A few months ago, I reviewed Skinny Liver, a book about the most common liver disease in the United States—nonalcoholic fatty liver disease (NAFLD). Some studies estimate that up to 30 percent of Americans have fatty liver disease.
In 2012, the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterology Association (AGA) and the American College of Gastroenterology (ACG) issued practice guidelines to help clinicians navigate this condition. The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance From the American Association for the Study of Liver Diseases was recently updated.
Key points about the NAFLD Guidance
What is NAFLD? Evidence of fat in the liver that isn’t caused by significant alcohol consumption, certain medications, or hereditary disorders.
NAFLD risk factors: NAFLD is commonly associated with obesity, type 2 diabetes, and high triglycerides and low HDL cholesterol. Other conditions that are associated with NAFLD are sleep apnea, colorectal cancer, osteoporosis, psoriasis, endocrine problems, and polycystic ovary syndrome.
Steatosis, NAFLD, NAFL and NASH: What the heck do these mean? Steatosis means that fat has infiltrated the liver cells. As I mentioned, NAFLD is evidence of steatosis that isn’t caused by significant alcohol consumption, certain medications, or hereditary disorders.
There are two categories of NAFLD: nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). In other words, NAFL and NASH are both forms of NAFLD. NAFL is the less serious of the two and is defined as the presence of 5 percent of steatosis in the liver without evidence of hepatocellular injury. A diagnosis of NASH means there is more than 5 percent of fat in the liver cells along with injury. There may or may not be fibrosis in the liver.
Is NAFLD Serious? Yes. There is the obvious risk of cirrhosis and liver cancer, but there are other risks. People with NAFLD have an increased risk of dying early. The most common cause of death in people with NAFLD is cardiovascular disease. There is also a higher risk of dying from cancer. Where liver-related mortality is the 12th leading cause of death in the general population, it is the second or third cause of death among those with NAFLD.
Can NAFLD be treated? Yes. If caught early, lifestyle changes such as exercise, weight loss, and eating a healthy diet can make a significant impact on fatty liver disease. Medications may also be prescribed, but lifestyle changes are critical.
Want to know more about fatty liver disease? Click here to learn more about this condition that responds well to modifications in diet along with exercise. Skinny Liver is available in Hep’s bookstore. Be sure you don’t read the entire book in one sitting. Try reading a chapter and then going for a walk. Your liver will appreciate it.