Among the most common health conditions and liver diseases in the Western world is non-alcoholic fatty liver disease or also called fatty liver. With the increasing incidence of obesity, diabetes and metabolic syndrome, there was a simultaneous increase of non-alcoholic fatty liver disease. What non-pharmaceutical options do we have to deal with fatty liver?
Definition and causes of NAFLD
Non-alcoholic fatty liver (NAFLD) is not a specific condition, but a wide range of conditions with a common feature, deposition of fat in hepatocytes of non-alcoholic origin. The progression of the disease may have poor health outcomes, as it may cause cirrhosis, liver failure or even cancer. Fatty liver is characterized by increased oxidative stress, inflammation and destruction of liver tissues (apoptosis).
Causes of fatty liver vary as it may be due to genetic factors or even lifestyle. Major risk factors for developing liver steatosis are:
- Insulin resistance
- Hyperglycemia, either in pre-diabetic or type 2 diabetes
- Hyperlipidemia and mainly high serum triglycerides
As the disease is asymptomatic, diagnosis is usually done randomly in a routine check or abdominal ultrasound.
Food supplements and treatment
It is a fat-soluble vitamin with strong antioxidant action. It supports the action of other antioxidants, such as vitamin A and in combination with vitamin C protects hepatocytes from oxidative damages of liver tissues, reduces levels of transaminase, fat accumulation in the liver and inflammation. Many studies have also shown that vitamin E can also prevent NAFLD. The recommended dose is 800-1,200 IU per day.
SAMe (S-Adenosyl-methionine) is a substance derived from the amino acid methionine and is known for its antidepressant properties. It has a strong anti-inflammatory activity while replenishes glutathione levels in liver, one of the most powerful antioxidant systems. Supplementation of SAMe normalizes liver enzymes while increases the ability of the liver to excrete toxins.
N-acetylcysteine (NAC) is a source of L-cysteine. It is a precursor molecule of glutathione, which is the basic mechanism of detoxification of cells. Individuals with NAFLD have reduced levels of glutathione. In addition, as NAFLD is characterized by increased oxidative stress, NAC helps in the production of glutathione and protect cells from the oxidative damage caused by free radicals and toxins.
Lecithin and betaine
Lecithin is a source of phosphatidylcholine which is further converted into choline. Choline is a precursor molecule in the production of betaine, a substance that helps reduce homocysteine levels in body. Studies have shown that supplementation of choline (lecithin) and betaine protects liver cells from NAFLD, as they help reduce serum lipids, decrease levels of transaminases and reduce fat deposition in the liver.
Coenzyme Q10 is the key energy of cells in the mitochondria. It has strong antioxidant and anti-inflammatory properties. According to several studies, supplementation of CoQ10 helps reduce liver transaminases and inflammatory factors (CRP) while also affects the profile of hormones responsible for fat deposition (leptin, adiponectin). The recommended dose is 100 mg daily.
Like vitamin E, omega 3 fatty acids exert strong anti-inflammatory action. They reduce the toxicity of fat accumulation in the liver (lipotoxicity) and appear to positively affect insulin action on cells (insulin sensitivity). In addition, omega 3 intake has been found to reduce serum triglycerides and histological lesions of the liver. The recommended dose is 750 to 1000 mg per day.
Some studies have shown that taking resveratrol (500 mg) can help protect tissues from oxidative stress in NAFLD. The reason is that it is a very potent antioxidant that activates AMPK, which reduces the deposition of fat in the liver and insulin resistance. However, more studies are needed on its effectiveness in treating NAFLD.
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