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 Liver disease isn’t just linked to alcohol
  As we near a season of indulgence, Dr Vijay Chandraraj says be aware of the dangers of fructose
Historically, liver disease has been assumed to be linked to alcohol. However, Non-Alcoholic Fatty Liver Disease
(NAFLD) is rising exponentially, and this is now considered the most common form of liver disease in the Western world.
The liver is our largest internal organ, located in the upper right side of the abdomen and it plays a number of vital roles which include aiding digestion, detoxifying the blood, regulating blood sugar and fighting infection.
NAFLD occurs when fat begins to accumulate within liver cells; the liver is described as ‘fatty’ when the fat content exceeds more than 5 percent of the liver tissue.
However, in the early stages, NAFLD does not cause visible health problems, so as increasing levels of fat silently accumulate, patients often remain completely unaware. Many cases are actually diagnosed during routine blood tests for other reasons.
Worryingly, if left untreated, this disease may progress to hepatitis (inflamed liver) with pain and acute clinical signs or may
progress to cirrhosis (scarring and irreversible damage), eventually resulting in liver failure or cancer.
Speed of progression is affected by genetic and environmental factors, but research shows that smokers, those who are overweight, have type 2 diabetes, have high blood pressure, high cholesterol or metabolic syndrome, are at much higher risk.
The good news is that, if caught early and tackled promptly, this condition is reversible.
As always, the functional medicine approach is to identify and then address the root-causes of any condition.
Although obesity is closely linked to this disease, research overwhelmingly links Western ‘fast-food’ diets (high in fructose and high-fructose corn syrup) as being a major driver of this condition.
High fructose intake increases a process named ‘de novo lipogenesis’ (DNL) contributing to fat accumulation in the liver, increased intestinal permeability (leaky-gut) and gut microbiome imbalances.
Fructose is a simple sugar, present naturally in fruit and honey. It is also the major constituent of table sugar (which is 50% fructose) and fructose glucose syrup (FGS) (which is over 50% fructose).
The key to treating and reversing fatty liver disease is through diet and lifestyle approaches.
It is vital to identify and reduce our intake of fructose, starting with addressing the types and quantities of processed foods in our diets. Fruit can still be eaten as whole foods, as in this form they contain fibre, vitamin C, flavanols, and other antioxidants, which have a protective function against fatty liver. However, I would recommend avoiding dried fruit and fruit juice, which have a more concentrated sugar content and often added sugars.
Alcohol needs to be minimised, along with any other drugs, which put extra strain on the liver in detoxification and elimination.
Weight loss is often important to help reverse insulin resistance, which is a major driver of this condition in overweight patients.
Addressing ‘leaky-gut’ and an imbalanced gut microbiome through a functional medicine gut-healing regimen will help optimise gut-healing and reduce inflammation. This is essential as an inflamed gut is closely linked with an inflamed liver.
Exercise is a powerful intervention. 30 minutes of moderate-intensity activity, such as brisk walking or cycling, at least three times weekly, can reduce the fat-content of the liver through improvements in insulin- resistance.
Nutritional supplements can also help to treat ‘fatty liver’; these include curcumin (turmeric) and omega-3 fatty acids which also reduce inflammation, vitamin E as an antioxidant and milk-thistle, which helps support detoxification.
As you consider your health-based New Year’s resolutions, keep in mind the advice given here alongside practicing a greater awareness of food labels and avoiding those hidden sugars. Reduce your processed food intake and give your liver a Happy New Year.

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