Fatty liver

After Obesity and Diabetics, Fatty liver becomes the third epidemic across the globe.

There are two kind of fatty liver condition. Non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD). Needless to say alcoholic fatty liver disease caused by the consumption of alcohol. NAFLD caused by excess consumption of carbohydrates. Fatty liver itself a serious health condition also can lead to many other health hazard.

This post focus only on non-alcoholic fatty liver disease (NAFLD). Before getting into the subject, lets understand little bit of liver and its function.

Liver is on the right side of the abdomen, behind the rib-cage. It rests just below the diaphragm, to the right of the stomach and overlies the gallbladder.  Live is a dark reddish-brown in color.

Liver is heaviest and the second-largest organ in the body. Also, the largest gland. It primarily made up of a specialized cells called hepatocytes.  Though the liver performs more than hundred different functions, the major ones are

                    The liver plays a central role in all metabolic processes in the body.

                     Processing macro nutrients Fat (fatty acids), Protein (amino acids) and Carbs (glucose and fructose)

        Storing and releasing of vitamins and minerals, as and when needed

                    Synthesizes bile acid to digest fat

                    Detoxifying and metabolizing medications, alcohol, and other chemicals

                    With the help of vitamin K, liver synthesizes a special / important proteins needed in the bloodstream, such as albumin and clotting factors

                    Enzyme activation and Excretion of bilirubin, cholesterol, hormones, and drugs.

It is okay to have a very small amount of fat within the hepatocytes, In fact it’s quite normal. But, when the accumulation of fat exceeds the normal, it becomes a disease. If more than 5% of the liver's hepatocytes are made up of triglycerides (Fat), then it a condition known as hepatic steatosis.

Hepatic steatosis is the earliest stage of NAFLD. The disease can progress slowly from simple non-alcoholic steatosis (NAS) to non-alcoholic steatohepatitis (NASH) and subsequently to hepatic fibrosis, cirrhosis of liver and hepatoma. {End-stage liver disease known as cirrhosis, wherein damaged liver cells die off and are replaced by scar tissue that impairs function that can lead to liver failure or liver cancer (hepatoma)}

Fatty liver disease often isn't diagnosed until it become the more serious condition non-alcoholic steatohepatitis (NASH), which is characterized by inflammation and liver cell damage.  High triglycerides and elevations of the liver enzymes (ALT, AST, GGT) in the blood are the good indicators to diagnose NAFLD. Can be confirmed with ultrasound / CT scan. If required by biopsy.

It is not that all people who have NAFLD end up with severe liver disease. But, the chances to become NASH is pretty high. Also, excess fat in the liver is metabolically unhealthy and it not only affects the function of liver, also increases the risk of metabolic disorders, heart disease, kidney disease, and type 2 diabetes.

As the epidemic of NAFLD is mainly related to insulin resistance, Obesity is an important factor for an insulin resistance and insulin resistance is the one of the reason for metabolic disorder like Diabetics.

Excess fat accumulation in abdominal, central obesity or visceral obesity causes low-grade inflammation. Which caused by insulin resistance. It's estimated that 90% of obese adults have NAFLD and the childhood obesity epidemic has led to a dramatic increase in fatty liver condition in <16 age group.

Is it possible to reverse the fatty liver condition? Yes !  If it’s alcoholic fatty liver, quit alcohol (in any form) and switch to HFLC.  if it’s Non- alcoholic fatty liver, just switch to HFLC life style.

HFLC is nothing but cutting down, the all kinds of refined carbs, sugar, restricting the consumption of carbs that include grains /cereals.  Yes, by cutting down the carbs and meeting the daily calorie need from fat with adequate amount of protein, one can reverse non-alcoholic fatty liver condition to healthy liver condition.

HFLC not only helping you to reversing of non-alcoholic fatty liver, Also helps to reverse  Obesity, type 2 diabetes  and minimize the risk of heart / kidney disease. Again, HFLC  life assures the healthy liver and efficient liver function. 

Overcome the condition of fatty liver by eating fat (saturated)!

References:  (Click on the image to enlarge)

Diabetes Mellitus

Diabetes (type 2) is a second largest epidemic disease affecting the human population after obesity.  In terms of business prospective, diabetics is a highly profitable industry!!!  Yes, 40+ billion dollar (drugs) industry and expected to reach $55.3bn in 2017. (In India it’s about Rs 100+ crore per annum and growing at the rate of 11% per annum)

There are three main types of diabetes: type 1, type 2, and gestational diabetes. Type 1 diabetes is usually diagnosed in children, where body does not produce insulin at all. Gestational diabetes is a condition pregnant women who have high blood sugar levels during pregnancy. 

Here, let’s focus only on the Diabetes (type 2) which can be prevented and reversed thru food, without any medication.

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abetes is often referred by physicians as diabetes mellitus. Described as disorder of metabolism or metabolic diseases in which the person has high blood sugar, (hyperglycemia) either because of inadequate production of insulin, or because the body's cells do not respond properly to insulin, or both. In simple words, Diabetes is a condition where the amount of glucose in your blood is too high because the body cannot use it properly.

Before analyzing the causes of the diabetes, let’s see what the reputed medical organizations and associations say about Diabetes.  NHS (The National Health Service), WebMD, ADA (American Diabetic Association) were saying that “Diabetes is a lifelong condition that causes a person's blood sugar level to become too high”. In other words, there is no permanent cure only management thru medication. The same management can be done thru diet also, without any harmful and expensive medications!!   

Let’s begin with the first condition, “inadequate production of insulin” As I mentioned in the earlier post(s) when we eat high carb food, the carb’s are further broken down into sugar by carbohydrate metabolism and absorbed in the blood stream causes blood sugar raise. (hyperglycemia) Since, high blood sugar is toxic to the body a hormone called insulin produced by the β cells of the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy (cell metabolism)

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If there is inadequate production of insulin from the pancreas, the excess sugar (above normal level) can’t be sent or pushed inside to the cell. Which leads to the high blood sugar condition, called Diabetes.

The second condition is that, “body's cells don’t respond to insulin” meaning your pancreas produces enough insulin but, your cells aren’t responding or “deaf” to the insulin (known as Insulin Resistance) Hence, glucose can’t enter into the cell and blood sugar remains high and you become diabetic.

Why pancreas not producing enough Insulin? The nutrition and dietetics associations and other medical associations like diabetic and cardiac of different nations are advising to consume between 300g – 350g carbohydrates per day or around 50% – 60% of calories should come carb’s, this magnanimous amount of carb’s beyond human limits. I mean, pancreas is not meant or designed to produce so much of insulin to handle 300g of carb’s. It can handle only about 100g of carb per day. However, 50g is the ideal. (Refer human vs food post)

Insulin is the safety mechanism to handle the high blood sugar condition (also, has many other important function will discuss in other post) and meant to store fuel inside the body to support starvation.  But, eating 3 times high carb's food keep spiking the blood sugar and insulin, which is not physiological in nature. In other words, we overuse insulin / overdrive pancreas.

Over a period of time, the β cells of the pancreas “fed up” and “give up” to produce insulin or became incompetent to produce enough insulin. Consuming High carb's food is the ONLY reason for inadequate insulin production. 

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Why do the cells become Insulin Resistance? Again, due to the high carb diet always spike / keep the insulin level above normal and the cells are overdosed or overexposed to the insulin. Over a period of time, the cells became “deaf” or non-responsive to insulin. Hence, glucose can’t enter in to the cell which leads to the high blood sugar condition (even the insulin available) and you become diabetic.

It’s clear that, diabetic is a man-made disease (disaster) by excess consumption of carb’s. Just by restricting the carb’s it can be prevented and cured or reversed.

Even after knowing the facts, it’s quite unfortunate that Diabetic associations around the world, recommends the high carb meal (whole wheat bread, rice, fruits, low glycemic foods) that’s why they say “Diabetes is a lifelong condition” in order to keep the business alive (40+ billion dollar business!!!)

So is low glycemic food (complex carbs) good for diabetic ? Up to some extent. Again it’s not a perpetual solution for diabetic. The low glycemic food (complex carbs) also raises the blood sugar above the optimal range. The only difference is, blood sugar rise is not rapid. It’s like a slow release. At the end, the net carb count exceeds the human limit. Hence, you still need medication.

Will exercise help for diabetic? Exercise will not help the inadequate insulin condition. However, it helps to increase the cell sensitivity to insulin. Cutting down the carb’s is the easy and practical way to come out of diabetic.

Is diabetic linked with family history ? This is what the Diabetic association’s claims. But, not true. This is because, the kids were habituated to eat the same food of the parents. Hence, they also started eating high carb's food and end up with diabetic. (there is no family link or genetic link)

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So, What should I eat? First let me start with what should I not eat. Quit all kinds of cereals, grains in any form (bread, pasta, rice), fruits, low glycemic food and all kind of processed food. Eat, the food that do not spike or raise the blood sugar above the normal range. i.e. saturated fats like whole eggs, Fish, Meat from animals and birds, Butter, Cheese, Avocado, seeds like Almonds, Flax, Walnuts. (Refer : High Fat Low Carb Diet for more detail)

Please note : Those who are taking diabetic medications, directly switching to HFLC diet along with diabetic medication may lead to Low blood sugar (hypoglycemia) condition. Hence, please make sure to monitor your blood sugar and maintain the blood sugar diary (after every HFLC meal, get the blood sugar measured and documented) and accordingly reduce the medication. On a weekly basis show the blood sugar diary to your physician and gradually wean-out the medication and live diabetic free life.

Remember, you are not only saying good-bye to diabetic you are also coming out of Obesity (if you are obese) and reducing the risk of Hypertension, Cardio vascular diseases, kidney failure, neuropathy, retinopathy, etc. (will see in detail in another post)

Live Happy & Diabetic free life with Fat !

Video courtesy :  Stuff Made Simple :  Diabetes - made simple

 

BMI

I am sure you all must have come across the term BMI. Yes, it’s a scale to measure weight range from underweight to Obese. You may even have BMI app in your smart phone. I mentioned in my last post, that BMI is a flawed concept. It doesn’t reflect the degree of obesity of an individual.

Body Mass Index is based on the height and weight of a person.  It does not take into account muscle mass, bone density, overall body composition, race and sex differences.

Here is the BMI equation:  BMI = weight in kilograms divided by height in meters squared.

BMI equation or formula was derived in the early 19th century by a Belgian astronomer, mathematician, statistician (NOT a physician) called Lambert Adolphe Jacques Quetelet, to provide a statistical data to a government, by an quick and easy way to measure the degree of obesity of the general population.

Quetelet derived this quick tool, for general population only NOT applicable to an individual. In other words, Quetelet derived BMI formula for government statistical needs, NOT for Physiology. 

Quetelet, didn’t provide a valid physiological reason to square a person's height and left behind the waist measurement, which is a key factor to define the degree of obesity. Abdominal fat affects organs like the kidney, liver and the waist circumference is the clear indication of abdominal fat levels.

BMI formula goes awry for a person with person with strong bones, lean muscle and low fat will have a high BMI or obese!! Also, BMI hyperbolizes thinness in short people and fatness in tall people.

It’s totally unacceptable to have very sharp boundaries (just a decimal place) to distinguish the obesity level underweight (Below 18.5), ideal (18.5 – 24.9), overweight (25.0 – 29.9) and obese (30.0 and above).

Let’s be honest to ourselves,  Its not a Medical or Engineering entrance cutoff mark to have a decimal place accuracy. Physiological limits cannot up to a decimal precise.

Studies have proven that, Waist size linked to risk of diabetes, CAD, CVD, regardless of BMI. Waist-to-height ratio is a better indicator to measure the degree of obesity than BMI.

Then why the medical associations around the world, continue to practice this 200-year-old hack? Because medical insurance /Food/ fitness industries lobbies the medical associations to continue the BMI, in order to keep their business alive. (Medical insurance companies charge higher premium for high BMI, to sell more breakfast cereals, Fitness club and gym membership and buying of fitness equipment)

The flawed BMI formula, puts several millions of Americans into overweight or obese category but, the fact is they are “perfectly healthy.” The more dangerous is that it also puts millions of people, whose BMIs in the “normal” range, but are actually considered “unhealthy” based on their other physiological markers. Below is the published article for your ready reference.

BMI puts most of the Olympic sprinter (Swimmers and Athletes) or Wrestlers (who are build, lean and toned muscles) into Overweight to Obese range!  Because, muscle weighs more than fat.  Example, 182 cm (6ft) tall Olympic 100 meter sprinter weighing 90kg may have the same BMI (26) of a sedentary person's waist of 96 cm (38'') of the same height and weight.

So, what is the correct way to measure? There are couple of equations available online, which include the waist size, sex, race etc. but, the simple screening tool that I follow is waist to height ratio. I.e. waist circumference should be less than half of your height.  

                                        

                                             Waist circumference      =     <Half of Height

Example,  182 cm (6ft) tall should have a waist circumference of  91 cm (36") or less.

So, don’t focus on reduction of weight, rather focus more on reducing the waist size, in order to live healthy. The HFLC diet ensures the considerable reduction on the waist size, as a brownie point for you lose the weight as well.