle changes result in 7 percent to 10 percent weight loss significantly improve NAFLD. If you weigh 200 pounds, that's 14 to 20 pounds. The obesity drug orlistat failed to improve insulin resistance or fat accumulation in the liver tissues of people with NAFLD, according to the researchers.
So far, a specific diet for NAFLD is lacking. Making healthier food choices and decreasing your calorie intake, however, can help promote weight loss. Gradual weight reduction improves insulin levels, according to Tolman and Dalpiaz, reporting in "Therapeutics and Clinical Risk Management." Rapid weight loss may make fatty liver disease worse, however. Furthermore, it's best to avoid low-fat diets and opt for a low-glycemic, low-calorie diet, according to the writers. A low-glycemic diet consists of foods that don't cause a rapid increase in blood sugar. For example, nonstarchy vegetables and beans are low-glycemic; whereas, refined carbohydrates such as white bread and white pasta are high-glycemic.
Medications approved by the Food and Drug Administration for NAFLD are lacking, but the cholesterol-lowering class of drugs known as statins may help reduce fat accumulation in the liver if you have high cholesterol, according to "Therapeutics and Clinical Risk Management." If you have diabetes, the blood sugar-lowering drug metformin helps reduce elevated insulin, according to the journal. Metformin is not recommended if you don't have diabetes. Talk to your doctor about other medications that might help improve insulin sensitivity or decrease fat accumulation in the liver, if she decides medication is necessary.
In general, exercise is beneficial for your health. Your body needs physical activity to remain healthy. Exercise may help some aspects of NAFLD, according to the result of studies published in the July 2012 issue of the "Journal of Hepatology." The study found that aerobic and/or resistance exercise decreases liver fat but not alanine aminotransferase, or ALT, in adults with NAFLD. ALT is an enzyme that helps predict liver function.
- University of California San Francisco: Non-Alcoholic Fatty Liver Disease
- Therapeutics and Clinical Risk Management: Treatment of Non-Alcoholic Fatty Liver Disease
- Minerva Gastroenterology and Dietology: Weight Loss: Cornerstone in the Treatment of Non-Alcoholic Fatty Liver Disease
- Journal of Hepatology: Exercise and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis.