Older adults with NAFLD are at increased risk of cancer and have a 60% higher risk of death from any cause than those without the disease. Eventually, a liver transplant may become the last option.
NAFLD develops when the liver stores too much fat, producing an inflammatory response that increasingly interferes with liver function. Obesity, high blood pressure, high cholesterol, diabetes and a family history of liver disease can all increase the risk.
There are currently no drugs on the market to treat NAFLD. But some manufactures of liver supplements claim that their products will detoxify and rejuvenate the liver. Supplements variously promise to optimize liver function, detoxify the liver and, of course, "promote" and "support" liver health. Yet studies presented at an American Association for the Study of Liver Disease and the National Institutes of Health seminar suggested that herbal and dietary supplements are responsible for as much as 20% of liver disease in the United States. Other studies have found that liver transplant and death occurred more frequently in people who took herbal dietary supplements than those who did not.
Milk thistle, also known as silymarin, is the most common herbal supplement for liver problems in the U.S. Silibinin, the active ingredient in silymarin, acts as an antioxidant, neutralizing free radicles that contribute to inflammation. The results of trials and studies are mixed. Some have found reductions in inflammation and in enzymes associated with liver damage. Other studies have not found such evidence or found reductions that were 'not clinically significant". The majority of these studies used weak methodologies and had funding sources with a vested interest in the outcome. Studies of other common ingredients such as zinc and licorice root have produced similarly inconclusive outcomes.
An additional problem in the US is that supplements are not tested by and are only weakly regulated by the FDA, so the purity and concentration of ingredients is unpredictable.
But the liver is an unusual organ in that it can often regenerate and repair itself. So there is a lot that we can to to avoid or even reverse NAFLD. Here are few things that you might consider.
Symptoms of NAFLD include fatigue, pain on the right side of the abdomen, swelling and jaundice. But by the time such symptoms appear the disease is already well advanced. So even without symptoms it is a good idea to have your doctor test you for liver disease, especially if you are older than 50 years. The basic screening is a blood test so you can ask to have it included in your annual workup.
Losing extra weight can reduce your risk or even the severity of the contrition if you already have it. Losing 5% to 10% of your body weight is enough to make a positive impact.
If you needed still another reason to move toward a Mediterranean type diet, here it is. A 2018 study found a 29% reduction of fat levels in the liver compared to those following a standard American diet.
If you drink alcohol, do so in moderation or stop entirely. Drink lots of water. Tea and coffee are also good options.
This one will shock you. Exercise! Aside from helping to manage your weight, exercise has a direct benefit to liver function. The increase in heart rate and blood pressure during exercise can act like a "mini cleanse" for the liver. About 30 minutes five times a week is enough to make a difference.
Funny, isn't it, how the same recommendations keep showing up again and again? Maybe there is something to them.
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