Ok… Have to put your science caps on for this one. But we are talking about how to decrease your risk of developing two major health problems… Fatty liver- or NAFLD and Heart Disease.
The incidence of fatty liver in the overweight population is very, very high. Fatty liver used to be most common in alcoholics… not anymore. Fatty liver or NAFLD leads to very significant downstream effects on our health. Worst case… it progresses to NASH where the liver fibroses (turns to scar tissue) and the only treatment is a liver transplant. Hep B used to be the number one reason people needed a liver transplant… not anymore. NASH is #1. NAFLD or fatty liver also leads to other inflammatory metabolic consequences and increases your risk of developing type 2 diabetes, heart disease, stroke, hypertension, and so on.
Although fatty liver is far more common in the obese (in some studies more than 50% of obese individuals have it) … it also occurs in lean people if their stomach is larger than their waist. The predictors of having NAFLD or lean fatty liver are high triglycerides, abdominal obesity, high AST, ALT (liver enzymes your physician measures at your annual physical). If those numbers are over 40, and your triglycerides are high… perhaps you should ask about whether or not an ultrasound of your liver is needed.
In addition to metabolic and genetic factors, muscle atrophy and loss of muscle strength, unhealthy eating patterns (i.e., High cholesterol and fructose intake), and changes in intestinal flora (your microbiome) are also important influencing factors that do not only promote the occurrence of fatty liver disease but also aggravate its progression. Studies have shown that the decrease of butyrate-producing Eubacterium may play an important role in the development of NAFLD. What does that mean?
You have more foreign DNA in your gut from bacteria than you have in the rest of your body. The microbiome has become a very important tool in assessing people’s health… and in moderating their risks for developing certain diseases. There will come a day soon where a stool transplant can cure disease… lead to weight loss, etc.
The bacterial species mentioned above is critically important to us maintaining good health. Why? Well… when the bacteria produce butyrate it causes many downstream effects that are beneficial to our health. Many! It decreases gut inflammation, decreases the risk of colon cancer, heart disease, NAFLD, and has been associated with decreased frailty, and improved cognition. WOW. Sounds crazy… it’s not. Check out the diagram below… those are some of the downstream effects of what happens when these bacteria are active in our gut.
Do we all have those bacteria? No. Why? Our diets. These bacteria thrive on lower glucose, lower fructose, higher fiber diets. So they are relatively absent in the guts of people who eat a typical American diet and they are higher in people who eat a more Mediterranean Diet. They thrive on fiber… that can be psyllium husk too… (Don’t go out and put down a cup of this a day… that’s not healthy either). The best way to increase fiber is to increase vegetables and legumes. The gassy feeling/bloating goes away as these bacteria reappear in your gut and start processing the fiber within a few weeks.
These same bacteria are capable of lowering cholesterol… as is the fiber itself. The fiber can bind to cholesterol in your intestine and prevent it from being reabsorbed into your liver. The bacteria can change cholesterol to another compound that we excrete.
This is a fascinating area of study… food as medicine. The more we learn about our microbiome the more fascinating it becomes.
If you have fatty liver…. or are suspicious talk with your doctor. In its early stages, it is treatable. NAFLD can take many years off your life… and unless you look for it you will not know it exists.