When people hear about fatty liver disease (FLD), they usually shrug it off as something that happens to people who consume alcohol every day or who binge drink. Add in poor dietary habits, and it’s a recipe for FLD, cirrhosis, and even liver organ failure.
But today, nonalcoholic fatty liver disease (NAFLD) is increasing in prevalence, and not just in adults—children are being diagnosed with NAFLD at an alarming rate. In fact, NAFLD has become the most common cause of liver disease and can lead to NASH (nonalcoholic steatohepatitis, which is liver cell damage as well as fat and inflammation in the liver), cirrhosis, and liver cancer. According to the National Institute of Diabetes and Digestive and Kidney Diseases (part of the National Institutes of Health):
- 30 to 40 percent of adults (about 1 in 3) have NAFLD
- about 10 percent of children between the ages of 2 and 19 in the US have NAFLD
- between 80 and 100 million Americans have NAFLD
- approximately 7 million American children have NAFLD
- 38 percent of children with NAFLD are obese
- 23 percent of children with NAFLD have NASH
- 24 percent of people globally have NAFLD, nearly doubling over the past 14 years
Like the name states, nonalcoholic fatty liver disease is an accumulation of fat in the liver that’s not caused by regular or excessive alcohol consumption. Risk factors include hypothyroidism, insulin resistance, hyperglycemia, type 2 diabetes (which can also result from NAFLD), obesity, choline deficiency (an essential nutrient; approximately 90 percent of Americans are deficient) and other factors. In addition, prescription and OTC medications as well as poor dietary choices also lead to NAFLD, including things like fried foods, foods and drinks with added sugar, carb-heavy foods (white bread, pasta, etc.), fat-laden foods, and high amounts of salt. The liver needs plenty of water to help it function optimally, so dehydration—something that affects up to 75 percent of Americans—can be another contributing factor.
As reported by many sources including the National Institutes of Health (NIH), NAFLD is the primary cause of chronic liver disease, and its prevalence is increasing at a rate equal to the increase of obesity. Researchers believe that soon, NAFLD will become the main cause of liver-related illness and death. Although the medical community has found very few treatments for NAFLD, a strong spotlight is now being focused on the liver-gut-diet connection, since there’s a close functional association between the gut and liver. In an NIH review on PubMed, researchers stated that “the current evidence supports the association between NAFLD, the gut microbiome, and the role of diet.”
Research from multiple studies has found that exercise is one important component to preventing NAFLD and other diseases of the liver. Resistance exercises in particular were shown to lower the amount of fat in the liver and also significantly reduced cholesterol levels. Studies also showed that any type of physical activity can help—liver fat in participants of the study decreased 0.87% for every 1,000 steps taken, whereas liver fat increased 0.87% for every hour of sedentary behavior.
The latest study states that probiotics were beneficial in treating both NAFLD and NASH—with no major adverse side effects. Not only did probiotics restore gut flora to normal, they also reversed or stopped the progress of these diseases. The importance of a healthy gut microbiome is something functional medicine practitioners have long known, and your functional medicine doctor can determine which type of probiotic will return balance to your microbiome. But remember that probiotics, like all other supplements, are not a one-size-fits-all solution—it’s never a good idea to self-prescribe supplements.
Every probiotic is different, not all are of good quality, and not everyone needs the same amount or the same type. Taking the wrong probiotic or the wrong quantity for your particular imbalance can throw your gut balance even further out of whack.
While the right probiotic for your gut health is important for many reasons, supplements alone aren’t enough. Dietary changes are necessary to get and keep your microbiome in proper balance which, for the most part, will eliminate the types of foods that contribute to or worsen NAFLD. In general, a diet of whole foods—fresh fruits and vegetables, healthy fats, grass-fed meats, whole grains—is great for your gut balance and can help make you healthier in general.