NAFLD, Sugar, My Liver & Me: My Fatty Liver Story. Updated September 2019.

I have had a horrible relationship with sugar. Like most animals, I find the taste of it addictive and irresistible. My mouth and brain would have an orgasm if I put a spoonful of honey or jam on my tongue and it’s hard not to keep going until it’s all gone. I used to smell sweet foods and the smell made me instinctively want to find them and eat them, like a hungry bear. Biscuits, chocolates, cakes, fruit juice, sweets, jam, honey, treacle, fudge, tarts, mince pies, liqueurs, syrups, I used to crave all of it, all the time. Those cravings have all but gone now and this is how I did it.

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So far so lovely. I love to eat sweet foods and the sweet things seem to want me to eat them. They are everywhere, whichever way I turn there are treats waiting to be eaten, especially at Christmas. People give me sweet things as gifts, so they must be good! So why not enjoy them?

Now here is the downside. Too much sweet stuff for years has been making me sick and I need to fix that. I’m not well and it’s at least partly because of my relationship with sugars.

On the outside I look healthy. I feel OK. However about five years ago I went to the doctors for a routine health check. Cholesterol and blood pressure and diabetes tests were all very healthy and I thought that was great but I was called in later by my GP and told the liver function tests showed I have a high level of an important indicator for liver disease. The doctor said it had been high on a blood test a few years prior and it had increased further above the normal healthy range.

NAFLD is characterised by the build-up of excess fat in the liver of people who do not drink more than recommended guideline amounts of alcohol. (1)

So I had to go to the hospital for more blood tests, an ultrasound scan and a fibroscan and it was found that I have a fatty liver although it’s not badly scarred. Yet. This was all very scary because while was going for tests and waiting for results I was reading about fatty liver disease (NAFLD as I’m not an alcoholic) leading to cirrhosis and ultimately liver cancer and death. The only diet or lifestyle advice I could find out at this point was to ‘avoid the sweet stuff’. I was able to guess that too much booze was probably worse for me than it is most people at this point with my liver being a bit sickly already. I did some reading online and found the British Liver Trust website.

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Around the same time there was much noise on the internet and in the press about high fructose syrup being bad for you and there being too much of it in processed foods and in soft drinks. Research showed that consuming high sugar foods leads to accumulation of triglycerides in the liver. (2)

When the results all came in the advice did not sound that bad. At the time I wrote down a summary of what I was told: ‘Just fatty liver. Cut down alcohol & don’t get fat’. I remember being told to carry on as I was as I wasn’t doing anything wrong. My GP was advised to monitor my condition with regular blood tests. NAFLD seems to be fairly common and I heard of a few other people I know having similar experiences and  noting really seeming to come of it. It’s an early stage disease with few if any symptoms noticeable to the patient.

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At about 90 kilos I wasn’t overweight at the time and fairly lean as well at about 10% to 12% body fat, although without a six pack. Somehow I have a fat liver without being very fat overall. I’m exercising regularly and eating healthy and I look OK but I’m unhealthy inside. It doesn’t make sense. All I could do was carry on trying to live healthy. After a couple of years the blood tests results were improving and I stopped worrying.

Life, a wife and a house move happened over the next couple of years and my healthy habits deteriorated. I felt like home maintenance and DIY could substitute for running, cycling and lifting. Frozen pizzas, pies and other ready meals seemed like a good way to make time for home improvement and our new home turned out to be long overdue for some basic maintenance.

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Is fixing this sort of thing good exercise?

Forward on to last autumn and I did my blood test as usual and the doctor asked to see me to give me my results as usual. When I went in she told me my result was as high as it’s ever been. From this point on I was shocked and numb from the neck up as she tested my blood pressure, felt and tapped my abdomen and asked my weight (102kg at the time). She told me my BMI is too high and that’s a risk for strokes. She reminded me I have Non Alcoholic Fatty Liver Disease, (said it like a Disease with capital D) and if I didn’t improve I would have to referred to a specialist at the hospital. I need to try and improve by March when I will have another blood test.

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I walked away feeling like I’d been punched, the word ‘Disease’ ringing in my ears. Don’t get me wrong, the doctor wasn’t unduly harsh with me. She was kind and told me what I needed to be told. I heard it even if I may have been dumbstruck at the time. Afterwards my wife tried to make me feel better and asked me what I was going to do. I decided to cut out all added sugar and all alcohol for a start as I know those are bad for my liver, I decided to run and cycle every week as well as lifting weights, I decided to cut out protein bars and cookies as I may have been feeding my liver too much protein and I decided to find out what else I could do.

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None of these for me!

I haven’t eaten a protein treat since as well. I’m not sure those are healthy any more. I had started adding those to my diet over the previous couple of years, so they could be a factor in causing my liver inflammation. I’ve never been a heavy drinker but I’m pretty sure booze doesn’t make your liver better so that’s got to go. I had been eating lots of sugary foods, biscuits in particular as well as other treats. I only had one drink per day over Christmas and I moderated the sweet treats. I have had none so far in 2019.

I’ve found the Fatty Liver foundation website very useful as it has more information on what I wrong with me and what I can do about it. This is their recommended diet to reduce fatty liver disease. I think the important one for me is minimising sugar:

  • Limit alcohol consumption, remember it is a liver poison
  • Limit saturated fat to less than 7% of calories and go easy on red meat
  • Use low fat or skim dairy products
  • Eliminate trans-fat and all hydrogenated oils and minimize the use of industrial seed oils like corn, soy, and cottonseed
  • Cut way down on salt — the goal less than 1500 mg/day
  • Minimize added dietary sugar. Eliminate all high fructose corn syrup
  • Use extra virgin olive oil for cooking and take three tablespoon per day like
    cough medicine
  • Don’t buy prepared foods without reading the label, there isn’t actually much
    that you can buy
  • Eat lots of fruits and vegetables but watch the salt
  • Learn to like kale, lima beans, brussel sprouts, etc.
  • Look for fiber like whole wheat bread no white breads and use brown rice
  • Eat fatty fish like salmon at least a few times a week
  • East skinless chicken or turkey and lean pork
  • Minimize processed meats like ham
  • Explore new foods like quinoa as a grain
  • Eat plenty of vegetable protein like beans.
  • Keep in mind that eating out is mostly unhealthy so be thoughtful (3)

That’s a long list but I think it’s worth trying. It’s all from a cirrhosis patient that set up the website. A lot of that is already known good health advice but it’s worth reading and relating it to liver health which seems to be central to overall health.

Another piece of advice I found from various sources online is that coffee is good for me! (1)(4)(5) So from now on I’ll be drinking nice hot cups of java every morning. I’ve been avoiding too much caffeine for years but now it seems like it’s not that bad for me if I don’t have too much and if I have decaf after midday it won’t harm my sleep. I’ve been missing out on an everyday health drink and harmless morning stimulant!

Studies have shown that coffee may have health benefits, including protecting against Parkinson’s disease, type 2 diabetes and liver disease, including liver cancer. Coffee also appears to improve cognitive function and decrease the risk of depression. (4)

Coffee consumption can significantly reduce the risk for hepatic fibrosis and cirrhosis. (5)

I’ve got hopefully a long life ahead of me and I need to spend some of that life trying not to get sick. Otherwise the latter part of my life could be spent in poor health with low quality of life. That would be no fun for anyone so it could be worth missing out on some enjoyable foods and drinks and learning to like other things.

After about two months since I saw the doctor and I weighed 99.6kg so that’s a loss of about 2.5. I don’t want to lose weight any faster than that. I feel less fat as well so I’m happy with that. I’ve found it helpful to think of alcohol and sugar as poisonous to me. They have been slowly poisoning me so it’s a logical conclusion. If I totally avoid all sweet foods and drinks I don’t have the taste for them and the cravings have almost gone.

In September 2019, 10 months in I’ve totally stopped eating or drinking anything anything sweet except for one portion of fruit per day and I don’t crave it. I found an interesting article the other day by the author Gretchen Rubin. She writes about her experience of quitting sugar and it’s similar to my own but without the disease. Here is a quote that explains how it feels to her:

For me, what’s the greatest benefit of quitting sugar? Easy. It’s the fact that I no longer feel any cravings for sweets or carb-y foods like bread. I’ve quieted that boring noise in my head about “Now, later; two, three; it’s my birthday; it’s special; more, more, more.” I’m not distracted and drained by my attempts to resist a plate full of cookies at a meeting, or the free samples at a bakery, or the ice cream we have in our kitchen freezer. I don’t eat sugar, so those temptations vanish.

For me, it’s so, so, so much more pleasant not to eat sugar! Someone said, “But where’s the joy in life without the occasional brownie?” and I said, “Not eating brownies gives me more joy than any brownie every did.” For me. (6)

There has also been a scientific study that shows that cutting out sugar could be a treatment for NAFLD:

The study, carried out by Researchers at University of California San Diego School of Medicine and Emory University School of Medicine sought to measure change in liver fat after eight weeks of a low sugar diet compared to a typical diet.  The researchers found that the children in the low-free sugar diet group had a reduction in liver fat of 31 percent on average, while the children in the typical diet group showed no improvement. Blood test measures of liver inflammation also indicated significant improvement for children in the low-free sugar group compared to the typical diet group.

“The substantial improvement seen in just eight weeks makes us believe that a diet low in free sugars has the potential be a clinically relevant treatment,” (1)

I’ve also had a hepatology clinic appointment and I was told I’m doing the right things and congratulated on my weight loss. I’ve had some more blood tests and I have an ultrasound scan soon.

I’ve just had the ultrasound scan and she told me she saw nothing of concern. I asked if my liver is fatty and she said no. I’ll wait to hear from the doctors and the may want to keep monitoring me but for now it looks like my liver has become healthy. In what I have read online I haven’t heard much about a fatty liver becoming un-fatty by cutting out sugar, sweeteners and alcohol but I’m here to tell you it can work.

I’m updating this page from time to time. Wish me luck!

 

Links to quotes and references etc:

(1) https://britishlivertrust.org.uk/

(2) https://www.ncbi.nlm.nih.gov/pubmed/26556483

(3) https://www.fattyliverfoundation.org/

(4) https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/coffee-and-health/faq-20058339

(5) https://www.fattyliverfoundation.org/coffee

(6) https://gretchenrubin.com/2019/07/why-and-how-i-quit-sugar

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/