Written by There is a lot of talk about the prevalence of non-alcoholic fatty liver disease (NAFL) and its increase. NAFL comes as quite a shock to a lot of people seeing as how for a long time, fatty-liver was considered a disease that only plagued those who tended to enjoy alcohol, but as we take a look into what fatty-liver actually is, we can see why its increased prevalence makes sense.
NAFL is basically an accumulation of excess fat in the cells of the liver (hepatocytes). The severity can vary a lot, from simple symptoms (i.e an elevated blood score) to progressively worse forms ending in cirrhosis or end-stage liver disease. This means that while there can be genetic factors involved, generally nutrition and lifestyle is a big contributing factor to NAFL.
How?
Well, to over-simplify it: When an individual has an increased energy intake (generally from sugar) those molecules need to go somewhere. Ideally, the release in insulin would push the glucose into muscle cells and then into the liver -with very little ever entering your blood stream (this is why if blood sugar is elevated, there has been an excess for a while). However, when skeletal muscle is low and the energy intake is high the increased demand for storage can result in the buildup of fat on the liver. So, those with obesity, type-2 diabetes, insulin resistance, and dyslipidemia will have a higher risk factor.
Alright, so now that we have an idea of how NAFL progresses, let’s get to the good stuff: What can we do about it!
Balance Energy Intake Through Nutrition & Exercise
This one is an obvious one. We already learned that too much energy-in (generally through sugar intake) needs to be stored somewhere, so those that cannot regulate their metabolic function and energy-out will be more likely to develop NAFL.
Generally speaking, those that are insulin resistant will have a tougher time regulating these functions so reducing the energy-in that you are getting from less-than-ideal sources is a great place to start. Focus on reducing energy-dense foods like processed foods, processed carbs, and very high-fat foods. Get in a ton of veggies, a good amount of protein, and high quality fats. This will ensure you have the more nutrient-dense food, but without a huge increase in calories.
The next step is to get rid of that stored energy and balance what you’re getting in. Exercise during the week, lift weights to increase muscle mass and therefore your ability to store glucose, and move as much as possible. If you’re insulin resistant, doing some low-intensity cardio work can do wonders for improving metabolic flexibility.
Supplement with L-Carnitine & Alpha-Lipoic Acid
I’ve realized that I don’t like to do too much hard-teaching in these posts, so we’ll speak about the research behind these compounds.
Both L-Carnitine & ALA have been used successfully in improving values related to NAFL, as well as acting in a preventative and protective manner for the liver and its enzymatic processes. While both L-Carnitine & ALA can improve energy metabolism, the great thing about both is that L-Carnitine wors through pushing beta-oxidation and using fat for energy, while ALA will work more on the side of pushing glucose into cells to be metabolized for energy. The other benefits of ALA and LCARN are also on the anti-oxidant potential and the protection from cell damage.
The only caveat is that neither of these supplements can be used effectively if there is no form of exercise or no way to properly use energy. While ALA and LCARN can improve energy function and start to liberate energy stored in hepatocytes on the liver, it still needs to go somewhere.
ALA has also been shown to improve ALT and AST values on blood panels (Gianturco, 2013)
However, when used properly, the benefits are substantial.
James
References:
Gianturco, Vincenzo, et al. “Impact of combined therapy with alpha-lipoic and ursodeoxycolic acid on nonalcoholic fatty liver disease: double-blind, randomized clinical trial of efficacy and safety.” Hepatology international 7.2 (2013): 570-576.
Masuoka, Howard C., and Naga Chalasani. “Nonalcoholic fatty liver disease: an emerging threat to obese and diabetic individuals.” Annals of the new York Academy of Sciences1281.1 (2013): 106-122.
Tricò, Domenico et al. “Metabolic Features of Nonalcoholic Fatty Liver (NAFL) in Obese Adolescents: Findings From a Multiethnic Cohort” Hepatology (Baltimore, Md.) vol. 68,4 (2018): 1376-1390.
