4 Strategies to Reverse Fatty Liver Disease Naturally
Fatty liver disease where there is excess buildup of fat around the liver is increasing globally, where the estimated numbers of people having the disease is around 25%. In 2007, the estimate for the Asian Pacific region was between 5% and 24%; it’s probably higher now.
In Asia alone, it is estimated that 20% to 30% of the adult population is afflicted with the disease.
There are basically 2 kinds of fatty liver disease: alcoholic fatty liver disease and non-alcoholic fatty liver disease or NAFLD. It’s the latter which is the most common among folks who don’t drink excessively and which I will share on the strategies to reverse fatty liver disease naturally.
What is Non-Alcoholic Liver Disease?
Non-alcoholic liver happens when there is excessive fat buildup in the liver. While it’s normal to have a little bit of fat in the liver, anything more than 5% fat in the liver classifies as fatty liver.
While fatty liver occurs in people who overindulge in alcohol, non-alcoholic fatty liver is different; it normally affects folks who are overweight, have prediabetes, Type 2 diabetes, metabolic syndrome and insulin resistance.
The problem with both normal and non-alcoholic fatty liver is that if left untreated, the condition can cause swelling to the liver resulting in non-alcoholic steatohepatitis (NASH) and later progress to liver cirrhosis and even liver cancer.
When the condition reaches the non-alcoholic steatohepatitis stage, inflammation and scarring of the liver occurs. If it gets worse, there’ll be scarring of the liver which will pave the way for the disease to progress to cirrhosis and liver failure.
The risk factors are obesity, high triglycerides levels, Type 2 diabetes, metabolic syndrome and insulin resistance.
Causes of Non-Alcoholic Fatty Liver
These are the main causes of non-alcoholic liver disease or NAFLD:
- Insulin resistance – this is by far, the most common denominator for NAFLD since most people who have this condition have Type 2 diabetes and metabolic syndrome both of which are caused by insulin resistance, even for people who aren’t fat or obese.
- Excessive consumption of sugar and refined carbohydrates – the modern diet is driving the rates of NAFLD up because sugar laden foods and drinks and highly refined carbs are its main characteristics, not only in the Western societies but also in Eastern ones like Japan. And we all know that such junk food causes insulin resistance which in turn contributes to NAFLD, Type 2 diabetes, metabolic syndrome, heart disease and a host of other chronic health conditions. Fructose, one of the main culprits in causing NAFLD in the form of high fructose corn syrup is added to so many common foods and beverages that it’s frightening.
- Obesity and visceral fat – obesity rates have been going up and it is very closely linked to an increased risk of NAFLD. And it’s not just adults who are getting NAFLD but obese children as well. And when a person is obese, he/she carries visceral fat i.e. abdominal fat which surrounds the organs in the body and visceral fat contributes to an increased risk of NAFLD. Now you may think that only obese folks have visceral fat. Unfortunately folks who aren’t obese may also be at risk of developing NAFLD because they can have visceral fat as well especially if the fat is around the midsection.
- Unbalanced intestinal flora and other gut issues – poor gut health especially unbalanced intestinal flora and other similar gut issues have also been linked NAFLD.
Symptoms and Diagnosis of Non-Alcoholic Liver Disease
- Loss of appetite.
- Enlarged liver.
- Pain in the upper right abdomen.
- Yellowing of the skin and eyes (jaundice).
Because this chronic condition doesn’t have any initial symptoms, most of the time folks who suffer from NAFLD discover they are afflicted with it only when they are tested for another condition and the results point to the liver as being a possible health issue.
To accurately diagnose NAFLD, these blood tests are used:
- Complete blood count.
- Liver enzyme and liver function tests.
- Tests for chronic viral hepatitis (hepatitis A, hepatitis C and others).
- Celiac disease screening test.
- Fasting blood sugar.
- Hemoglobin A1C, which shows how stable your blood sugar is.
- Lipid profile, which measures blood fats, such as cholesterol and triglycerides.
Imaging procedures are also included in the diagnosis of NAFLD:
- Plain ultrasound – this is often the initial test when liver disease is suspected.
- Computerized tomography (CT) scanning or magnetic resonance imaging (MRI) of the abdomen – although these procedures lack the ability to distinguish nonalcoholic steatohepatitis from nonalcoholic fatty liver disease, they may still be used.
- Transient elastography – this is an enhanced form of ultrasound that measures the stiffness of your liver. Liver stiffness indicates fibrosis or scarring.
- Magnetic resonance elastography – this combines magnetic resonance imaging with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver reflecting fibrosis or scarring.
Treating and Reversing Fatty Liver
Since both alcoholic and non-alcoholic fatty liver are chronic conditions caused by lifestyle choices, treating and reversing both types of fatty liver diseases would entail lifestyle changes. No medication will be able to reverse your fatty liver if you’re afflicted with it.
What I’ll do is go through each of the proven strategies that will slowly heal your liver and reverse it to its prior healthy state.
Since obesity and being overweight are one of the main risk factors and causes of fatty liver, then the obvious choice here is to lose weight.
Weight loss has been proven to be one of the most effective ways to get rid of fatty liver, whether it’s just by diet alone, a combination of diet and exercise or diet and bariatric surgery. In fact, just with diet alone with a 5% reduction from the initial weight will see improvements in the fatty liver conditions of those with NAFLD.
In this 6-month study of 31 patients with NAFLD by the University of São Paulo in Brazil, they were put on a calorie restricted diet which had a reduction of 500 to 1,000 calories per day. They were divided into 2 groups: the 1st group was to adhere strictly to the diet while the 2nd group adherence was relaxed. At the end of the study, the non-adherence group saw only decreases in BMI and waist circumference while the adherence group saw not only reductions in BMI and waist circumference, their insulin resistance, visceral fat and liver density tests also improved dramatically together with an increase in HDL as well.
In another study in Japan, 33 overweight adults were divided into 2 groups. The 1st group was asked to follow a calorie restricted diet while the 2nd group was instructed to exercise in addition to following a calorie restricted diet. At the end of the study, the 2nd group which had exercise added saw more reductions in body weight, BMI & visceral fat; both groups saw significant improvements in the reduction of liver fat.
Morbidly obese adults where bariatric surgery may prove more effective than dietary and exercise interventions will also see their NAFLD improving significantly after weight loss.
In a study by the GEM Hospital and Research Centre in India, all patients undergoing bariatric surgery from July 2012 to July 2013 underwent a routine liver biopsy at the time of bariatric surgery. If the biopsy specimen indicated NAFLD, patients were asked to undergo a 2nd biopsy after 6 months. 88 of 134 index biopsy specimens indicated NAFLD. All these patients had various levels of improvement of their NAFLD shown in their the 2nd liver biopsies 6 months after bariatric surgery.
Regular exercise done several times a week has been shown to be effective in decreasing fat in the liver even if the there is little or no weight loss.
The best types of exercise are endurance type exercise, HIIT (high intensity interval training) and resistance training.
In this 3-month study by the Tel Aviv Medical Center in Israel, 82 patients with NAFLD were randomized into 2 groups: the 1st group was assigned to do resistance training on non-consecutive days and the 2nd group was assigned to do stretching. At the end of the study, the resistance training group lost more liver fat, improved body composition and lipid profiles much more than the stretching group.
In a Japanese 5-week study by the Waseda University, 33 elderly men were instructed to go on the stationary bike 3 times a week. Their liver fat levels were measured before and after the study. At the end of the 5 weeks, cardiovascular endurance improved and liver fat was reduced although there wasn’t any weight loss.
In another British study by the Newcastle University, 28 Type 2 diabetic patients were randomized into 12 weeks of HIIT or standard care. By the end of the 12 weeks, there was a 39% reduction in liver fat of the HIIT group.
Newcastle University also carried out another 12-week study on 23 patients with NAFLD. Like the previous study, they were also randomized into HIIT and standard care groups. The HIIT (high intensity interval training) group was instructed to do 30 to 40 mins of stationary bike intervals 3 times a week. At the end of the 12 weeks, the HIIT group lost much more liver fat and body composition improved more than the standard care group.
All that being said, a large scale Italian study by the La Sapienza University in Rome randomized patients from 22 diabetes centers into low to moderate and moderate to high exercise programs that were done twice a week for 12 months. At the end of the study, both groups had similar reductions in liver and visceral fats.
If you’re a senior like me, I would suggest either HIIT on the stationary bike or an aerobic activity like brisk walking several times a week plus resistance training at least twice a week. This way, not only will you decrease your liver and visceral fats, you’ll also slow down muscle loss that comes with age (age-related sarcopenia).
Follow a Low Carb Diet
Since insulin resistance is one of the main causes of NAFLD and low carb diets improve insulin sensitivity, then following a low carb diet is the most logical thing to do when either preventing or reversing the condition.
The main reason for the success of low carb diets over other diets in the treatment of NAFLD stems from the fact that when carbohydrates are restricted, there are less blood sugar spikes and with that, less insulin spikes thereby decreasing insulin resistance.
In this pilot 6-month study by Duke University, 5 patients with NAFLD were instructed to follow a very low carb ketogenic diet with 20 grams of carbs or less per day. At the end of the 6 months, all the 5 patients saw dramatic improvements in their NAFLD besides losing a considerable amount of weight.
In another short 2-week study by the University of Texas Southwestern in Dallas, 18 patients with NAFLD were randomized into 2 groups. The 1st group was put on a very low carb ketogenic diet while the 2nd group was put on a calorie restricted diet. At the end of the study results showed that although patients in both groups saw reduced liver triglycerides, the very low carb ketogenic group saw higher reductions than the calorie restricted group.
In yet another study that prove that a low carb diet is the most appropriate diet for fighting NAFLD even short term carbohydrate restriction can help. In just 6 days on a low carb diet the liver volume and liver fat decreased to the level that it took a calorie restricted diet to achieve in 7 months.
In this 12-week study by the University of Córdoba in Spain, 14 obese men with NAFLD were put on a ketogenic Mediterranean diet. 13 of the participants had their liver fat dramatically reduced; and 3 of these 13 men had complete reversal of their NAFLD condition proving the efficacy of the dietary intervention.
Increase Natural Fat Intake Especially Mono-saturated Fats and Omega 3
Low carb and ketogenic diets are naturally high in fats. But what I’d like to emphasize is that if you have NAFLD, focus more on mono-saturated fats and omega 3 because these have been shown to be beneficial to folks with NAFLD.
In an Italian 8-week study by the Federico II University in Naples, 45 Type 2 diabetics with NAFLD were randomized into 4 groups: low GI (glycemic index) group, MUFA (mono-saturated fatty acids) group, low GI + exercise group and MUFA + exercise group. The 2 MUFA groups had over 25% reduction in liver fat while the other 2 low GI groups had only less than 10% improvement in liver fat reduction.
Another larger scale study was conducted by the University of Valladolid in Spain where 306 obese patients with NAFLD were randomized into 2 groups: mono saturated fats group and poly saturated fats group. The mono saturated fats group showed the most improved markers for liver fat at the end of the study.
This 12-month study that had 11 patients randomized into 2 groups showed that omega 3 was helpful for cutting liver fat as well. Olive oil enriched with omega 3 was included into the diet of the 1st group while the other group had their usual diet. At the end of the study, the group with enriched olive oil with omega 3 had dramatically improved liver enzymes while in the other group there wasn’t much change.
This other 6-month Italian study from the University of Catania confirmed that omega 3 had a positive impact on fatty liver. 40 patients with NAFLD were randomized into 2 groups: the 1st group received 2 grams of fish oil supplement per day while the 2nd group did not. By the end of the study the group that was given the fish oil supplement saw complete reversal of NAFLD in 33.4% of the patients while another 50% had overall reduction in liver fat. In contrast the group that didn’t receive the fish oil supplement saw only some liver fat reduction in 27.7% of the patients while the remaining 72.2% did not experience any positive change in their NAFLD.
In another 3-month Chinese study by the Third Military Medical University in Chongqing, China, 88 patients with NAFLD randomized into 2 groups with the 1st group given 4 grams of fish oil a day while the 2nd group was given corn oil. The results showed remarkable improvement in the liver enzymes and lipid profile of the fish oil group while the corn oil group didn’t see any improvement at all.
The therapeutic dosage of fish oil used in these studies was 2 to 4 grams a day so that’s what you should aim for if you’re consuming fish oil supplements. That being said, if you prefer not supplement with fish oil, eating fatty fish like salmon and cod several times a week will also help as would eating lots of avocados and olive oil both of which are rich sources of mono saturated fats.
Taking it Forward…..
Non-alcoholic fatty liver is easily preventable and also reversible in its early stages.
Following a whole food low carb diet with an emphasis on mono saturated fats and omega 3 with complete avoidance of sugar, processed and refined carbohydrates while exercising at least 3 times a week will not only prevent NAFLD from getting worse if you already have the condition, it will also slowly reverse it.
For folks who haven’t the faintest idea how to start on a low carb diet, I’ve written a post to simplify this for everyone.
If you need personal hand holding and coaching on starting and maintaining a low carb diet, I’m available for consultation; just email me: firstname.lastname@example.org or complete the contact form below.