Lifestyle Matters: How to Prevent Fatty liver, Diabetes, and Heart disease.

I have been doing a lot of research into the pathways that result in a fatty liver (fat deposition in liver) and belly fat and how to prevent it.  These two conditions are the precursors to the development of diabetes and its related kidney and heart disease, as well as liver cirrhosis and cancer.  The disturbed metabolism caused by fat in the liver results in pre-diabetes, inflammation that makes the liver fibrotic, and in abnormal cholesterol processing. The latter increases deposits of cholesterol plaques in the heart and peripheral blood vessel which increases risk of heart disease, heart attack, heart failure and stroke.

Many drugs are being used or studied to address these diet- and inactivity-induced diseases once they occur.  However prevention of disease in the first place is the best and most effective way to promote health and save health dollars.  How we live and how we eat affects directly how healthy we are, how our bodies will age, and how much health care services we will use as we age.

I have new rationale for recommendations to prevent disease such fatty liver,  pre-diabetes and the subsequent diseases that evolve from these. Part of the recommendations are supported by recent data presented in publications in the journal Diabetes Care  volume 39 October and July 2016 issues, as well as volume 40 supplement. The latter focuses on the 2017 standards of diabetes care and  prevention. It’s also good to report that these conventional medicine publications are now acknowledging and discussing how leaky gut and altered gut bacteria of the microbiome are key players in the inflammation and malaise of obesity- and fatty liver-derived diseases. In addition it is now understood that multiple organ systems are being affected simultaneously in the setting inflammation and metabolic derangement from unhealthy lifestyle. 

 Lifestyle modifications can delay onset of diabetes by 15 years and decrease incidence of diabetes by 20-28%.  Further, these lifestyle modifications below can cut the risk of heart disease in half even for those at very high genetic risk (NEJM 375;24:2346-58, 2016).

In order to prevent these conditions I recommend the following:

  1. Caloric restriction (for those with sedentary lifestyles :women keep calories 1000-1200/day, men 15-1700/day) with a daily deficit of 500 calories per day is needed if you are overweight or obese. We can survive and actually thrive by eating very little, if we use right foods and hydration. In fact, fasting with adequate hydration for a few days can reverse a lot of damage and inflammation, particularly if followed by the correct diet and lifestyle afterwards.
  2. Cycles of fasting for 12-16 hours act  (example is not eating from dinner till lunch time next day, and not making up the missed calories at that next meal) to shift metabolism into using of the calories in excess you have stored, instead of continuing storing more calories at the wrong places.   Further, fasting makes you a little ketotic which can improve metabolism and fuel utilization of stored fat.
  3. Avoid all fatty foods, fried, animal fat, red meat. All these promote “obesogenic” bacteria in the intestines, and metabolites of red meat directly stimulate deposits of cholesterol plaque in your heart vessels. Who needs this?
  4. Avoid sweetened foods and drinks, especially anything with fructose. Fructose tells your liver to store fat and blocks the ability of your insulin to communicate well with your liver to process your carbohydrates correctly. And after this you are screwed!  Because your insulin no longer works to help you!  You must act and make major changes to reverse this if you are committed to prevent diabetes.
  5. Avoid processed food (anything made by a machine or covered in packaging) which are mostly made of flour, fats, and sugar. Choose whole, and fresh foods instead.
  6. Useful Supplements include Vitamin D3, curcumin and berberine, and good omega 3 fats (such as in avocado or fish) to decrease inflammation.
  7. The right pre and probiotics: A diet rich in vegetables and fiber ( like chia seeds) promote the gut to produce good bacteria. These bacteria activate the right gut hormones that help you feel fuller with less calories, less hungry for longer periods of time, and naturally this leads to weight loss. See also my other 2017 blogs on this evolving topic.
  8. Antioxidants I recommend include colorful veggies, berries, and/or n-acetyl cysteine (NAC) and alpha lipoid acid, particularly if you already have inflammation, fatty liver and/ or pre diabetes.
  9. If you snore or wake yourself or your partner multiple times a night: get evaluated for sleep apnea, and if you do, do whatever is necessary to fix it. Having low oxygen in the body causes the kidney to react by increasing blood pressure. Low oxygen also activates pathways of inflammation that lead to rapid aging and fibrosis in the liver,  kidneys and other organs. Get close to 7 hours of good sleep whenever possible.
  10. Walk every day at least 30 minutes.  If you are sitting for hours at a desk for your work, set a timer every 30 minutes to remind you is time to stand up and move.
  11. Don’t smoke, and if you do please find ways to stopping.
  12. Lastly, learn stress reduction.  See my blogs on meditation at my public Facebook site : Integrative endocrinology with Dr. Beatriz Olson  for suggestions on how to start or look up Mindfulness based stress reduction (MBSR) teachers or programs in your area.
  13. If you already have Type 2 diabetes and hypertension, in addition to recommendations above, I also recommend you and your doctor use the following medicines to maximize your wellness: metformin with B12, GLP-1 agonist, a flozin, and ARB.

Be well and stay tuned for whenever the next time it is that I have a few hours to write about things that really make a difference in transforming your health.

Posted in Lifestyle, Nutrition & Weight, prevention of endocrine disease, Wellness & Prevention