Non-alcoholic fatty liver – NAFLD – disease, diet

Non-alcoholic fatty liver is a disease that many Poles are not aware of. It often appears with lifestyle diseases such as type 2 diabetes, hypertension and obesity. Diet is very important in her treatment. With the right diet, you can also prevent its appearance.

Non-alcoholic fatty liver disease, or NAFLD for short, is a very common health problem. Fatty liver is associated with civilization diseases, among others obesity, type 2 diabetes, cardiovascular disease. It is worth being aware of what non-alcoholic fatty liver disease is, how to prevent it and how to support treatment through simple lifestyle changes, including modification of eating habits and increase of physical activity.

The non-alcoholic fatty liver disease covers the entire spectrum of fatty liver disease in persons not consuming significant amounts of alcohol. The disease is usually defined as steatosis found in liver histology or imaging in a situation where other causes of this condition are excluded.

Usually, the liver disease is associated with alcohol abuse (consumption of more than 30g ethanol per day by men and over 20g per day by women), taking hepatotoxic drugs and the occurrence of genetic diseases causing steatosis.

Non-alcoholic fatty liver disease – not just fatty liver

Non-alcoholic fatty liver disease can occur without concomitant inflammation or fibrosis of the liver cells (so-called non-alcoholic fatty liver (NAFL)) and with features of fatty liver and inflammation with liver cell damage (non-alcoholic fatty liver disease – NASH).

In the second case, we can talk about a higher risk of fibrosis, leading to already fatal disease – liver cirrhosis and its complications, including hepatocellular carcinoma. Underlying development of NAFLD is metabolic syndrome and insulin resistance as well as associated oxidative stress.

Non-alcoholic fatty liver disease – risk factors

Non-alcoholic fatty liver disease affects men more often than women, especially in old age. The main risk factors include obesity, in particular, the so-called abdominal obesity, which is characterized by the accumulation of abdominal fat and type 2 diabetes, dyslipidemia, metabolic syndrome. Diseases such as hypothyroidism and pituitary gland, polycystic ovary syndrome or obstructive sleep apnea are also less associated with NAFLD.

Main causes of fatty liver disesae
Main causes of fatty liver disesae

Non-alcoholic fatty liver disease – a new civilization challenge

NAFLD is undoubtedly an increasing problem in our society. It has been shown to be the most common chronic liver disease in developed countries, affecting between 17 and 46% of the population. Its incidence in the world varies significantly depending on the region of the world and diagnostic methods and ranges from 6 to 35%, and in European countries 20-30%.

Non-alcoholic fatty liver disease – lifestyle changes as a basis for treatment

Lifestyle modification is extremely important in the treatment of NAFLD, consisting primarily of changing eating habits and increasing physical activity. For people who are overweight and obese, a gradual reduction in body weight (approx. 0.5 kg/week) is necessary. It has been shown that a loss of at least 7% of the initial body weight in these people reduces steatosis and reduces the inflammatory process in the liver. Appropriate physical activity adapted to the patient’s health and abilities will also be of great importance.

Stages of disease
Stages of disease

Non-alcoholic fatty liver disease – diet in NAFLD, what to choose, what to avoid?

Significant nutritional risk factors for the development of NAFLD include, above all, a high-energy diet, leading to an increase in body fat and excessive consumption of simple sugars and saturated fatty acids. Therefore, nutrition strategies should be based on optimizing the energy value of the diet and reducing the consumption of simple sugars and saturated fatty acids).

To date, the Mediterranean diet is undoubtedly the best-studied diet in the context of preventing and supporting NAFLD treatment. It is based primarily on leafy vegetables, legumes and fresh herbs.

Non-alcoholic fatty liver disease – the Mediterranean diet

The classic Mediterranean diet also has a lot of whole grains, in moderate amounts fish and nuts, as a source of polyunsaturated fatty acids, as well as milk and dairy products. Olive oil consumed a special place. Low meat consumption and moderate young red wine are also important. Desserts are primarily fruit – no added food sugar appears anywhere.

Such product selection – high consumption of plant products, low animal fat translates into an optimal share in the diet of monounsaturated and polyunsaturated fatty acids, dietary fibre and antioxidants, indicated in the context of prevention and treatment of NAFLD. Beneficial effects of this diet are observed in patients with NAFLD as early as 6 months after its use.

In the context of the development of NAFLD, the excessive consumption of simple sugars, especially fructose, is particularly unfavourable. High consumption of fructose or glucose from sweet drinks or highly processed products (e.g. sweets, confectionery, instant meals) has been shown to be associated with an increased risk of NAFLD.

The recommendations for reducing alcohol consumption for people with NAFLD are the same as for healthy people. In turn, coffee is a very desirable fluid in the prevention and treatment of NAFLD. Research indicates that regular consumption of 2-3 cups of coffee a day reduces the risk of developing and progression of NAFLD.