Fatty liver—that only happens to people who drink alcohol, right?

However, this occurs much more frequently in Western lifestyles than one might think. Lack of exercise, high body weight, and a diet high in processed foods and sweetened, high-fat foods can contribute to the development of fatty liver disease.

Approximately 30% of adults worldwide suffer from non-alcoholic fatty liver disease (MASLD: Metabolic Dysfunctional-Associated Steatotic Liver Disease). In Germany, approximately one in four people are affected. Fatty liver disease is diagnosed when 5% of liver cells are fatty.

Since the liver has no nerve cells, changes in liver tissue often remain undetected for a long time and are discovered by chance during an ultrasound examination of the abdominal organs.

Even normal blood values (liver values) do not rule out fatty liver disease. However, the fatty liver index (FLI) can provide indications of this. This requires the waist circumference, body mass index, and laboratory values for triglycerides and the gamma-GT value of the liver. Values below 30 indicate an unfavorable prognosis, while values above 60 indicate a favorable prognosis.

Fatty liver disease can develop into liver fibrosis (connective tissue remodeling) and, in turn, cirrhosis of the liver (scar tissue remodeling). In the worst case, this can lead to liver cancer.

Leaky gut, liver disease, and more!?

An intact intestinal barrier is essential for our health, and this is significantly influenced by our “microbiome.” If the microbiome is disturbed, “unfavorable” intestinal bacteria enter the liver and cause damage to the liver by releasing pro-inflammatory messenger substances. It is particularly worthwhile to take a look at the gut in patients with food allergies, irritable bowel syndrome, but also chronic fatigue, “brain fog,” joint problems, and autoimmune diseases.

Special tests of the microbiome can be used to investigate and treat dysbiosis. However, there is no magic formula for this, and treatment is highly individualized. In the short term, the gut microbiome can be influenced by probiotics and prebiotics. However, the microbiota quickly returns to its original state. In the long term, the microbiome can only be influenced by a consistent change in diet.

Recommendations for the health and stabilization of the microbiome:

• CAVE saturated fatty acids: Saturated fatty acids, which are mainly found in animal-based foods, should be avoided in particular.
• Limit short-chain carbohydrates, such as baked goods, white flour, and processed foods with “hidden” sugar. Sweets and sugary drinks are also unfavorable.
• Fruit sugar in moderation: Recently, the well-known “5-a-day” rule (5 servings of fruit and vegetables a day) has also been adjusted. Now, 3 servings of vegetables and 2 servings of fruit are recommended.
• Caution with harmful substances: Alcohol, medications such as NSAIDs (“non-steroidal anti-inflammatory drugs”): ASA, ibuprofen, diclofenac, Voltaren
• Promote beneficial bacterial strains through fermented foods, which are found in sourdough bread, yogurt, buttermilk, cheese, crème fraîche, kimchi, and sauerkraut.
• Choline as a detoxifier for the liver: Choline can have a positive effect on fat metabolism and liver detoxification. It is found in fish, poultry, eggs, dairy products, and legumes. It is also contained in vegetables such as broccoli, cauliflower, and Brussels sprouts.
• A balanced vitamin D level
• Coffee without sugar: even moderate coffee consumption can support liver function. However, it should be enjoyed without added sugar.
• Exercise and work-life balance: we now know that regular endurance sports and a good work-life balance are essential for good health. Moderate exercise is recommended, ideally 150 minutes of endurance sports per week.