What is fatty liver?
Fatty liver, fatty hepatosis, liver steatosis - all these concepts reflect the same pathological condition, which can develop as a result of exposure to a wide variety of factors. At the same time, the literal translation of the English term “fatty liver” – “fatty liver” – attracts attention because it is understandable to both the doctor and the patient. Like an obese person, a “fatty liver” is subject to a whole range of diseases. However, in most cases, fatty liver is completely reversible if the causes leading to its formation are eliminated. It is this indisputable fact that should first of all be drawn to the attention of both doctors and patients, since timely recognition of fatty hepatosis makes it possible to prevent the development of inflammation, which is much more difficult to treat.
What causes fatty liver?
There are many reasons for the deposition of fat in the liver, but in two thirds of patients it is still alcohol. In second, third and subsequent places are diabetes mellitus, obesity and hyperlipidemia (increased levels of certain fractions of fat in the blood due to genetic reasons and corresponding food preferences). Less common causes of fatty liver include taking certain medications, gastrointestinal surgery, and hereditary diseases. In addition, these factors can be combined.
What research should you listen to?
Research directly related to human health is divided into two main groups - epidemiological and interventional.
Epidemiological studies study the relationships between causes and effects : for example, smoking and lung cancer, exercise and heart disease. Such studies may show that two processes are related, but this does not mean that one is necessarily the cause of the other. For example, based on the presence of a television in the house, one cannot conclude that television causes heart disease. The issue here is not the presence of a television, but the sedentary lifestyle caused by watching television.
Causality is best identified through intervention studies . Participants in such studies are exposed to a certain effect (intervention), and then the results are compared with data from a control group.
No matter how authoritative epidemiological studies are, their results cannot end the debate about how much fat is to blame for obesity. This still requires intervention studies. If fat really makes you fat, then low-fat diets should be effective for weight loss?
In order to assess the effectiveness of a particular technique as accurately as possible, it is necessary to summarize the results of several studies. That's exactly what the respected international scientific community known as the Cochrane Collaboration did. The scientists were especially interested in the ability of the experiment participants to maintain a stable weight for a long time.
Low-fat diets were compared with diets that, while restricting calories, did not completely eliminate fat. Low-fat diets led to very modest results: after 18 months, the participants weighed the same as at the beginning of the experiment.
Diets that did not eliminate fat outperformed low-fat diets. What conclusion suggests itself? Low-fat diets are less effective for weight control than diets that contain fat.
The statement that fat does not make you fat and that reducing your fat intake does not help get rid of the body's accumulated fat reserves seems illogical. However, everything falls into place when we understand how fat deposits in our body are regulated.
Alcohol and liver – enemies?
So, back to alcohol. It doesn't matter what you prefer - mumbling or Hennessy. Fatty liver has become a common diagnosis for representatives of high strata: politicians, businessmen, diplomats, artists. They are not alcoholics, they do not even abuse alcohol in the generally accepted sense. It’s just that for these categories of citizens, a glass of cognac or vodka is either an indispensable attribute of buffets and presentations, or a means of relieving stress after a working day, and sometimes during it. They feel great the next morning and are completely unaware of the need to reduce their drinking. Such patients are very surprised when examination reveals pathological changes in the liver.
Each person's reaction to alcohol is individual; this is due to genetically determined enzyme activity, gender, age, etc. Thus, in women, hormonal levels contribute to increased damage from alcohol to the liver, and in half of the representatives of the Mongoloid race, the toxic breakdown products of ethyl alcohol are neutralized much more slowly than in Europeans. In addition, a person may have concomitant diseases that he is not even aware of, for example, viral hepatitis or diabetes. At the same time, these diseases significantly increase the sensitivity of liver cells to alcohol. When talking about liver diseases, you should always remember that the liver is a very reliable, silent and patient organ, which often makes its suffering known when there are no more reserves for recovery. If you drink and don't eat, fatty liver disease will appear faster. However, even the most exquisite delicacies with a full range of vitamins will not save you from fatty liver - this has been proven both in animal models and in numerous clinical studies.
How food turns into fat: no, carbohydrates and sugar do not go into fat - 6 myths
Have you ever thought about how we get fat?
Well, that is, it’s clear - eat a lot, wider your waist. But how does the body convert food into fat? People are much less interested in this process than in the opposite process - the breakdown of fat, and in vain - because without understanding the other side of the coin, it is difficult to get it.
We decided to talk about this amazing transformation in simple, understandable words and give a couple of important tips that will help you better understand your body and make it easier (yes, we veiled the word “lose weight”).
This article will be especially helpful for those who believe that specific macronutrients (such as fat or carbohydrates), foods, and meals are to blame for their weight gain.
So, let's go.
The first thing that is important and needs to be accepted: any macronutrients in large quantities contribute to fat gain . Yes, even protein, if you eat more of it than you need, i.e. Get more calories in a certain period of time than you can spend on energy needs.
The key to storing fat is not what you eat, but how much. Many continue to stubbornly not believe in this, citing some arguments about the glycemic index or insulin. We would like to once again remind you of the important points (briefly):
- The glycemic index does not affect weight loss, it only affects blood sugar levels. If you eat a product with a high GI, this only means that after eating it, your blood sugar level will rise faster than if you eat equal portions of other carbohydrate foods.
This does not mean that all the calories from it will inevitably go to fat, it only means what is written above. Only those people who have problems with this, such as diabetes, insulin resistance, etc., need to monitor their GI.
- Insulin is not the “fat gain hormone,” as it has been dubbed on the Internet. Insulin resistance is based on a) physical inactivity (little amount of movement in life, which, by the way, more dangerous than smoking), b) stable overeating, c) heredity.
As you can see, both factors depend only on you. We ourselves create a vicious circle for the body: we eat a lot of food, the body releases a lot of insulin. A lot of insulin + low activity = low responsiveness of cells to it. Low cell responsiveness to it = high insulin resistance. High insulin resistance = diabetes and other troubles.
We discussed the whole process in detail in the article about insulin , don’t be lazy to study it.
- Protein is not directly stored in fat, but it makes you fatter. If you eat a lot of protein (it is generally accepted that by “a lot of protein” they mean more than 2 grams of protein for every kg of body), you will spend less fat and carbohydrates.
Here we will quote Lyle MacDonald, known to everyone who loses weight and exercises, he clearly explained these processes:
“The protein will not be converted into fat and stored. But if you eat a lot of protein, the body will use it for energy (rather than carbs and fats). Which means other nutrients will go into reserves.
Which means that overeating protein will make you fat, just not directly, but due to the fact that all the fat you eat goes under the skin.
Of course, protein has the highest thermic effect; more incoming calories will be used to digest food. So too much protein is less likely to make you fat anyway, but if the balance is exceeded, you will get fatter.
But not through direct conversion of protein into fat, but through a decrease in the number of other nutrients burned.
- Sugar doesn't go straight into fat. A lot of people (you can’t even imagine how many people believe this) think that if you eat sugar, you’ll never lose weight, no matter what.
Of course, otherwise it would be very sweet (yes, irony) and simple: well, just don’t eat this and you are guaranteed to lose weight. But is that really what happens? Scientists asked themselves this question and conducted a 6-week study of 2 low-calorie diets.
The first diet consisted of sugars at 43% of total calories. The second is only 4%. There were no significant differences in body weight or subcutaneous fat loss between the two diets .
Everything again comes down to the notorious calories, so let them go!
- Carbohydrates also do not go directly to fat.. And again, Lyle's quote:
An excess of carbohydrates still affects your fat reserves, preventing you from burning the fat you eat during the day. This is why exceeding your daily caloric intake by 500 calories of fat or 500 calories of carbohydrates makes you fat, they just do it for different reasons and in different ways.
An additional 500 calories of fat are simply deposited under the skin, 500 calories of carbohydrates make it so that all the fat eaten during the day will go into reserves, because carbohydrates will be oxidized, not fats.
- However all of the above does not mean that any fat eaten goes into fat. More precisely, not quite so: every day, all dietary fat is deposited in fat cells after eating - it does not remain floating in the blood and is not burned immediately after eating.
But if you are on a diet, then fat is taken from reserves to provide the body with the missing energy. But an excess of dietary fat is directly stored in reserves.
We need to eat fat, we really, really need it for the production of cholesterol , bile, cell membranes, etc.
So, imagine you ate something tasty and healthy. What will happen in your body after this? The teeth thoroughly grind the food, and saliva moistens it - this is necessary for convenient passage through the gastrointestinal tract and further breakdown.
Saliva, by the way, contains enzymes (enzymes) that break down complex food components into simpler ones. Next, the bolus of food is sent to the stomach, which begins to contract in order to grind the food even more and mix it with gastric juice.
Pepsin, an enzyme that breaks down proteins into molecules that consist of two or more amino acids - peptides, and hydrochloric acid help break down food, turning it into a liquid or semi-liquid substance called chyme.
It enters the initial part of the small intestine or the so-called duodenum (the place where the gallbladder secretes bile). In order for fats to be more easily absorbed by the body, bile dissolves them in water.
Enzymes from the pancreas enter the duodenum and then break down sugars, fats and proteins. Now that everything has dissolved and is in liquid form, absorption occurs through the mucous membrane of the small intestine.
After all, all nutrients are distributed throughout the body. What happens to former carbohydrates?
So, the resulting glucose enters the bloodstream, from where it goes either to glycogen (in the liver and muscles), or to the necessary needs of the body.
Fat also goes into the bloodstream, but then goes to the liver. Not all lipids are absorbed by the body; for example, fats from peanuts are not absorbed. The liver uses some fats to synthesize other important substances (such as cholesterol), and sends the rest to fat cells, where they remain until needed.
Proteins break down first into peptides, then into simple amino acids, which are absorbed through the mucous membrane of the small intestine and enter the bloodstream. From here, some stored amino acids are used for the construction of various tissues necessary for the body.
It is quite difficult to achieve an excess of protein in the body (protein reserves in the body are about 10-15 kg, and even if you eat 200-300 grams per day, this is much less than what the body can store) and in any case, there will be no protein processed into fat and stored.
“Excess” protein is not excreted from the body and does not rot in the kidneys, it’s all nonsense. The body simply begins to use protein as energy, and other nutrients (fat and carbon) will go into reserves.
The important point that you need to take away from all this for your successful and wonderful weight loss:
- If you eat more calories, no matter which macronutrients, than you need, you will gain weight.
- If you eat a lot of carbs and little fat, you will burn a lot of carbs and little fat. Better eat less carbohydrates (40-60% of your diet) and you will burn less carbohydrates and more fat.
- A lot of protein does not equal weight loss. If you eat a lot of protein, you burn a lot of protein and little fat and carbohydrates); eat less protein and you'll burn less protein (and therefore more carbs and fat).
- Fat is deposited and consumed every day, regardless of the caloric content of the diet, this is a constant. We only get fat if we store more fat than we burn. We lose weight if the body uses more fat than it has time to store. And this is determined by the overall calorie deficit during the day.
An important point: if you do not eat fats, then carbohydrates turn into fat through de novo lipogenesis. This occurs when calories from fat fall below 10% of your total daily calorie intake. For example, when on a 2500 diet we eat less than 250 calories from fat (less than 27 grams of fat).
In short, you will not deceive weight loss and your body. You need to eat all your macronutrients, distributing them so that you end up with a calorie deficit of 10-20%. Absorbing one of the macronutrients (protein, fat or carbohydrates) will not give you extra points.
If a person eats more than his norm, he gets fat, regardless of cheating with macronutrients. We very, very strongly recommend that you read the book “ Dietary Nonsense ,” which will help you get rid of the false myths that poison your life.
View the book
What is the point of observing all these stupid but strict restrictions, doing what you don’t want, if it doesn’t work and this has been proven a long time ago ?! After all, losing weight is very easy - you just need to listen to yourself, know how the body works, eat right and exercise for your pleasure.
But everything unnatural - carbohydrate-free diets, protein meal replacements, fasting - these are typical dietary nonsense, which usually lead to serious disorders in the body, including anorexia, bulimia, colitis, gastritis, etc. And it’s not at all possible to lose weight help.
- The main secret to losing weight: is it important to eat right to lose weight?
- 10 myths about the dangers of sugar: no, it’s not a drug!
- Glycemic Index: 9 Evidence Why It’s a Useless Parameter for Weight Loss
[Total votes: 32 Average: 4.4/5]
Bone Wide
This article was reviewed by a certified nutritionist who has a bachelor's degree in nutrition and dietetics, D. G. Veremeev.
Articles are for informational and educational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician with any questions you may have about a medical condition.
Why is fat deposited in the liver?
The fact is that the liver bears the main burden of oxidizing fatty acids, as a result of which the body is replenished with energy reserves. Alcohol damages the membrane of liver cells and disrupts the function of enzymes involved in the transport and oxidation of fatty acids. This leads to disruption of their normal metabolism and accumulation in the cell. In type 2 diabetes mellitus (typical of middle-aged and elderly people), obesity and hyperlipidemia, the relationship between the amount of fat penetrating the liver cell and the cell’s ability to utilize it is also disrupted.
What's good about fat?
Natalya Denisova:
“Fats are divided into neutral fats and fat-like substances (phospholipids, sterols).
Neutral fats consist of glycerol and fatty acids. There are saturated, monounsaturated and polyunsaturated fatty acids.
Saturated fatty acids (SFAs) are mainly found in animal fats, which are refractory and are solid at room temperature.
Animal fats, on the one hand, are very necessary for the body, because they perform all the functions I have listed. They are, for example, sources of vitamins, especially A and D. But it is precisely with an excess of animal fats in food that the increase in cardiovascular diseases, primarily atherosclerosis, is associated. Cholesterol plaques on the walls of blood vessels can lead to myocardial infarction and stroke.
However, this does not mean that you should completely abandon animal fats. To be honest, I can’t imagine how you can refuse them. If we drink milk, eat meat and dairy products, then in some quantity they enter the body every day. Too much saturated fat is harmful, but there is nothing wrong with eating a sandwich with butter once a day.
Vegetable oils consist of mono- and polyunsaturated fatty acids (MUFA and PUFA) and most often have a liquid consistency. Two of the polyunsaturated acids are essential - linoleic (omega-6) and linolenic (omega-3). They should enter the human body with vegetable oil or marine fish oil. To provide yourself with a sufficient amount of PUFAs, a person should consume at least a tablespoon of vegetable oil per day.
PUFAs not only participate in fat metabolism, but also help the body reduce the amount of cholesterol in the blood. That is, people suffering from cardiovascular diseases can take omega-3 fatty acids as medicine. Polyunsaturated fatty acids also help improve the functioning of the nervous system. Omega-6 acids and omega-3 acids should be in the diet in a ratio of 10:1.
Animal fats are more difficult to break down than vegetable fats, are less absorbed, and their excess leads to the development of atherosclerosis. Vegetable fats, on the contrary, help fight cardiovascular diseases. But animal and vegetable fats in the diet should be approximately equal. And we should not forget that the development of many diseases, including cardiovascular diseases, largely depends on the individual characteristics of a person and his hereditary predisposition to certain diseases.”
Why is fatty liver dangerous?
The main danger of this condition is that excess fat, under the influence of various factors, begins to oxidize with the formation of highly active compounds that further damage the cell. And this is the next stage of the disease – hepatitis, that is, inflammation of the liver. In this aspect, it is appropriate to compare fatty liver with a warehouse of fuels and lubricants, which must be guarded by an armed guard, since one spark is enough to start a fire. The progression of inflammation leads to the death of liver cells (hepatocytes), their replacement with skeletal connective tissue, and ultimately to impaired blood circulation in the liver and the development of liver failure. These, in fact, are the main manifestations of cirrhosis.
How does fatty liver affect your health?
Fatty liver is insidious in that it often does not manifest itself in any way. Some people are brought to the doctor by a feeling of heaviness or dull pain in the right hypochondrium, nausea, and an unpleasant taste in the mouth. Having a rough idea of the location of the organs, patients believe that their liver hurts. But there is nothing to hurt in the liver, because there are no nerve endings there, they are only present in the capsule and bile ducts. Typically, painful sensations are associated with impaired motor activity (dyskinesia) of the biliary tract. In most people, signs of fatty liver are detected by chance during an examination for some other reason. For example, a patient undergoes an ultrasound examination (ultrasound) of the abdominal organs or he consults a doctor about some other disease (coronary heart disease, diabetes mellitus, etc.), and during the examination the doctor reveals abnormalities in the structure and function of the liver.
How to identify fatty liver?
Diagnosis of fatty liver and its complications is complex. An experienced doctor always begins by carefully collecting anamnesis (memories of the patient’s life), paying special attention to the dose and regularity of alcohol intake, as well as concomitant diseases. Then the patient is examined to identify external signs of damage to the liver and other organs, determine the size of the liver and spleen. And only after this comes the stage of laboratory and instrumental methods:
- Ultrasound allows you to detect indirect signs of fat deposition in the liver, accurately assess its size, and sometimes identify changes characteristic of cirrhosis.
- A biochemical blood test provides valuable diagnostic information about the presence and nature of inflammation, impaired bile metabolism and functional reserves of the liver.
- Testing for the presence of hepatitis viruses is mandatory: this is due both to the fact that viral hepatitis is the most common cause of liver damage in the world, and to the fact that, in particular, the hepatitis C virus can disrupt fat metabolism in the liver.
- Additional examination, including determination of immunological parameters, computed tomography and liver biopsy, is prescribed if there are special indications.
How to treat fatty liver?
First of all, it is necessary to either eliminate or minimize the effect of the factor that led to the deposition of fat in the liver. This is almost always possible in relation to alcohol, unless we are talking about the formation of addiction, when the help of a narcologist is required. Patients with diabetes mellitus and hyperlipidemia should be monitored jointly by an endocrinologist and a cardiologist, respectively. All patients require a low-fat diet as well as adequate daily physical activity.
When these measures are not enough, the doctor prescribes special medications that affect fat metabolism in the liver. Only an experienced doctor can determine what causes liver changes in a particular patient and how severe they are. If you have any suspicions, consult a gastroenterologist or hepatologist.
Type of carbohydrates and DNL
They say it affects the amount of fat that is formed from carbohydrates - “carbohydrates from sugar and buckwheat are not the same.” It’s really not the same thing, buckwheat consists of starch, which is all digested into glucose, and sugar is digested into glucose and fructose. But this does not give sugar any magical ability to be stored in fat. Everything again comes down to the presence of EXCESS energy.
Thus, according to a systematic review and meta-analysis of randomized controlled and cohort studies on the effect of consumption of dietary sugars on body weight in adults and children (30 out of 7895 trials (RCTs) and 38 out of 9445 cohort studies were included in the review as acceptable) it was found that: “Among people on ad libitum diets (i.e., without strict control of food intake), consumption of sugars or sugar-sweetened beverages is a determinant of body weight. An increase in the proportion of sugar consumed is associated with an increase in body weight, while a decrease is associated with a decrease. The findings suggest that the mechanism by which increased sugar intake may contribute to increased body fat is through energy imbalance rather than the physiological or metabolic effects of mono- and disaccharide intake. Those. The amount of energy received by the body exceeds its expenditure. For example, sugar-sweetened beverages are less filling, which can lead to heavy consumption, and solid foods with sugar tend to be high in energy density (e.g., cookies, chocolate) and are more likely to provide excess energy from such foods than from other foods. . In addition, this conclusion confirms that, according to 12 studies, for a period of 2 weeks to 6 months, replacing sugars with other carbohydrates (including those with a lower GI) against the background of an isocaloric diet (deficient) did not cause changes in body weight. That is, qualitative changes in the form of carbohydrates without changing their quantity did not change the current situation. However, it should be considered that high intakes of dietary fructose may promote liver fat deposition, visceral fat, and serum lipids, independent of the effect on body weight.” (Dietary sugars and body weight: systematic review and meta-analyses of randomized controlled trials and cohort studies. Lisa Te Morenga, Simonette Mallard, Jim Mann. BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.e742 )
Another study that examined DNL from carbohydrates, with a surplus of 50% (!!!) of maintenance calories created by either sucrose or glucose alone in women with normal weight or obesity, showed that “... de novo lipogenesis was 2-3 times higher than after control treatment in all subjects. The type of carbohydrate used to overeat (sucrose or glucose) did not have a significant effect on de novo lipogenesis in either group. The increase in DNL after glucose and sucrose overfeeding occurred to a similar extent in lean and obese women, but did not significantly contribute to overall fat balance." (De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. McDevitt RM1, Bott SJ, Harding M, Coward WA, Bluck LJ, Prentice AM. Am J Clin Nutr. 2001 Dec;74(6):737- 46.)
An entire scientific conference on the topic “Relationship of the Glycemic Index to Lipogenesis in Humans” failed to establish a clear difference in the extent of DNL after consumption of polysaccharides (starches) and simple sugars, despite different changes in blood glucose and insulin levels. I quote: “The clear relationship between the glycemic index of dietary carbohydrates and its ability to stimulate lipogenesis awaits further study.” Until now, nothing has become clearer, and every second person declares that “fast carbohydrates go into fat.”
(Parks, E. J. (2002) The relationship of the glycemic index to lipogenesis in humans. In Proceedings of the 6th (Millenium) Vahouny Conference, [Kritchevsky, D, editor])
