Diet and taboos for fatty liver

More than 90% of mild to moderate simple fatty liver diseases do not require medication. As long as they adjust their diet and exercise regularly, they can be completely reversed in 3-6 months.； The core principles of diet are to "control added sugars, limit bad fats, and have enough high-quality protein." There are no foods that must not be touched, there are only dietary structures that require strict control of amounts. You don't have to go on a vegetarian fast, which will easily make things worse.

A while ago, I helped my distant cousin who works in sales to treat fatty liver disease. The 32-year-old young man’s physical examination showed that he had moderate liver disease and his transaminases were twice the normal value. The doctor almost prescribed him liver-protective drugs. He was so frightened that he patted his chest on the spot and said he would never eat meat again. I stopped him from talking nonsense, so I adjusted according to the above principles for 4 months. I went for a review last week and found that the fatty liver has turned into mild, the transaminases are all normal, and even his protruding beer belly has shrunk.

What’s interesting is that many people’s first impression of fatty liver is that “eating too much meat will make you fat.” In the past two years, there were many opinions recommending a vegetarian diet to reverse fatty liver. I met an aunt in her 60s before. After hearing this statement, she ate a vegetarian diet for half a year. On the contrary, the fatty liver increased from mild to moderate. After asking, I found out that she eats two large bowls of white rice every meal, uses more rapeseed oil for cooking than when she ate meat before, and likes to stew a pot of white fungus soup with rock sugar for afternoon tea every day. Isn’t this higher in calories than eating a piece of braised pork? Now the academic circles have long agreed that excessive intake of carbohydrates, especially refined carbohydrates and added sugars, is more likely to induce fatty liver than fat. This is mostly the reason why lean people, especially those who don’t like to eat meat, develop fatty liver.

You don’t have to completely give up white rice and steamed buns as staple food. Just replace one-third of the grains with oats, quinoa, steamed corn, and sweet potatoes. Don’t buy the multigrain biscuits on the market that claim to be “sugar-free and fat-reduced.” If you look down the ingredient list, if the first three are wheat flour, non-dairy creamer, and white sugar, they are all pitfalls. I once had a patient who took this as a snack every day. After eating it for a month, he gained three pounds. He said that he was clearly eating a fat-reducing meal. He couldn’t laugh or cry.

On the contrary, you should eat more protein. Don’t be afraid of getting fat and just boil vegetables every meal. Think about it, in order for the liver to transport the accumulated fat out, it needs apolipoprotein as a "transport truck". High-quality protein is the raw material for building the truck. If you don't have enough raw materials, the fat will pile up in the liver and cannot be transported out. Will it become more and more serious? Lean beef, steamed fish and shrimp, eggs, sugar-free soy products are all fine. My cousin used to eat takeout barbecue, but later changed to bringing a palm-sized pan-fried chicken breast every day at noon, or ordering a steamed sea bass from the workplace canteen, adding a cup of sugar-free soy milk and a boiled egg in the morning, and occasionally making tofu soup at night. After eating, he will not be craving for milk tea in the afternoon, but it is much more comfortable than eating takeout heavy in oil and salt before.

Oh, by the way, many people ask if fatty liver disease means that fat cannot be touched at all? No, this is also an old misunderstanding before. The current consensus is to "eat fats first." It is perfectly fine to eat a small handful of good fats such as olive oil, avocado, and plain nuts every day. On the contrary, it can help regulate blood lipids. What you need to avoid are saturated fats such as oil, lard, and fatty meat that have been fried repeatedly, as well as trans fatty acids hidden in milk tea, crispy bread, and puffed foods. These two are the "bad elements" that will really pile fat on the liver.

Many people develop fatty liver disease without drinking alcohol or eating fatty meat. Most of them fall into the trap of "added fructose". Especially in ice cola, fruit tea, bottled fruit juices with fructose syrup, and even in many so-called healthy "zero fat drinks", fructose does not require insulin regulation. Drinking it directly goes to the liver to synthesize fat, which is more harmful to the liver than drinking ordinary sugar water. I once met a college student who never drank alcohol or ate late-night snacks. He even had two bottles of ice cola a day in summer. His physical examination revealed mild fatty liver disease, and he was confused.

In terms of taboos, there is actually nothing that will cause trouble if you touch them. It is just a few minefields that should be stepped on as little as possible. The first thing to mention is alcohol. Whether it is white wine, beer or red wine that is said to soften blood vessels, as long as it contains alcohol, it will increase the metabolic burden on the liver. For people who already have fatty liver, it is best not to drink alcohol. If you have social events, drink it at most 1-2 times a month. Do not drink more than 1 tael of white wine or more than 1 bottle of beer at a time. Don’t use "a small amount is fine" as an excuse.

There are also many people asking about liver-protecting health products. Are milk thistle, liver-protecting tablets and the like useful? To be objective here, if you just have a simple fatty liver and your transaminase is completely normal, there is really no need to eat. All these things are metabolized by the liver. Eating too much will add more work to the liver. My cousin bought more than 300 yuan of imported milk thistle. After eating it for half a month, the transaminase was checked, but the transaminase was even higher. After he stopped, he adjusted his diet and it came down. If the transaminase is really abnormal, just take the medicine prescribed by the doctor, and don't buy random supplements on your own.

Oh, by the way, don’t always think that everything will be fine if you eat lightly. I have seen many people boiling vegetables for a while, and slumping on the sofa to check their mobile phones after eating. After half a year, their fatty liver has not been cured. If you smoke three or four times a week, walking briskly or jogging for 30 minutes each time, the effect is better than eating fat-reducing meals every day.

To put it bluntly, fatty liver is a "lifestyle disease that you are accustomed to." Don't be overly anxious, don't take it seriously, and don't torment yourself with extreme fasting or vegetarianism. Eat well, drink less sweets, and stay up less late. It's more effective than any health supplement.