It's outrageous: I'm 165cm tall and weigh 80kg, but I have fatty liver...

During the physical examination at the end of the year, many people were diagnosed with fatty liver.

Fatty liver disease is neither serious nor minor, and there are no special symptoms. Therefore, people often find out that there is something wrong with their liver after receiving a physical examination report.

Some people may wonder: "Fatty liver should be related to fat. I am thin and rarely eat meat, so why do I have fatty liver?"

0 1

How does fat accumulate in the liver?

There are many types of fatty liver, here we only talk about the most common type: non-alcoholic fatty liver.

If fat is compared to gasoline, then the liver is equivalent to a gas station. The fat in food is like oil. After being digested and absorbed by the human body, it enters the liver. When the body needs it, the liver breaks down the stored fat and sends it into the blood. The difference from a gas station is that, on the one hand, the liver has the ability to produce and synthesize some fat. On the other hand, the fat entering and leaving the liver does not rely on cars, but on proteins.

In this way, the fat in the liver has two sources (from food, synthesized by the body) and one way out (consumed by the body). If the fat consumed by the body is not as much as the fat in food, synthesized by the body, they will accumulate in the liver and form fatty liver.

Liver, Image source: pixabay

0 2

Why do vegetarians get fatty liver?

There are two reasons.

First, too much fat is synthesized by the body.

Bricks, steel bars, and concrete on a construction site are clearly separated, and even if they are stuck together, it is not difficult to distinguish them; but this is not the case with the three major nutrients. When you eat, sugar is sugar, fat is fat, and protein is protein, but after entering the blood, they may transform into each other.

For example, many people are afraid of cholesterol when they see it. They remove the yolk from an egg and only eat the egg white. In fact, the cholesterol in our body mainly comes from the liver. The liver uses the products of sugar metabolism to actively synthesize cholesterol. Even if you don't eat a little cholesterol, as long as the energy intake exceeds the standard, the cholesterol will exceed the standard due to this mechanism.

The relationship between vegetarianism and fatty liver is similar. Some people rarely eat meat, but eat too much refined rice and white flour. The sugar in rice and flour may be converted into fat and stored by the liver, which can cause fatty liver.

Second, insufficient protein intake.

As mentioned before, protein is needed to transport fat into and out of the liver. If there is not enough protein, then even if the body needs fat very much, the liver will not be able to transport it out.

Healthy liver and non-alcoholic fatty liver disease, Image source: mayoclinic

Research by the Chinese Nutrition Society shows that adult men need an average of 60g of protein per day, and adult women need 50g. Pregnant and lactating women need even more, and should supplement with an additional 20g of protein per day. This protein can come from vegetarian or meat foods.

However, the protein in vegetarian diets often lacks essential amino acids, with soybeans being the only exception. Therefore, nutritionists recommend that 30% to 50% of the daily protein intake should come from fresh meat and soybeans.

In summary, the Dietary Guidelines for Chinese Residents recommends consuming 120-200g of meat per day , including 40-75g of seafood, 40-75g of poultry and livestock meat, and 40-50g of eggs. On the contrary, if you only eat vegetarian food and do not take in enough protein, it may cause disease.

0 3

How should we eat?

As the saying goes, "the heart is connected to the fingers." In fact, our body surface sensory system and internal organs sensory system are very different. If a finger is scratched by paper, it will hurt a lot; while internal organs, such as the liver, are more concerned with "bearing humiliation and bearing heavy burdens." Therefore, in the early stage of fatty liver, there are no special symptoms, at most a dull pain in the right upper abdomen (where the liver is located) .

The symptoms are not obvious, but the consequences can be serious. If fatty liver is left untreated, liver damage will gradually worsen and may lead to cirrhosis. At that time, not only will the liver function be affected, but other parts of the body may also be affected. For example, it will affect the immune system and cause infection; because ammonia metabolism is blocked and ammonia accumulates in the body, it will affect the brain.

However, there is no need to be particularly anxious. Hospitals have an indicator to determine whether one is overweight, called the body mass index (BMI). Studies have shown that as long as the BMI drops by 5%, the impact of fat on the liver will be greatly alleviated; if it drops by 10%, the liver can completely return to normal, no different from a healthy person.

BMI = weight (kg) / height² (m)

Large-scale surveys in recent years have shown that the biggest nutritional problem for Chinese people is not that they are not full, but that they do not eat a balanced diet. Earlier this year, the Chinese Nutrition Society published a pamphlet that listed various manifestations of an unbalanced diet. As long as everyone follows the experts' advice and adjusts their lifestyle, they can basically rest assured.

Dietary factors related to cardiovascular and metabolic diseases, Image source: Scientific Research Report on Chinese Dietary Guidelines (2021)

Finally, I still want to remind you: don’t lose weight too quickly.

If you lose weight too quickly, a large amount of fat will be mobilized, which may exceed the liver's tolerance and cause fatty liver.

References

[1] Ge Junbo, Xu Yongjian. Internal Medicine[M]. People's Medical Publishing House, 2013.

[2] Zhu Danian, Wang Tinghuai. Physiology[M]. People's Medical Publishing House, 2013.

[3] Chinese Nutrition Society. Dietary Reference Intakes of Nutrients for Chinese Residents (2013 Edition)[M]. Science Press, 2014.

[4] Chinese Nutrition Society. Dietary Guidelines for Chinese Residents (2016)[M]. People's Medical Publishing House, 2016.

[5] "Scientific Research Report on Dietary Guidelines for Chinese Residents (2021)" [J]. Journal of Nutrition, 2021, 43(02): 102.

[6]PATEL NS, DOYCHEVA I, PETERSON MR, et al. Effect of Weight Loss on Magnetic Resonance Imaging Estimation of Liver Fat and Volume in Patients With Nonalcoholic Steatohepatitis [J]. Clinical Gastroenterology and Hepatology, 2015, 13(3): 561-568.e1.

[7]TSAI JH, FERRELL LD, TAN V, et al. Aggressive non-alcoholic steatohepatitis following rapid weight loss and/or malnutrition [J]. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2017, 30(6) : 834–842.

[8]WONG V WS, CHAN WK, CHITTURI S, et al. Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 1: Definition, risk factors and assessment: Asia-Pacific NAFLD guidelines [J]. Journal of Gastroenterology and Hepatology, 2018, 33(1): 70–85.

[9]CHITTURI S, WONG V WS, CHAN WK, et al. The Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 2: Management and special groups: Asia-Pacific NAFLD guidelines [J]. Journal of Gastroenterology and Hepatology, 2018, 33(1): 86–98.

[10] Zha Xiliang, Yao Libo. Biochemistry and Molecular Biology[M]. People's Medical Publishing House, 2013.

END

The author of this article: Zhao Yanchang, contracted author of Tadpole Music Notation.

Source: Tadpole Musical Notation

Editor: Heart and Paper