How Fat is Your Liver?
Think of two other people you know.
One of the three of you has a fatty liver.
Those are the stats for it, anyway. And even worse, up to one out of every four people that are obese have inflammatory liver disease, called nonalcoholic steatohepatitis (NASH).
As Nate explained last issue, NASH is characterized by inflammation and damage to the liver cells not caused by alcohol.
The good news is that fatty liver does not necessarily lead to NASH.
The bad news? NASH is on the rise, and it’s not easy to treat. Both fatty liver and NASH can be asymptomatic, meaning you don’t even know you have it. People usually find out after having blood work that shows elevated liver enzymes, and the diagnosis is confirmed by a liver ultrasound.
So what’s causing this epidemic of fatty, inflamed livers if it’s not alcohol?
Research hasn’t pinned down one specific cause of fatty liver, but risk factors include insulin resistance, obesity, and elevated blood lipids and triglycerides.
And what’s the biggest contributor to high cholesterol and triglycerides? Nope, not dietary fat.
So it’s not a surprise that one study found that excessive soft drink and fruit juice consumption was strongly correlated with fatty liver, even after controlling for other dietary factors and physical activity.
As little as one drink per day was correlated with fatty liver, but the most severe fatty liver was associated with four or more drinks per day.
Two of the most common soft drinks consumed were cola sweetened with 55% fructose and fruit juices colored with caramel.
To be clear, observational studies don’t prove causation, but other research has indicated that fructose (found in sodas and fruit juice) may be especially detrimental to the liver.
Fructose was originally thought to be a safer form of sugar for diabetics, because it does not spike blood sugar as much as glucose. Instead of being absorbed from the intestine to the bloodstream, fructose is sent to the liver for processing.
But once it’s there, fructose is easily metabolized to triglycerides. It also reacts with proteins to form advanced glycation end products (AGEs) which do exactly what their acronym implies – cause inflammation and age you.
Research is ongoing as to whether fructose is truly worse for you than glucose, but one thing is clear — refined sugar and a high-carbohydrate diet have been connected to fatty liver disease.
I was surprised by one finding from the study- that diet cola was also one of the most frequently consumed beverages linked to fatty liver. Since diet soda doesn’t contain sugar, something else about the soda was at work, and the researchers think it’s the aspartame.
Does this dress make my liver look fat?
The issue with aspartame (or one of them, anyway) is that it is metabolized in the liver, and the liver just doesn’t seem to know what to do with it. According to the study authors, aspartame metabolism causes mitochondrial dysfunction, contributes to fat accumulation, and damages mitochondrial DNA, which can all lead to fatty liver.
However, new research indicates diet soda may have an even more insidious effect by actually contributing to weight gain (which is a risk factor for fatty liver).
How can something without any calories actually cause weight gain?
Be on the lookout for your June issue of Natural Health Solutions, because I’ll give you all the details there. (Not a subscriber? Get signed up here.)
Back to the study- another suspected culprit in the study was the caramel color found in regular and diets colas and specific fruit juice drinks. The researchers state that caramel color could contribute to fatty liver because it contains inflammatory compounds and may contribute to insulin resistance.
As I mentioned before, the scary part about fatty liver is that once it has progressed to NASH, it is very hard to stop or reverse the condition.
Only 12 of the 31 patients in the study who completely stopped drinking sugary beverages were able to revert their liver to a normal state.
(It doesn’t say that they were asked to stop drinking diet soda, though, which is curious. I wonder if success rates would have been better if they made sure not to drink diet soda as well.)
According to the Cleveland clinic, treatment involves weight loss and limiting carbohydrates and fructose consumption. Certain medications are being investigated for treating fatty liver, and just recently, new research suggests vitamin E may be an effective treatment for NASH.
Prevention is key.
Kick the soda habit, even diet soda. Reduce your sugar and refined carbohydrate intake. Avoid caramel and other artificial colors. Watch out for aspartame.
One reader wanted to know if sucralose (Splenda) is a safer option. Research in animal and humans is suggesting no, it’s not. It’s been found to reduce beneficial bacteria in the gut, raise blood sugar and insulin levels, and may even cause DNA mutations.
(Mom and Dad, if you’re reading this, please throw out your Splenda packets!)
Avoiding sugar and artificial sweeteners is advice you’ve probably heard before, but it bears repeating. It’s not just about keeping a healthy weight to look good, but protecting one of your most vital organs.
Take care of your liver. You have only one.
To living well,
P.S. Like what you’re reading? Have a health topic you’d like us to research? Let us know! firstname.lastname@example.org
Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Can J Gastroenterol. 2008 Oct; 22(10): 811–816.
Sucralose, A Synthetic Organochlorine Sweetener: Overview of Biological Issues. J Toxicol Environ Health B Crit Rev. 2013 Sep; 16(7): 399–451.
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