Belgian
We won’t say that the liver is our “third brain” after the intestines, which are in direct connection with our brain, but almost. Little known for a long time, it has not yet revealed all its secrets. But we now know that the liver is much more subtle than the simple “factory for emptying” our waste (alcohol, medications, etc.) that we often imagine. We now know that the liver eliminates toxins and also produces countless proteins essential to our body. “It is essential to life. If it no longer functions, this leads to liver failure for which the only curative treatment is liver transplantation. There is no treatment like for the kidneys for which dialysis can be performed. Given the complexity of the liver, there is no system to replace it,” warns Doctor Christophe Moreno, director of the Gastroenterology department at Érasme hospital.
Three million Belgians affected
Hepatic steatosis – more commonly called fatty liver – is an accumulation of fat (triglycerides) within the hepatocytes. For a long time, cirrhosis was attributed solely to excessive alcohol consumption, which almost systematically leads to fatty liver, but this is far from being the only cause. Excessive consumption of sugars and fats, which is the responsibility of a majority of the population with the explosion of agri-food industrialization, can impair the functioning of the liver by causing the appearance of inflammation and increasingly scarring. more numerous. Three million Belgians are affected.
5 to 10% of patients with a steatotic liver develop cancer or cirrhosis
Before a person becomes yellow and confused from liver dysfunction, years and years of evolution pass. Although we do not yet know why, approximately 5-10% of patients with a steatotic liver develop liver cancer or cirrhosis. The traditional blood test does not make it possible to establish the diagnosis of fatty liver even if excess cholesterol or the presence of diabetes can alert you. “Classic liver tests by blood test (transaminases) are not very specific and can vary if Dafalgan is taken regularly, for example. Furthermore, they say nothing about the severity or not of the disease. But we can perform a FIB-4 from a blood test which calculates the presence of numerous scars using different parameters. It is little known to patients in general and too little practiced by general practitioners. For around ten years, there have been non-invasive techniques such as liver elastography or fibroscan, which takes a few minutes.”
An asymptomatic disease
The problem with fatty liver disease is that it is asymptomatic even in cases of early cirrhosis. Chronic fatigue may be the only symptom. “Alcohol remains the leading cause of mortality due directly to the liver, but it is not the most common cause of fatty liver. The main causes today are excess weight, poor diet and a sedentary lifestyle. Furthermore, a fatty liver without scarring will not lead to liver-related death, but patients can still have cardiovascular problems and see an increased risk of cancer.”
Fortunately, the liver’s ability to regenerate throughout life is extraordinary.
The increase in people with a fatty liver follows the curves of obesity. The very good news is that the liver has extraordinary resilience. Its capacity to regenerate throughout life is great as long as the synthesis and elimination functions are preserved. Just by losing between 7 and 10% of your weight, the fat in the liver decreases and the scars can regress. By removing the causes of aggression, the liver does much better. But there is currently no magic treatment to cure fatty liver, even if drugs are in development. The solutions are to be found in a better lifestyle. For people who are unable to lose weight, there are endoscopic techniques which consist of reducing the volume of the stomach using devices developed by the gastroenterology department of the Erasmus hospital. These techniques allow you to lose 10-20 kg and improve diabetes.
The disease of the future
In people who consume excessive alcohol, fatty liver almost systematically develops. It will appear in 80% of obese and/or diabetic people. Some studies now show that consuming just one can of soda per day is already harmful to the liver. Amandine De Paepe, the “popess” of nutrition in Belgium and author of several best-sellers, goes further in her book Once Upon a Liver. A whole series of everyday ailments are linked to fatty liver. “Liver disease is the disease of the future because of the overconsumption of sugar which accumulates in the liver and muscle reserves. A fatty liver has a direct impact on blood sugar levels by leading to hormonal imbalance, slowed metabolism, chronic fatigue, poor menopause, more wrinkles or acne, low energy, nocturnal awakenings.”
From 30 years old
“We really do too little prevention. The probability of having a fatty liver is linked to weight and age from 30 years old. My patients are not sick but they are not in good shape and three out of four have a fatty liver. They eat too much starchy foods (pasta, rice, bread) which are not consumed while exercising and are stored in the liver. However, a fatty liver can prevent weight loss because a body full of sugar will burn it rather than fat.” Any tips for regaining a healthy liver? Juices and smoothies are not good. Fruit is edible. This cannot be drunk. The basis of a meal, including in the morning, is vegetables. But even at restaurants, vegetables represent the smallest portion. “People’s knowledge of nutrition is low and we focus too much on calories. People who have too much cholesterol are given too many statins. The reality is that we eat too little fiber, too many additives and overcooked foods. Healthy eating should be much more plant-based by incorporating healthy proteins and not so much ground meat in which there is a lot of sugar and fat.”
