Fatty Liver Disease

Authors: Colina Yim, NP & Dr. Hemant Shah, TWH Liver Centre (Created February 2009)
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What is fatty liver?

Your liver breaks down fat from the food you eat. The liver is the fat factory for the human body. It processes and stores fat. When the food you eat has more fat than your body needs, the liver stores that fat. Other parts of your body also build up fat in this situation. A person has a fatty liver when fat makes up at least 5-10% of the liver. When the fat has built up in a person who does not drink a lot of alcohol, your doctors call that NAFLD or Non-Alcoholic Fatty Liver Disease.

What is NASH?

NASH stands for Non-Alcoholic Steatohepatitis, and is a very serious type of non-alcoholic fatty liver disease. When you have NASH, the fat is causing inflammation and swelling in your liver. Over time, NASH damages the liver, and this can happen in people who do not drink alcohol or drink very little.

2-6% of the general population has NASH. Up to 1 out of 5 adults with NASH can develop cirrhosis (severe scarring of the liver), and up to 1 out of 10 may experience liver-related deaths. Some people will develop liver failure and need a liver transplant.

What causes fatty liver disease?

Non-alcoholic fatty liver disease can be mild to very serious (for example NASH). A person with a buildup of simple fat in their liver is more at risk of liver injury than someone with no fat.

The most common cause of fatty liver disease in Canada is obesity. About 75% of obese people are at risk of developing a simple fatty liver, and up to 23% are at risk of developing fatty liver with inflammation.

Other causes of fatty liver disease can be:

• starvation
• protein malnutrition
• intestinal bypass surgery for obesity, and
fast weight loss

Certain conditions predispose a person to fatty liver disease, including diabetes, hyperlipidemia (high cholesterol or triglycerides in the blood), and high blood pressure.

Other causes of fatty liver disease include genetic factors, medications, drugs, and chemicals. These causes are much less common.

Are children at risk for developing fatty liver disease?

Yes, children are at risk for fatty liver disease because of the increase in childhood obesity. Visiting a doctor regularly is important because fatty liver disease can be found in children as young as 4 years of age.

The Canadian Liver Foundation says 1 in 10 children are overweight, and fatty liver disease can be found in up to half of obese children.

What symptoms are caused by fatty liver disease?

Generally, there are no major symptoms; but, you may feel discomfort (at the level of the liver), fatigue, and a general feeling of being unwell.

How can I find out if I have fatty liver disease?

Blood tests may show that you have mild inflammation in your liver. An ultrasound of the liver can show a fatty liver or an enlarged liver. The only test that will prove you have a fatty liver (but is rarely done) is a liver biopsy. A biopsy is a procedure where a doctor puts a needle into the liver and takes a sample of the liver tissue. It is then examined under a microscope.

Is there treatment for fatty liver disease?

All people with fatty liver should speak with their doctors about slow and lasting weight loss by eating the right foods and exercising. Patients who also have diseases such as high blood pressure, high cholesterol or diabetes should improve and control their diseases through medication as well as exercise and diet.

Right now there are no specific medications that can effectively treat fatty liver disease.

How can I prevent fatty liver disease?

Here are some tips to prevent the disease:

• Live a healthy lifestyle
• If you are overweight, try to lose weight slowly and continually
• Eat foods that are low in saturated fats and high in fibre
• Exercise at least 4 times a week through different activities such as walking, swimming, gardening and stretching
• Avoid alcohol
• Avoid abdominal fat. A waist measurement of more than 102 cm (40 inches) for men and more than 88 cm (35 inches) for women will put you at risk of developing fatty liver disease

For more information, please visit the Canadian Liver Foundation's Website at www.liver.ca or the Toronto Western Hospital Liver Centre at http://www.torontoliver.ca/

This information was put together using information from the Canadian Liver Foundation's website at http://www.liver.ca/