Diet and Fatty Liver Disease - Fatty liver

Diet and Fatty Liver Disease - Fatty liver

What is hepatic steatosis

Fatty liver disease is a real degeneration of the liver, caused by the accumulation of triglycerides in the hepatocytes.


In general, hepatic steatosis is reversible thanks to diet and drug therapy; however, in a percentage of 5-10% of cases it can evolve into liver cirrhosis, especially if the subject abuses alcohol.


Causes

Known more commonly as "fatty liver", fatty liver disease is caused by an excessive intake of alcohol, carbohydrates and dietary lipids, or by an impaired ability to dispose of fat.
The causes of hepatic steatosis are many and can give rise to the disease in an autonomous or multifactorial way; the most frequent are:

  1. Exogenous toxic agents such as "nervine" molecules and drugs: alcohol, phosphorus, tetracyclines (antibacterial drugs that inhibit protein synthesis), carbon tetrachloride (dry cleaning solvent, coolant and fire extinguishers but currently out of use), anabolic steroids etc.
  2. Obesity and related hyperalimentation
  3. Dyslipidemias (hypertriglyceridemia, LDL hypercholesterolemia, etc.)
  4. Nutritional deficiency (protein-energy malnutrition that causes a reduction in circulating lipoproteins; it is a typical condition of the third world, of the disadvantaged, chronic alcoholics and psychiatric patients)
  5. Steatosis gravidarum (quite rare but very serious and frequently inauspicious).

All of the above causes are influenced by the subject's diet.



Symptoms

The symptomatology of hepatic steatosis is rather heterogeneous; primarily hepatomegaly (liver enlargement), pain in the right hypochondrium (right under the ribs), jaundice (yellowish pigmentation of the skin and eyes - in an advanced state) and finally splenomegaly (enlargement of the spleen).

From the haematic point of view, an increase in transaminases (enzymes-specific markers of liver cell damage) and in prothrombin time (blood clotting speed influenced by proteins synthesized by the liver; longer prothrombin time = worse liver function) may occur ).

Role of the Diet

The diet for the remission of hepatic steatosis acts directly on the removal of the triggering causes; therefore, it is essential to follow some rules of food hygiene as nutritional therapy:

  1. Abolition of hepatotoxic drugs (mentioned above)
  2. Abolition of alcohol and any other nerves (including caffeine and theine)
  3. Abolition of sugary drinks and sweets in general
  4. Abolition of junk food or junk food
  5. Drastic reduction of products containing significant quantities of food additives
  6. Caloric restriction and consequent negative energy balance
  7. Moderation of the intake of carbohydrates, especially refined and / or simple
  8. Moderation of the intake of fat, especially saturated
  9. Moderation of cholesterol intake
  10. Increase in dietary fiber intake
  11. Increase in antioxidant intake
  12. In case of undernutrition / malnutrition, achievement of 1 gram of protein per kg of body weight and of the total vitamin ration
  13. Promotion of a diet to purify the liver, namely: intake of good doses of ascorbic acid, polyphenols, cynarin (stimulator of the gallbladder) and silymarin (which increases the synthesis of liver proteins and inhibits that of inflammatory mediators and free radicals); in practical terms it translates into: high frequency in the consumption of citrus fruits, artichoke (containing cynarin), milk thistle (silymarin), apple, blueberry, cabbage and raw extra virgin olive oil (antioxidants).

In addition to following the diet for hepatic steatosis, it is possible to facilitate the pathological course of the disease by also taking some drugs; among these we remember: glutathione, urodeoxycholic acid, silymarin, thiopronine and phosphatidylcholine; in alcoholic abuse methadoxine is also indicated.




More info: Diet for the Fatty Liver, a practical example "

References

Hepatocellular carinoma - M. Colombo - Elsevier - page 48

Complete treatise on abuse and addiction. Volume 1 - U. Nizzoli, M. Pissacroia - Piccin - page 984


Medical reasoned therapy - A. Zangara - Piccin - page 927

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