This is how you protect yourself from fatty liver disease

More and more men are suffering from the dangerous consequences of fatty liver, even those who are slim. Here you can find out how it arises and how to prevent it

What exactly is fatty liver?

As the name suggests, this disease is an obesity of the organ. The fatty liver – medically called “steatosis hepatis” – arises from the storage of fat in the liver. This fat is deposited in the liver in the form of fat vacuoles. Even if a fatty liver can regress, you should not underestimate the disease. Because the fatty liver is considered the preliminary stage of diseases such as hepatitis or cirrhosis of the liver.

We explain the common disease, its causes and symptoms and tell you how you can protect yourself: Starting with a healthy diet to losing weight, because obesity is also one of the reasons for fatty liver.

What are the causes of fatty liver?

For a long time, liver obesity was practically only diagnosed in people who drink too much alcohol. The causes of fatty liver can also be found in the wrong diet.

This is about the so-called non-alcoholic fatty liver(after the English term non-alcoholic fatty liver disease, abbreviated NAFLD), the cause of which lies in the derailment of the metabolism, mostly triggered by improper nutrition. The liver is not only responsible for detoxifying the blood. It also ensures that the cells always have all the nutrients they need. This is why a healthy liver always has a small amount of fat on hand. However, if you overeat too quickly for too long, a chain reaction starts that causes the body to store more fat than the naturally intended amount. Doctors speak of fatty organism when more than 5 percent of the liver cells have visibly stored fat. In a full-blown fatty liver, it is even 50 percent of all cells or even more.

What are the symptoms of fatty liver?

Your liver can almost suffocate in fat, but you don’t notice anything – the organ doesn’t feel any pain. Only when the liver is already greatly enlarged is it sometimes noticeable through feelings of pressure in the upper abdomen. (If it hurts badly in this area, it is mostly migrating gallstones – completely different construction site.) A stressed liver can also make itself felt through tiredness – but who leads such a relaxed life that there are not umpteen other reasons for the dullness Question could come? Until the liver is irreversibly damaged, there are practically no symptoms. A timely diagnosis is therefore difficult.

The fatty liver can be seen on the ultrasound image, but very late: “Only when significantly more than 10 percent of the cells have stored fat,” adds Worm. More precise imaging processes are so complex and expensive that they are only used in studies. A biopsy, i.e. a tissue removal, would also be very accurate. However, nobody undertakes such drastic interventions without justified suspicion – being often tired is not a sufficient indication on its own. Fortunately, an abundance of studies has now shown that the doctor can find out about obesity by combining different blood values.

Fat trap: sick can soon become life-threatening
An obese liver suffers in a number of ways. Inflammation often occurs. The possible consequences are always the same, whether it is fat, viruses, alcohol or other poisons: If it cannot be contained, more and more liver tissue loses its function and becomes scarred – this is called fibrosis and later cirrhosis. A tumor can then develop from the fibrinous tissue. But even if that doesn’t happen: at some point a cirrhotic liver will no longer be able to perform its tasks, and without a transplant, that’s it. But as startling as these prospects may be, obesity in your liver has put your life in serious danger long before it happens, because it drastically increases the risk of diabetes, heart attacks and strokes.

What are the dangers of fat deposits in the body?

Not only fat people have fatty livers. Around 15 percent of slim people also suffer from it. The reasons for this are fat deposits in the body and genetic causes.

Researchers call those affected Tofis (from thin outside, fat inside – i.e. thin outside, fat inside). Their often poor blood lipid values ​​have puzzled the doctors – only now are the connections slowly clearing up. The root of fatty liver disease is how the body deals with the excess calories. Some people can park a lot of fat exactly where it belongs, namely under the skin. Even if the bacon rolls created in this way don’t exactly improve your chances of flirting on the beach: this is probably an advantage for your liver. In these people, despite being significantly overweight, their blood values ​​are often okay; their risk of developing diabetes or suffering from a heart attack is not increased. But in people whose bodies cannot store the fat in the subcutaneous tissue, it often ends up in tissues that cannot handle it. One speaks of ectopic (stray) fat. In the beginning only the liver is affected, but later almost all other organs of the body, including the brain and bones. The stray fat paralyzes the cells and can even kill them. 

Disturbed vessels: The fat wanders around dangerously in the body
The fat becomes a danger if the body doesn’t know what to do with it. A layer of fat would be a great place – but this is a highly active tissue and must therefore be well supplied with blood. However, if you eat really lavishly for a long time, you force the fat cells to grow and multiply very quickly – the blood vessels may not keep up. Then the cells are no longer adequately supplied with oxygen and send out alarm messages that fuel inflammation and thus stimulate vascular growth. “The inflammation also reduces the cells’ sensitivity to the hormone insulin,” explains expert Worm. This works like a key, without which no new fat can get into the cells provided for it.

When this happens depends on the individual and also genetically. The fact is: fat goes astray faster in men. Whatever your figure looks like: a bulging stomach is an alarm signal! The ball indicates that fat has accumulated in the abdominal cavity – then the liver is practically always fatty. And don’t try to blame everything on genes – lifestyle also plays a decisive role. Numerous factors influence whether an inflammation just flares up or blazes up – for example, whether you are well supplied with nutrients such as vitamin D and omega-3 fatty acids. But stress and poor sleep also fuel the process. Ultimately, two questions are decisive: How much exercise do your muscles get and where do the calories you feed come from?

Killer glucose: carbohydrates cause fatty liver

Ultimately, carbohydrates are primarily responsible for fatty liver, and most of them consume (too) many nowadays.

It may seem like a contradiction, but the connection becomes clear when you look at the role of insulin: When you eat, all the usable carbohydrates end up in the blood as individual glucose molecules. With the help of insulin, they are channeled into cells. It has to be done quickly, otherwise the sugar will damage the blood vessels. So that glucose has priority, insulin slows down fat utilization. In the cells, the glucose is either used immediately for energy production or stored in the liver and muscle cells. These memories are limited, however, because glucose is just a wild card for intense exertion. If these don’t exist, meaning you lead a comfortable life but still eat plenty of carbohydrates, the stores are full. This initially makes your muscle cells less sensitive to insulin – they keep the door closed, so to speak. In order to get rid of the excess sugar anyway, more insulin is released. And indeed the glucose disappears from the blood – but where does it go?

A study from Yale Universityshows: In this metabolic situation, the insulin resistance, the glucose is converted into fat in the liver. In this situation, however, the doors of the fat cells are often tight. You already know what happens next: the fat has to be stored in the liver or ends up in other tissues via the bloodstream. It then triggers inflammation in the vessels, which can promote arteriosclerosis on the inside of the veins. If it is the coronary arteries that seal, it comes to a heart attack, if arteries in the brain are affected, you suffer a stroke. The risk of diabetes also increases: with increasing obesity, the pancreas and liver also become insulin-resistant, they can then hardly be regulated – and the sugar metabolism derails more and more. If even enormous amounts of insulin are no longer enough,

How do you prevent fatty liver disease?

You can prevent fatty liver disease, especially by losing weight. But a lighter lifestyle, i.e. more sport and less sugar, is also a precaution.

The liver can recover if you lose weight. You don’t have to wait until your figure is fit for the beach again. Research by the University of Newcastlehave shown that you can defat the liver quickly and effectively without losing too much weight: by fasting. The test subjects (all diabetics) consumed 600 calories daily in the form of powder shakes, plus 200 calories from vegetables with a little dip – and in this way already lost 30 percent of liver fat in the first week. Both the blood lipid and blood sugar levels improved immediately. In the further course, even pancreatic cells believed dead regenerated.

“The key to this development, which was first observed after gastric surgery, is the drastically reduced energy intake,” says expert Worm. It is even better if the 800 calories allowed daily contain as few carbohydrates as possible but enough protein: “Otherwise too much muscle mass will be broken down.” If you are carrying a lot of excess weight with you, however, a 2-week fast is usually not enough to make muscles and adipose tissue sensitive to insulin again. That means: If you don’t want to bring your metabolism back on the wrong track, you either have to fast more often, lose weight significantly or shape your life a little differently – above all more actively.

More exercise and less sugar than prevention

To prevent your liver from becoming fatty again after such a fast, it is best to try a double strategy:

  1. Increase movement: More endurance training is good, more strength training is even better. Because the more muscle mass you have, the more blood sugar you can store. In addition, thicker muscles consume more energy with every movement. Studies show: Even in people who are already insulin-resistant, every burst of activity improves their current situation, and the effect lasts for the rest of the day. 
  2. Lower insulin requirements: Eat in such a way that the body can get by on smaller amounts of the hormone. Reduce your carbohydrate intake and give your metabolism as much relief as possible during the night. Do not add anything after dinner, especially no carbohydrates (so no beer, no apple carvers). About 4 hours after the last bite (which you slept through blissfully), the healing mini-fast begins until the first meal of the new day. Increase the effect by having a low-carb dinner or (if breakfast is not your cup of tea) extending the insulin break until morning. Even coffee without milk and sugar does not destroy the effect. This is how you keep your metabolism on track – and your liver fit.

How do I eat properly if I have fatty liver?

Now you know how to prevent fatty liver disease. But what to do if you already have fatty liver? First of all: don’t panic! Fatty liver is basically a benign disease. Only if the causes that led to the liver damage are not eliminated in good time can it become a serious danger and in the worst case lead to liver cirrhosis or hepatitis. Otherwise, fatty liver disease can usually even completely regress. Here are a few tips on which diet can contribute to the regression of fatty liver:

  1. Goodbye alcohol:   If you suffer from fatty liver, you should completely avoid alcohol.  
  2. Drink plenty of water: The basic requirement for a balanced and healthy diet is to drink enough fluids: At least 2 liters a day. Conventional mineral water or tea is recommended. Fruit or vegetable juices should only be drunk diluted.
  3. Rely on whole grain products: If you have the choice between whole grain bread or white bread, then it is best to opt for the former and avoid the quickly digestible sugars that are found in white bread, cakes or sweets, for example.
  4. Fruit and vegetables: True to the motto: “One apple a day, keeps the doctor away”, you should buy fruit and vegetables, because they contain many vitamins and minerals. Already knew? In order not to lose such valuable substances when cooking, it is advisable to only briefly cook or stew the vegetables. 
  5. Protein, protein, protein: foods containing protein are particularly helpful in combating fatty liver. Hard-boiled eggs, (lean) quark, yoghurt or cheese are ideal sources of protein. But be careful: it is better not to grab cheeses that are too fatty and avoid the mostly fatty fried eggs or scrambled eggs with bacon. 

The general rule is: Avoid a diet that is (too) high in fat. You should also make sure not to consume too many carbohydrates, but rather to follow a protein-based diet – with plenty of fresh fruit and vegetables. 

Medical check-up: this is how you recognize fatty liver

Perhaps it will soon be enough to take a single blood test to detect fatty liver disease. Until then, your doctor has to collect several values ​​and combine them correctly. A check overview.

1. Collect classic blood values: For a meaningful indication of the state of the metabolism, you need two blood values ​​that your doctor may have already collected during a check-up: the triglycerides (free fats) and the “good” HDL cholesterol. Then you do the math: Triglyceride value divided by the HDL value. The result should be less than 2. Significantly higher values ​​(in men from 3.5, in women from 2.5) are typical for insulin resistance – thus also for fatty liver and an increased risk of diabetes and heart attack.

2. Measure blood sugar levels:The fasting value is usually measured, but this is the last to react conspicuously. The result – usually given in milligrams per deciliter (mg / dl) – becomes more meaningful if you also have the insulin content in the blood measured. This is given as a thousandth of a standard unit (mU for milli-unit) per milliliter. You multiply the glucose value with the insulin value and divide the result by 405. Values ​​greater than 2 indicate insulin resistance. Diabetics are at 5.

3. Analyze typical liver values:There are 3 blood tests that indicate liver cell damage. You will find the abbreviations GPT, GOT and GGT on the laboratory slip. But these values ​​are not always reliable: even if they appear normal, the liver can be fatty or even inflamed. In any case, increased values ​​are an occasion to check whether a fatty liver is present.

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