12 questions about fatty liver

  1. What is fatty liver?

Fatty liver is a disease in which the liver increases its content of fat (triglycerides and cholesterol). The liver may increase its size and becomes yellowish. It is frequently associated with bad eating habits and lack of physical activity. Alcohol consumption is a common cause of fatty liver.

  1. What are the symptoms of fatty liver?

A fatty liver does not cause any symptoms in the majority of affected people. Some patients may feel slight tenderness or pain in the right upper quadrant of the abdomen, where the liver is. Some physical changes can be seen in people with fatty liver, such as a black coloration of the skin in the neck or armpits (a sign known as acanthosis nigricans).

  1. How frequent is fatty liver?

Fatty liver is one of the most frequent metabolic conditions, affecting approximately 20% of the adult population. Up to 70% of obese persons have fatty liver.

  1. What is the cause of fatty liver?

The cause of fatty liver is unknown. Frequently it is associated with the so-called metabolic syndrome or insulin resistance. This metabolic derangement is linked to unhealthy eating and physical activity habits. One of the common causes of fatty liver is alcohol consumption.

  1. Is fatty liver a genetic condition?

Fatty liver is not a hereditary condition, but there is some familiar association determined by some genetic predisposition and also because it is common that eating habits are shared in the same family, which may predispose to fatty liver development.

  1. What is the treatment of fatty liver?

The treatment of fatty liver is basically the modification of eating habits with a diet restricted in carbohydrates (sugar, pasta, rice, bread, corn, potatoes) and fats. Together with diet, increasing physical activity is key.

Medications are not part of the usual management of fatty liver, but in certain circumstances, vitamin E and pioglitazone may be treatment options.

  1. Is physical activity beneficial if I have fatty liver?

Physical activity is one of the most effective ways to reverse the liver injury caused by this condition. Physical activity must be gradual, ideally aerobic and regular (3 to 4 times per week). A medical checkup by a doctor evaluating cardiovascular risk before an exercise program is always a good idea.

  1. What diet should I follow if I have fatty liver?

A healthy diet is one of the two pillars of fatty liver treatment. The diet consists in the drastic reduction of sugar, decreasing carbohydrates such as bread, pasta, potato, rice and corn, avoiding animal fat. In addition, it is recommended to increase the consumption of vegetables, fish, nuts, avocado, and yogurt. A Mediterranean diet is probably one of the most healthy diets to avoid fatty liver and to decrease cardiovascular risk.

  1. Can I drink alcoholic beverages if I have fatty liver?

Alcohol, even in small amounts, may aggravate the liver injury in people with fatty liver. For this reason, it is recommended completely avoiding alcohol in people affected with this disease. This has the additional benefit of decreasing the intake of calories, helping losing weight, given that alcoholic drinks are a considerable caloric source.

  1. Can fatty liver be cured?

One of the features of fatty liver is its reversibility. People succeeding in changing their habits, losing weight and exercising may completely cure fatty liver.

  1. How is it evaluated the severity of fatty liver?

Nonalcoholic fatty liver may be classified as simple fatty liver when there is fat accumulation without inflammation and in nonalcoholic steatohepatitis when it is accompanied by inflammation and injury. Blood tests such as aminotransferases and sometimes a liver biopsy may help in differentiating both conditions.

  1. What are the risks of fatty liver?

Fatty liver progresses without symptoms for many years, even decades. Some people may develop most severe consequences of the disease if they get progressive liver injury (fibrosis), leading to liver cirrhosis or liver cancer (hepatocellular carcinoma). When these complications occur, one of the options is liver transplantation. Aside from these complications, people with fatty liver have increased risk for developing cardiovascular disease such as heart attacks or stroke, and diabetes mellitus.