Narayana Health Care

Fat like other substances needs to be carried to every corner of your body. Here they may be used for energy formation. If the amount of VLDL and triglycerides in your blood are more than required for consumed energy, the remaining gets stored under your skin as adipose tissue and in the liver as glycogen for later use.

When too much fat is build-up in the liver with insulin resistance because of any causes other than alcohol use, it is termed as Non-Alcoholic Fatty Liver. The silver lining is that the problems associated with the Non-Alcoholic Fatty Liver affect the entire body but the liver itself. This means that the reversal of the condition is possible. The disease may later advance into non-alcoholic steatohepatitis (NASH) which involves liver inflammation along with other symptoms.

Prevalence of Non-Alcoholic Fatty Liver Disease is projected to be around 9%-32% in the general Indian population, with a greater incidence rate amongst obese and diabetic patients.

To reverse Non-Alcoholic Fatty Liver Disease:

1. Read about it – Reading is important, there is so much that is going on in the medical research. Technological advancements, new drugs have changed the way of healthcare delivery. Reading brings you steps closer to actual action.
2. Keep Monitoring – It is beneficial to monitor it. The diagnosis for fatty liver is expensive but to monitor improvement in the liver condition is well in your budget. You can opt for Liver function tests including biochemical parameters (AST, ALT, GGT or Alkaline phosphatase), bilirubin, and albumin levels, and coagulation tests as prothrombin activity. The evaluation of albumin and prothrombin levels helps you assess the hepatic function and thus improvement or reversal of fatty liver.
3. Wise Medication Management – Fatty liver usually associates its presence with other health conditions like:

• Diabetes
• High cholesterol
• High triglycerides
• An underactive thyroid, or hypothyroidism
• Sleep apnea
• Polycystic ovary syndrome
• The hypoactive pituitary gland, or hypopituitarism

You must keep them in control by taking all your medications on time. Insulin oral or injections (Diabetes) should be administered timely and carefully. You can always inquire about preventive aspirin dosage (Atherosclerosis and Hypercholesterolemia) from your doctor. Statins can be helpful too.

Vaccines for Hepatitis A and B are reported to be beneficial. So is the annual flu shot.

While taking some medication is beneficial, others like cold medications and prescription painkillers acetaminophen, NSAIDs like Ibuprofen, and Naproxen, if taken too frequently can be harmful to the liver. Keep a check on such over the counter pills.

4. Sleep good and keep stress levels low – Try meditation, morning laughter clubs. Yoga and Pranayama are yet another absolute ways to keep stress levels low. Follow the same sleeping pattern each day and No electronic devices in the bedroom.
5. Mandatory Diet Plan – Consult a dietician for a recall.

• Eat smaller frequent meals
• Add more vegetable and protein to your plate
• Switch to low fat and calorie options
• Try whole grains and sprouts
• Less salt
• Less Sweet
• Consume Omega3 in flaxseed oil, canola oil, and walnuts.
• Vitamin E

6. Reduce alcohol intake – If you can avoid altogether, nothing better.
7. Adopt an activity regimen with a mix of light exercises like

• Zumba
• Dance
• Aerobics
• Swimming
• Cycling
• Light Weight exercises

8. Keep your weight in check – According to a study, 10% of weight loss can help reversal of the disease. You can choose your weight loss options from above (diet and increased physical activity) or weight loss surgery can be a choice of treatment. It includes procedures like Gastric Bypass, Gastric sleeve, Biliopancreatic diversion with a duodenal switch, gastric balloon, or gastric band. Whichever method you choose should be approved by your treating clinician. Prescription weight-loss drugs such as Saxenda, Orlistat, Belviq, Contrave, phentermine, and Qsymia can be recommended after checking food allergies and medical history.
9. Visit your doctor regularly
10. Set goals for all parameters like blood sugar, blood pressure (if at all), HbA1c, weight, cholesterol measurements, and cheat days to ditch diet restrictions.

By incorporating such small measures in your life, you can not only reverse the nonalcoholic fatty liver but also cease the progression in other atherosclerotic diseases which in the long run lead to a healthy and disease-free life altogether.

Dr. Sanjay Goja | Program Director and Clinical Lead – Liver Transplant, HPB Surgery, and Robotic Liver Surgery | Mazumdar Shaw Medical Center, Bommasandra & Narayana Superspeciality Hospital, Gurugram