Nonalcoholic Steatohepatitis or NASH is a silent liver disease. The major feature is fat storage in the liver, along with inflammation and liver damage. In its early stages, when there is just fat in the liver but no inflammation or damage, it is called “fatty liver” or nonalcoholic fatty liver disease (NAFLD). Both NASH and NAFLD are becoming more common in adults and children. Recent studies estimate its prevalence to be up to 30% in the United States. Its incidence is associated with obesity, hypertriglyceridemia, hypertension, and insulin resistance—the regular culprits.
It’s not really surprising if you think of the average American. Half are on at least one prescription. No exercise. A diet high in processed chemically laden foods, saturated fats, with a high glycemic load. While at the same time the diet is low in antioxidants, phytochemicals, and fiber. Add all these to toxins coming from their personal care and household products. So no surprise, you combine a crappy diet with day-to-day exposure to chemicals and its’ a big double whammy, Tammy.
I think you can guess the basic recommended changes. First, find the toxins in your house and personal care products and work to get rid of them. Start a slow detoxification program with saunas and exercise.
Nutritionally the first thing you do is CUT OUT THE CRAP.
All the diet changes that can help insulin resistance, obesity, and metabolic syndrome can also help NAFLD:
- Cut the fat. High fat diets have been found to be associated with deteriorated NAFLD and hyperlipidemia.
- Make sure the fat you do get is good fat.
- NAFLD is a characterized by steatosis, the abnormally high accumulation of triacylglycerols in liver tissue, which is associated with an impairment in the bioavailability of LCPUFAs. Researchers have demonstrated significant improvement in hepatic steatosis and inflammatory parameters in patients treated with EPA plus DHA (1 g, 0.9/1.5 EPA/DHA ratio) daily during 12 months.
- Delta5- and Delta6-desaturase activities may also be altered in NAFLD. These desaturase enzymes require cofactors such as Mg, Zn, and vitamin B6.
- Dietary cholesterol plays a determining, independent role in inflammation, especially in animal studies. Avoid foods that increase it.
- Many patients with NASH also have micronutrient deficiencies and do not have enough antioxidant capacity to prevent synthesis of reactive oxygen species (ROS), resulting in necroinflammation.
- Vitamin C and E have been found to be lower in people with NAFLD.
- Get good concentrated sources of antioxidants like pomegranate juice or tomato paste.
- Control Blood sugar.
- Aim for a diet with a low glycemic load.
- Avoid high fructose corn sugar (HFCS). Fructose increases lipogenesis which can lead to fat accumulation in the liver. But diet sodas are not your answer. The aspartame sweetener and caramel colorant are rich in advanced glycation end products which can potentially increase insulin resistance and inflammation.
There is not a lot of literature on the best diet changes. I guess that’s partly because it’s pretty obvious: consume a diet high in fruits, vegetable, whole grains and legumes. Let me know what you have tried and what has been successful. ~ Dr. Elizabeth Redmond
Causes of Nonalcoholic Fatty Liver Disease (P Angulo, 2006)
||Obesity, glucose intolerance, hypertriglyceridemia,
low HDL cholesterol, hypertension
||Protein-calorie malnutrition, rapid weight loss,
gastrointestinal bypass surgery
||Glucocorticoids, oestrogens, tamoxifen, amiodarone, methotrexate, diltiazem, zidovudine, valproate, aspirin, tetracycline, cocaine
||Lipodystrophy, hypopituitarism, dysbetalipoproteinaemia
||Amanita phalloides mushroom, phosphorus poisoning,
petrochemicals, bacillus cereus toxin
||HIV, hepatitis C, small bowel diverticulosis with bacterial overgrowth
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