Liver Steatosis: Most Effective Dietary Supplements

Non-alcoholic fatty liver disease (NAFLD) is an excessive accumulation of fat in the liver, affecting more than 5% of liver cells, not linked to excessive alcohol consumption. This condition includes a spectrum of disorders, ranging from simple fat accumulation (steatosis) to a more severe form, non-alcoholic steatohepatitis (NASH), where inflammation and potentially fibrosis occur, which can progress to cirrhosis and, in some cases, liver cancer.

Causes and Mechanisms

NAFLD is primarily linked to obesity, insulin resistance, and metabolic inflammation. These factors lead to fat accumulation in the liver, often in the form of triglycerides. If this accumulation is accompanied by inflammation, it can progress to NASH, a more advanced form that may result in liver fibrosis, cirrhosis, and sometimes hepatocellular carcinoma. The "two-hit" hypothesis suggests that the first step is fat accumulation, followed by a secondary factor, such as oxidative stress or inflammation, causing more severe liver damage.

Symptoms

NAFLD is often asymptomatic and discovered incidentally during routine blood tests or imaging. When symptoms are present, they include fatigue, discomfort or pain in the upper right abdomen, as well as liver enzyme abnormalities. If the condition progresses to NASH, more severe signs like jaundice (yellowing of the skin), ascites (fluid accumulation in the abdomen), and edema may appear.

Risk Factors

The main cause of NAFLD is an excess of calories, often related to a diet high in carbohydrates and saturated fats, combined with low physical activity. Other risk factors include obesity, type 2 diabetes, hyperlipidemia (elevated cholesterol), and hypertension. Genetic predispositions can also contribute to the onset of the disease.

Complications

Approximately 20% of NAFLD patients develop NASH, a more severe form that can lead to advanced liver fibrosis or even cirrhosis. These patients also have an increased risk of liver cancer (hepatocellular carcinoma), as well as cardiovascular diseases and type 2 diabetes.

Treatment

Treatment primarily involves lifestyle changes, as no specific medication is yet approved for treating NAFLD. Weight loss is a key element: a reduction of 7 to 10% of initial weight can improve steatosis, decrease inflammation, and slow the progression of fibrosis. It's advised to adopt a balanced diet low in sugars and saturated fats, and to favor omega-3 fatty acids. It's also recommended to limit sugary drinks and sodas. Regular physical activity, like 150 minutes of moderate exercise per week, can help reduce steatosis and promote weight loss. It's also essential to control other metabolic risk factors, such as hypertension, type 2 diabetes, and cholesterol issues. Contrary to some misconceptions, statins can be safely used to manage dyslipidemia in patients with liver steatosis.