Non-alcoholic fatty liver disease (NAFLD) is a general term that encompasses the variety of liver conditions that affect people who drink little or no alcoholhe. Its main characteristic is the excess fat stored in liver cells.
Non-alcoholic steatohepatitis (NASH) is the progressive form of the disease and is characterized by injury and inflammation of liver cells, which induce liver fibrosis (tissue scarring). If left untreated, it can lead to liver failure and liver cancer, and is one of the leading causes of liver transplantation in the Western world. NASH also increases the risk of cardiovascular disease and all-cause mortality in patients with obesity or type 2 diabetes.
Known causes of fatty liver disease are being overweight and/or obese, insulin resistance (such as that caused by type 2 diabetes), high blood glucose, or high triglyceride levels in the bloodstream. There are no “miracles” to treat it, but if one cheap, simple and proven strategy: the combination of a healthy diet (such as the Mediterranean diet), weight loss and regular physical activity.
It's nothing new, but it's always worth influencing it, even more so if the person doing it is one of the world's greatest experts in the field: the prestigious nutritionist Shira Zelber-Sagim, from the Faculty of Public Health at the University of Haifa (Israel). The specialist gave a plenary conference yesterday within the scope of the XXXIV National Congress of the Spanish Diabetes Society (SED), highlighting that what we eat affects the risk of developing non-alcoholic fatty liver disease and type 2 diabetes, and pointed out the close relationship that exists between the two diseases.
Good diet and exercise
“The most beneficial treatment for NAFLD is weight reduction, achieved through a Mediterranean diet combined with physical activity”stressed, and recalled that “people who have this disease must maintain a healthy eating pattern, which includes minimally processed or unprocessed foods (fruits, vegetables, legumes, whole grains, unprocessed meat and fish, etc.), which are low in sugar and saturated fat, and rich in polyphenols, vitamins, and healthy types of oils (like olive oils) and some types of fats (like omega-3 fatty acids). The Mediterranean diet encompasses all of these principles.”
But the most difficult thing is to ensure that this diet not only gains followers, but also that it does not lose them and is surpassed by new forms of food that are cheaper and more accessible to the general population. “Increasing exposure to industrialized ultra-processed foods has led to a move away from the Mediterranean diet and the adoption of a less healthy diet,” said Zelber-Sagim, who clarified that “Even partial adherence to the Mediterranean dietary pattern can be beneficial.” Therefore, it required a redoubled and determined effort from the authorities, making it “necessary to establish educational and political measures that facilitate healthy options for the population”; Among them, it is necessary to “help reduce the consumption of ultra-processed foods, thus helping to prevent NAFLD, diabetes and improve general health”.
This nutritionist specifies some Specific interventions to reduce the consumption of ultra-processed foods and sugary drinksranging from increase excise taxes, ban or create sweeping restrictions on your marketing and advertising (especially disclosure aimed at children and adolescents) and restrict its physical availability to particular measures to ensure that the healthy and nutritious options are available and accessible to all consumers (for example, subsidizing fruits and vegetables, using taxes on ultra-processed foods), promoting healthy food reformulation o carry out public health interventions (with special emphasis on vulnerable groups).
Science corners ultra-processed foods
One of the principles of the Mediterranean diet and other healthy eating patterns is minimize processed foods and prioritize home-cooked meals. However, ultra-processed foods currently represent an important part of the Western diet. “Ultra-processed products are often characterized by lower nutritional quality, high energy density and the presence of additives, packaging substances (in contact with food) and compounds formed during production, processing and storage”, explained Zelber. -Sagim, who likes example of typical ultra-processed products “carbonated drinks, packaged snacks, breakfast 'cereals', 'instant' sauces and many ready-to-heat products”.
The consumption of ultra-processed products has increased dramatically around the world. In the 10 countries participating in the European Prospective Investigation on Cancer and Nutrition (EPIC), which included 36,034 people aged 35 to 74 years, highly processed foods contributed between 61% (Spain) and 78-79% (Netherlands and Germany) of intake average energy.
Several studies carried out in different populations have shown an association between the dietary proportion of ultra-processed foods and the risk of several diet-related chronic diseases, such as obesity, cardiovascular risk factors, cancer, gastrointestinal disorders, frailty and mortality. Its consumption also has a strong impact on mental health. This was demonstrated a few months ago by work carried out by researchers at the Charles E. Schmidt School of Medicine, Florida Atlantic University (USA), who confirmed that the consumption of ultra-processed foods was linked to a higher risk of depression as it was observed that those who took them had statistically significant increases in adverse mental health symptoms.
It is known that ultra-processed accelerate the aging of organs, but also of neuronssince, according to a Chinese study published in the journal "Neurology", people who consume more highly processed products have increased risk of future dementia compared to those who ingest them sporadically.
bariatric surgery
A study by King's College London (United Kingdom) and the Catholic University of Rome (Italy) published in The Lancet this week shows that the metabolic (bariatric) surgery is more effective than medications and lifestyle interventions for the treatment of advanced non-alcoholic fatty liver disease. This is the first study to compare three active treatments for non-alcoholic steatohepatitis (NASH) and specifically investigate the effectiveness of metabolic surgery (weight loss surgery) in a randomized clinical trial. Scientists claim that the The ability of surgery to control and even improve fibrosis associated with NASH is of particular clinical relevance, as fibrosis is the main predictor of liver complications and poor cardiovascular outcomes and death in patients with NASH.
