The liver is a very important glandular organ, which is entrusted with numerous bodily functions.
Among other things, it is responsible for the metabolism of nutrients (amino acids, carbohydrates, lipids), the storage of vitamins and the transformation of all pharmacologically active molecules (drugs, caffeine, alcohol, etc.).
When functional overload occurs in the synthesis of fats, these are stored in the hepatocytes (liver cells), which become inflamed and sometimes break down.
We speak of fatty liver (hepatic steatosis) when the organ increases in size until it exceeds + 5% of the normal volume.
The causes of fatty liver can be traced back to: genetic disorders, metabolic pathologies, malnutrition and dietary factors, alcohol addiction, anemia, drugs, etc.
It occurs more frequently in people aged 50-60 and in pregnant women.
Fatty liver is often asymptomatic or causes localized discomfort in the right quadrant of the abdomen (not to be confused with gallbladder discomfort).
If neglected it can worsen into more serious ailments.
- Exclude alcoholic beverages.
- If you are overweight (especially in the visceral area), lose weight.
- Treat any metabolic diseases such as:
- Metabolic syndrome.
- Insulin resistance, hyperglycemia and type 2 diabetes mellitus.
- Hypertriglyceridemia.
- Hypercholesterolemia.
- Adhere to a proper diet (see below); in particular, it is necessary to keep under control:
- Amount of calories.
- Levels of vitamins.
- Breakdown of energy nutrients.
- Distribution of meals.
- If the subject lives in 3rd or 4th world conditions, cure Kwashiorkor.
- Prevent or treat severe anemia.
- Limit the intake of toxic molecules, drugs, pharmacologically active molecules, contaminants and pollutants.
- If present, treat hormonal imbalances of: cortisol, ACTH, T3, T4 and catecholamines.
- Drugs: cortisone, tetracyclines, anabolic steroids.
- Nervini: caffeine, theophylline etc.
- Certain food additives.
- Contaminants and pollutants: for example carbon tetrachloride.
The fatty liver diet may be slightly different depending on the individual's nutritional status:
- In case of obesity or overweight with evident visceral deposit, the diet should be low-calorie slimming. A reduction in total calories of -30% is recommended.
- The distribution of nutrients is similar to the traditional one of the Mediterranean diet, with greater importance of complex carbohydrates than simple ones and unsaturated (especially polyunsaturated) fats compared to saturated ones.
- The distribution of meals is quite traditional: breakfast 15% of the total calories, 2 snacks at 5%, lunch at 40% and dinner at 35%. It is possible to emphasize snacks to decrease the caloric intake of lunch and dinner.
- Since hepatic steatosis worsens as the glycemic index and glycemic load increase, the sources of carbohydrates should be:
- Low glycemic index: vegetables, slightly or medium sweet fruit, legumes and whole grains.
- In moderate portions: it is advisable not to exceed 150g of fruit at a time and 60-70g of cereals for first courses, legumes or bread at a time.
- Foods rich in fiber: especially the soluble ones which are able to modulate intestinal absorption.
- Foods rich in good fats: they have a positive effect on lipemia and improve the metabolic condition; particularly:
- Omega 3: they are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha linolenic acid (ALA). They play a protective role against all metabolic diseases and have an anti-inflammatory role. The first two are biologically very active and are mainly contained in: sardine, mackerel, bonito, sardinia, herring, alletterato, tuna belly, garfish, seaweed, krill, etc. The third, on the other hand, is less active but constitutes a precursor of EPA; it is mainly contained in the fat fraction of certain foods of vegetable origin or in oils of: soy, linseed, kiwi seed, grape seed etc.
- Foods rich in antioxidants:
- Vitamins: the antioxidant vitamins are carotenoids (provitamin A), vitamin C and vitamin E. They have a beneficial effect on all metabolic parameters, as they hinder oxidative stress.
Carotenoids are contained in vegetables and red or orange fruits (apricots, peppers, melons, peaches, carrots, squash, tomatoes, etc.); they are also present in crustaceans and milk.
Vitamin C is typical of sour fruit and some vegetables (lemons, oranges, mandarins, grapefruits, kiwis, peppers, parsley, chicory, lettuce, tomatoes, cabbage, etc.).
Vitamin E can be found in the lipid portion of many seeds and related oils (wheat germ, corn germ, sesame, etc.). - Minerals: zinc and selenium. The first is mainly contained in: liver, meat, milk and derivatives, some bivalve molluscs (especially oysters). The second is mainly contained in: meat, fish products, egg yolk, milk and derivatives, enriched foods (potatoes, etc.).
- Polyphenols: simple phenols, flavonoids, tannins. Some fall into the group of phytosterols (isoflavones). They behave more or less like vitamins. They lower oxidative stress and optimize lipoprotein metabolism; appear to correlate with a reduction in total and LDL cholesterol. They are very rich in polyphenols: vegetables (onion, garlic, citrus fruits, cherries, etc.), fruit and relative seeds (pomegranate, grapes, berries, etc.), wine, oil seeds, coffee, tea, cocoa, legumes and whole grains, etc.
- Foods rich in purifying and restorative substances for the liver: they are mainly cynarin and silymarin contained in artichoke and milk thistle.
- In case of protein malnutrition (third and fourth world, anorexia nervosa, severe alcoholism, etc.), improve the biological value of proteins and ensure their minimum daily intake.
- In case of generalized vitamin malnutrition (third and fourth world, anorexia nervosa, severe alcoholism, etc.), ESPECIALLY increase the intake of vitamin B12 (contained exclusively in foods of animal origin), biotin (like the previous one) and pantothenic acid (especially in legumes and in the liver).
- In case of severe anemia, increase the intake of:
- Heme iron: contained mainly in meat, offal and fishery products.
- Cobalamin: Vit B12 is typical of foods of animal origin.
- Folic acid: it is characteristic of raw vegetable foods (lettuce, apples, oranges, etc.).
- Especially avoid junk foods, fast foods, pastry foods etc.
- Supplements for metabolism:
- Silymarin and cynarin: purifying and regenerating for the liver.
- Glutathione.
- Phosphatidylcholine.
- Polyphenols and other antioxidants.
- Lecithins and phytosterols.
- Absorption modulating supplements:
- Fat sequestering agents: chitosan, lecithins, etc.
- Sequestering carbohydrates.
- Fibers: psyllium seeds, guar gum, glucomannan, guggul etc.
- Herbal remedies (for decoction, infusion, drug in capsules or tablets, etc.):
- Gentian.
- Artichoke.
- Milk thistle.
- Propolis.
- Rosemary sprouts.
- Fenugreek.
- Garlic.
- Licorice.
- Gymnema.
- Antidiabetics:
- Pioglitazone: for example Actos and Glubrava.
- Rosiglitazone: for example Avandia.
- Anti-obesity drugs:
- Orlistat: for example Xenical and Alli.
- Nutraceuticals:
- Betaine: for example Cystadane.
- Drugs for alcohol abuse:
- Metadoxine: for example Metadoxil.
- Especially hyperglycemia (or type 2 diabetes mellitus), hypertriglyceridemia and hypercholesterolemia.
- Intragastric balloon.
- Gastric band.
- Gastric bypass.
