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Non-alcoholic fatty liver disease

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By Ross Walker

Non-alcoholic fatty liver disease is defined as the presence of fat in the liver when no other obvious cause is present, such as alcohol abuse or any other potential liver toxin. With the increasing problems of diabetes and obesity in modern society, the incidence of non-alcoholic fatty liver disease is rising and, without appropriate management, may lead to cirrhosis of the liver.

Non-alcoholic fatty liver disease is divided into early non-alcoholic fatty liver and then the more significant non-alcoholic steatohepatitis. Non-alcoholic fatty liver disease is now the most common liver disorder in Western industrialised countries. There is a strong association with insulin resistance and the subsequent metabolic syndrome, which is the varying combination of tendency to diabetes, hypertension, specific cholesterol abnormalities manifested by high triglyceride and low HDL, and, most importantly, abdominal obesity. Another common association here is that of gout.

A recent disturbing report has suggested that fatty liver occurs in around 15% of children and 40% of people over the age of 60. Although it is much more common in people who are overweight or obese, fatty liver can still occur in people with normal body weight. In most cases, there are no symptoms of fatty liver disease, although with the more significant non-alcoholic steatohepatitis, affected people may experience fatigue, malaise and abdominal pain below the right side of the ribs where the liver is located. Although, occasionally a doctor may be able to feel an enlarged liver, fatty liver is more typically detected on blood tests, otherwise known as liver function tests or on the various scans available, such as ultrasound. If any liver abnormalities are detected, it is important to exclude other conditions such as alcohol abuse, infectious hepatitis, autoimmune disease and less common genetic abnormalities, such as haemochromatosis.

Fatty liver is more severe in older people, those with diabetes, those who are obese, and surprisingly, those who don’t drink coffee. Although fatty liver is not typically a life threatening disease, occasionally people still require liver transplantation because of this condition. Interestingly, the common cause of death in people with fatty liver is cardiovascular disease because the insulin resistant gene and subsequent metabolic syndrome account for now around 70% of atherosclerotic cardiovascular diseases i.e. heart attack, stroke, etc.

Management

Clearly, the best management of fatty liver disease is weight loss. Reducing the waist circumference to below 95cm for a male and 80cm for a female also reduces the amount of fat in the liver. A variety of therapies have been trialled for fatty liver with minimal success for most treatments. There have been some promising data using vitamin E 400 I.U. daily.

A number of diabetic drugs such as metformin and pioglitazone have been trialled with no real benefits, along with some newer diabetic drugs such as liraglutide. Liraglutide did demonstrate a weak benefit. Statin drugs have been trialled for this condition with no real benefits. Omega three fatty acids have also been trialled, with a slight trend towards improvement in liver function.

The most promising results to date have been with bergamot polyphenolic fraction. There have been significant improvements in liver function and reduction in fatty infiltration as seen on ultrasound when people were being treated with BPF 47% polyphenolic fraction. The most recent trial, which was placebo-controlled, involved 188 people with proven fatty liver, and after 16 weeks of therapy, all patients on BPF showed a significant improvement in liver function. The only product on the market that has this concentration of bergamot polyphenolic fraction is BergaMet pro plus. I have been saying for a number of years that all people over the age of 50 should take BergaMet pro plus twice a day purely as prevention against cardiovascular disease, diabetes and obesity, but these most recent studies show yet another benefit from what I believe to be the best natural product on the market. With the recent death of George Michael and his subsequent autopsy study that revealed death from cardiovascular disease and fatty liver, it is now emerging that yet another condition of the modern trends to overeating and under exercising is fatty liver. As the solution is so simple i.e. eating less, eating more naturally, moving more and taking a daily, very beneficial supplement (BergaMet pro plus), you must ask yourself the question, why aren’t more people doing so?

Disclosure: Dr Ross Walker has an association with BergaMet. 

Published: Thursday, May 04, 2017


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