Omega 3 For Fatty Liver
- Non-Alcoholic Fatty Liver Disease (NAFLD) affects a large proportion of the global adult population, but there’s no agreement on how to treat it.
- Omega-3 fatty acids have been shown to be beneficial in the treatment of hyperlipidemia and cardiovascular disease, and have recently been proposed as a treatment for NAFLD.
- Omega-3 fatty acids are important transcriptional regulators of hepatic genes.
- Clinical studies show that they reduce hepatic steatosis, improve insulin sensitivity, and lower inflammation markers.
- Human clinical trials generally confirm these findings but have significant design flaws.
When we think of ‘fat’, we often envision the visible fat on our bodies, but fat plays a vital role in supporting internal organs, including the liver. Fatty liver disease, also known as hepatic steatosis, occurs when excessive fat accumulates in the liver, impairing its functions. There are two primary types of fatty liver disease: Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic Fatty Liver Disease (NAFLD).
The liver, one of our most hard-working organs, normally has a small amount of fat in it, and that’s harmless. But a fat-loaded diet or heavy drinking can drastically increase the fat deposits in the liver, hamper its regular functions, and cause fatty liver disease.
This is a condition that can be reversed by taking up regular exercise and changing the mix of foods in your diet — strange though it may sound, a fatty liver can actually be helped by dietary fat, as long as it falls in the category of unsaturated fats and replaces saturated fats in the diet. As good (unsaturated) fats go, Omega-3 fatty acids are one of the best.
As per research, Omega-3 for fatty liver brings down the level of liver lipids and inflammation, thereby contributing to a reversal of fatty liver disease. In general, Omega-3 fatty acids have a very beneficial effect on many organ functions; consistent with that, Omega-3 and fatty liver are also closely connected.
Types of Omega-3 fatty acids
Omega-3 fatty acids are not made naturally in the human body, so they must be supplied to your body through food.
Omega-3 fatty acids come in three varieties: Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) primarily found in fish, and Alpha-linolenic acid (ALA) found in vegetable oils, nuts, flax seeds, and leafy vegetables such as spinach.
Understanding fatty liver disease
Hepatic steatosis is the medical term for fatty liver. The liver is the second largest organ in the human body and is in charge of processing nutrients from the consumed food and drinks as well as filtering out harmful substances.
Fatty liver is defined as having more than 5-10% fat in the liver.
Fatty liver disease is classified into two types based on the underlying cause: Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic Fatty Liver Disease (NAFLD).
Fatty liver disease initially presents little or no symptoms — the person who has it may not even know it — but over time, it causes severe liver damage, rendering the liver incapable of removing toxins and producing bile as it should.
If your liver contains too much fat, that can cause scarring, inflammation, cirrhosis, and eventually, liver failure.
NAFLD is a group of fat accumulation disorders in the liver that are not caused by alcohol. NAFLD severity can range from non-alcoholic fatty liver (NAFLD) to non-alcoholic steatohepatitis (NASH) with or without fibrosis to cirrhosis (scarring of the liver).
This can lead to hepatocellular carcinoma (liver cancer) in up to 27% of people with NASH and cirrhosis.
Risk factors for NAFLD
- A person’s risk of developing NAFLD increases if they have metabolic syndrome (high blood pressure, blood sugar, excess body fat around the waist, abnormal cholesterol and triglyceride levels).
- Obesity is the most common risk factor, followed by Type 2 diabetes and dyslipidemia (abnormal amount of lipids). Men are twice as likely as women to have the condition.
- Cardiovascular disease is the leading cause of death in NAFLD patients, regardless of other metabolic co-morbidities. Although liver disease or condition is the 12th leading cause of death in the general population, it’s the second or third leading cause of death in NAFLD patients. NAFLD is now the third leading cause of hepatocellular carcinoma (cancer).
- Fat infiltration affects more than 5% of liver cells in NAFLD. An abdominal ultrasound is the most commonly used imaging method for diagnosis, and a liver biopsy is the gold standard for determining the degree of fat infiltration.
Omega-3 fatty acids and NAFLD
Omega-3 fats are a type of polyunsaturated fat. There are three kinds of Omega-3s:
- Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) are primarily found in fish, and are also known as marine Omega-3s.
- Alpha-linolenic acid (ALA), the most common Omega-3 fatty acid in most Western diets, is found in vegetable oils and nuts (especially walnuts), flax seeds and flaxseed oil, leafy vegetables, and some animal fat, particularly from grass-fed animals. The human body primarily uses ALA for energy, with very limited conversion to EPA and DHA.
Your body must convert ALA into EPA and DHA, which is an inefficient process, because only about 8-20% of ALA is converted to EPA and 0.5-9% to DHA.
Several observational studies have shown that patients with NAFLD have lower relative hepatic levels of EPA and DHA than people who don’t have NAFLD. The reason for this is unknown.
What makes Omega-3 fats unique?
- They are a component of cell membranes throughout the body and influence the function of cell receptors.
- They serve as a starting point for the production of hormones that regulate blood clotting, artery wall contraction and relaxation, and inflammation. They also bind to cell receptors that regulate genetic function.
- Omega-3 fats have been shown to help prevent heart disease and stroke, may help control lupus, eczema, and rheumatoid arthritis, and may play protective roles in cancer and other conditions.
- The Omega-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs), specifically EPA and DHA, have been shown to help adults and children with NAFLD. A recent meta-analysis of 18 clinical studies found that Omega-3 supplementation resulted in significant improvements in cardio-metabolic risk factors (total cholesterol, LDL-C, HDL-C, triglycerides, and insulin resistance), liver enzyme levels (ALT and GGT), liver fat content, and steatosis score.
- Because EPA and DHA modulate gene expression in the liver, they promote fatty acid oxidation while inhibiting fatty acid synthesis and storage. More specifically, Omega-3 fatty acids inhibit the sterol regulatory element-binding protein 1 (SREBP-1) involved in fatty acid synthesis and storage, while stimulating peroxisome proliferator-activated receptors (PPAR) to increase fatty acid oxidation and PPAR-y to increase insulin sensitivity. The overall fat accumulation is reduced as a result of this gene modulation.
- Given the findings of significant improvements in liver fat content, steatosis score, and several cardio-metabolic risk factors in patients with NAFLD after supplementation with n-3 LC-PUFAs, adult and pediatric patients with NAFLD should be encouraged to increase their intakes of n-3 LC-PUFAs.
- This intake should be encouraged in conjunction with increased physical activity and caloric restriction, which effectively slows the progression of NAFLD.
Intake quantity of Omega-3 fatty acids
Based on the dosages used in the clinical studies:
- Effective daily intake for children appear to be 250mg of DHA
- And approximately 3 gm of EPA + DHA for adults
The minimum effective intake of n-3 LC-PUFAs is unknown, nor is it clear whether EPA is even required for therapeutic effectiveness, given that efficacy in children has been reported with supplements containing only DHA. Additional research is needed to answer these critical questions.
Although beneficial, Omega-3 consumption should be encouraged as one component of a comprehensive treatment plan that also includes a healthy diet and regular exercise (150-200 minutes of moderate to vigorous activity per week).
The Mediterranean diet has been shown to be especially beneficial for NAFLD:
- This diet not only improves heart health but also reduces insulin resistance and disease severity in people with NAFLD.
- A Mediterranean diet emphasizes on fish, fruits, vegetables, beans, whole grains, nuts, seeds, and olive oil, while limiting red meat and sweets and eating dairy, eggs, and poultry in small to moderate amounts.
- Although wine consumption is part of the Mediterranean diet, it should be avoided by those with any kind of fatty liver disease, since alcohol puts a load on the already suffering liver.
- People with cirrhosis have to stop drinking permanently, because alcohol increases the risk of developing hepatocellular carcinoma.
Other dietary measures for NAFLD include drinking coffee every day, which can slow the progression of liver fibrosis.
Omega-3 and fatty liver
In addition to Non-Alcoholic Fatty Liver Disease, Omega-3 fatty acids have shown promise in supporting the liver in cases of Alcoholic Fatty Liver Disease. Research suggests that Omega-3 supplementation can help mitigate liver damage caused by excessive alcohol consumption.
All evidence points to the fact that Omega-3 fatty acids are good for fatty liver. Its beneficial impact on liver health would be aided by at least 30 minutes of physical activity 4-5 days per week, as well as the management of sleep and stress issues.
Consult a qualified clinical dietician to help you fine-tune your diet to avoid aggravating fatty liver. Please incorporate Omega-3 fatty acids as one component of a comprehensive treatment plan that also includes a healthy diet and regular exercise (150-200 minutes of moderate to vigorous activity per week).
Vitamin E and Omega-3 for fatty liver
Alongside Omega-3 fatty acids, Vitamin E has also been studied for its potential benefits in fatty liver disease. Both nutrients may work synergistically to combat liver inflammation and oxidative stress.
Omega-3 fatty acids have a remarkable impact on fatty liver disease and should be part of a comprehensive treatment plan, including regular exercise and a healthy diet. Consulting a qualified clinical dietitian can help tailor a diet that supports liver health and avoids aggravating
fatty liver disease. By incorporating Omega-3 fats into your lifestyle, you can take proactive steps towards improving your liver health and overall well-being.
The Mediterranean diet has been shown to be especially beneficial for NAFLD. This diet not only improves heart health but also reduces insulin resistance and disease severity in people with NAFLD. Although wine consumption is part of the Mediterranean diet, it should be avoided by those with any kind of fatty liver disease, since alcohol puts a load on the already suffering liver. People with cirrhosis have to stop drinking permanently, because alcohol increases the risk of developing hepatocellular carcinoma.
Other dietary measures for NAFLD include drinking coffee every day, which can slow the progression of liver fibrosis. By incorporating Omega-3 fatty acids into your lifestyle and adopting a healthy diet and exercise regimen, you can take proactive steps towards improving your liver health and overall well-being.
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