High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
Fatty Liver : A "Drug-able" or "Lifestyle-able" Problem?
1. “Diabetes Of The Liver”
This Photo by Unknown Author is licensed under CC BY-NC
Fatty Liver
2. Dr. Natasha Iyer MBChB, ABAARM
Director,
Better Medical Centre, Calgary, Canada
www.better4life.ca
Dr. Shabnam Das Kar, MD, FMNM
www.drkarmd.com
3. Is It A “Drug-able” Or
A “Lifestyle-able” Problem?
4. WHAT IS FATTY
LIVER?
NAFLD (non-alcoholic fatty liver
disease) results from liver damage
due to the accumulation of fat
(triglycerides) and inflammation
within liver cells.
This Photo by Unknown Author is licensed under CC BY-NC
5. NAFLD
Non-Alcoholic Fatty Liver Disease To Metabolic Associated Fatty Liver Disease.
Fatty Liver is a component of Metabolic Syndrome.
MAFLD
6. Where Does The Fat In The Liver Come From?
• Higher carbohydrate intake
• DNL : Fat made in the liver from glucose, fructose and amino acids
8. The most common cause of death in patients with
NAFLD is cardiovascular disease.
Chalasani, Naga, et al. "The diagnosis and management of nonalcoholic fatty liver disease:
practice guidance from the American Association for the Study of Liver
Diseases." Hepatology 67.1 (2018): 328-357.
13. Lifestyle Interventions
• Food. What , when and how many times
• Fructose, uric acid
• Prevention of Sitting Disease
• Supplements
14. Weight Loss
Patients losing ≥5% body weight stabilized or improved
fibrosis in 94% of the cases.
Chalasani, Naga, et al. "The diagnosis and management of nonalcoholic fatty liver disease:
practice guidance from the American Association for the Study of Liver
Diseases." Hepatology 67.1 (2018): 328-357.
15. Is It A “Drug-able” Or
A “Lifestyle-able” Problem?
16. Liraglutide Versus
Intensive Lifestyle Management
Parameters Liraglutide 3 mg/day Intensive Lifestyle Intervention
Weight loss = =
Fibrosis = =
Sustained weight loss No. There was weight regain when stopped Yes
Liver Fat Increased when stopped Remained at lower level
Khoo, Joan, et al. "Comparative effects of liraglutide 3 mg vs structured lifestyle modification on body weight, liver fat and liver function in obese patients
with non‐alcoholic fatty liver disease: a pilot randomized trial." Diabetes, Obesity and Metabolism 19.12 (2017): 1814-1817.
18. NUTRIENTS REQUIRED FOR ENERGY PRODUCTION
Wesselink, E., et al. "Feeding mitochondria: Potential role of nutritional components to improve critical illness convalescence." Clinical Nutrition 38.3 (2019): 982-995.
Pizzorno, Joseph. "Mitochondria—fundamental to life and health." Integrative Medicine: A Clinician's Journal 13.2 (2014): 8.
1. Vitamins B1, B2,B5,B7, B12
2. Folate
3. Vitamin C
4. Vitamin E
5. CoQ10
6. Iron
7. Magnesium
8. Selenium
9. Taurine
10. Carnitine
11. Melatonin
12. Manganese
13. Zinc
19. Omega 3:
Dose , duration and blood levels matter
• Omacor 4 grams a day, which is 1840 mg of EPA and 1520 mg of DHA
a day.
• For 18 months
• Checked EPA DHA levels in Red Blood Cells
• For those individuals achieving a ≥2% absolute increase in DHA had
reduction in liver fat.
Scorletti, Eleonora, et al. "Effects of purified eicosapentaenoic and docosahexaenoic acids in nonalcoholic fatty
liver disease: results from the Welcome* study." Hepatology 60.4 (2014): 1211-1221.