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Non-alcoholic steatohepatitis, or NASH, is a severe form of non-alcoholic fatty liver disease (NAFLD). Fatty liver is a common condition among alcohol abusers. However, when a person gets fatty liver without consuming alcohol, it is calledNAFLD.
In NAFLD, fat deposition in the liver exceeds the normal range of5-10% of the liver’s weight. This excess buildup of fat can causeinflammation of the liver, which is called NASH. This condition is also called metabolic dysfunction-associated steatohepatitis, or MASH.
NASH itself is a reversible condition, and you can cure it with treatment, diet, and lifestyle changes. However, NASH can progress into an irreversible condition calledliver cirrhosis where scar tissues permanentlydamage your liver.
According to a report by theAmerican Liver Foundation, about 9-15 million people in the USA have NASH. Among these, about 11% of people develop liver cirrhosis.
Serum glutamic pyruvic transaminase, or SGPT, is an enzyme primarily present in the liver. Elevated levels of SGPT in the blood indicate damage or inflammation to the liver. However, it doesn’t necessarily mean that a person has NASH.
SGPT is also present in other tissues, such as the heart and muscles. High SGPT levels in the blood can also be due to problems associated with these tissues.
NASH patients often don't experience any symptoms at all. But some mayexperience the followingsymptoms with NASH:
When NASH progresses to scar formation and cirrhosis, you can experience the following signs and symptoms:
NASH is a severe stage of fatty liver disease. Fat accumulation in the liver is the initial phase of fatty liver disease. This fat accumulation doesn’t require medical management as it doesn’t influence the functioning of the liver significantly.
However, when the fat accumulation continues, this buildup causes inflammation of the liver which is called NASH.
See Also: How to fix non-alcoholic fatty liver disease (NAFLD)?
Unlike fatty liver, NASH requires early medical management to prevent scarring of the liver tissues — liver fibrosis. If scarring happens due to NASH, it leads to liver cirrhosis and liver failure.
Experts still don’t know exactly why people develop NAFLD and why it progresses to NASH in some. However, several factors increase your risk of developing NAFLD which may lead to NASH:
In early NAFLD, fat accumulates in the liver without harming its function. But as the fat continues to accumulate, it leads to a severe stage of liver disease or NASH.
Doctors can suspect NASH through patient history and physical examination. Doctors look for risk factors associated with NASH in the patient’s medical history, such as obesity and type 2 diabetes. Physical examination helps evaluate signs and symptoms of NASH, such as jaundice and edema.
Several other diagnostic tests are available for NASH, like:
When the patient’s medical history and physical examination suspect NASH, doctors recommend a blood test. A blood test is used to observe the amounts of liver enzymes in the blood, such as serum glutamic transaminase (SGPT) or alanine aminotransferase (ALT).
High blood SGPT indicates damage to the liver and hints at NASH. However, it doesn’t confirm NASH as elevated SGPT can also occur in conditions related to the heart and muscles.
A liver biopsy is the currentgold-standard diagnostic test for NASH where a portion of the liver tissue from the patient is studied under a microscope. The examination provides detailed information about damage to the liver tissues.
From a biopsy, doctors can tell whether the patient has NASH, liver fibrosis, or cirrhosis.
Experts recommend weight loss as the first-line treatment for NAFLD and NASH. Lowering cholesterol levels can also improve NASH and prevent further damage to the liver. That’s why dietary and lifestyle changes remain at the heart of treating NASH.
Studies show that weight loss can lower fat accumulation, inflammation, and scarring in the liver. If you have NASH, reducing 7-10% of body weight can reduce the inflammation and improve the condition.
Dietary and lifestyle changes can help weight loss and improve NASH. Theseinclude:
See Also: Dietitian-Backed Tips That Can Help You Lose Weight Fast!
Astudy shows that high cholesterol is a significant factor in causing liver inflammation or NASH. This study further explains that reducing cholesterol in the diet improves NASH.
To reduce cholesterol levels limit your intake of saturated fats such as processed or red meats, ultra-processed foods, and dairy products. You can replace these with monounsaturated and polyunsaturated fats present in olive oil, seeds, and nuts. Aplant-based diet is a great start to lower cholesterol.
A2021 study also suggests that exercise lowers total body cholesterol.
Related Link: Certified Cholesterol-friendly Meal Plan
Currently, there is no such medication to cure NASH. However, the FDA recently approved a drug -Razdiffra (Resmitirom) that can improve the condition of people with NASH. Doctors may also prescribe statins to reduce cholesterol in the blood.
If you have NASH, your diet should focus on losing weight and minimizing cholesterol consumption. The following foods are healthy to eat for NASH:
Plant-based diets rich in vegetables and fruits contain fiber and can help you lose weight and lower your cholesterol.
A study published in theJournal of Geriatric Cardiology suggests plant-based diet prevents obesity and promotes weight loss. A2023 European Heart Journal study indicates that a plant-based diet reduces total cholesterol - which improves NASH and prevents further damage.
Some healthy vegetables to eat for NASH include:
Some fiber-rich fruit options for NASH include:
Whole grains are rich in fiber whichhelps in weight loss. This is confirmed by a2019 studypublished in Nutrients Journal. Anotherstudyshows that consuming whole grains reduces cholesterol levels in your body.
So, whole grains promote a healthy weight and reduce cholesterol levels - thus significantly improving NAFLD and NASH.
Some whole-grain options include:
Fats don’t have a good reputation for their role in overall health, especially NASH. However, this doesn’t apply to all fats, especially omega-3 fatty acids.Experts recommend consuming omega-3 fatty acids to lower the risk of heart diseases in fatty liver.
Astudy shows that consuming omega-3 fatty acids improves liver fat in people with NAFLD and NASH. A2022 study by Nutrients Journal shows similar results, stating that omega-3 fatty acids can improve fatty liver.
Some sources of omega-3 fatty acids are:
Studies show that consuming coffee reduces the risk of NASH. Coffee is alsofound effective in inhibiting scar formation in the liver tissues. Preventing scar tissue can reduce the risk of liver cirrhosis and liver failure.
Experts recommend consuming more than two cups of coffee a day to experience its benefits for NAFLD and NASH.
Astudy on the role of vitamin E in treating fatty liver indicates that vitamin E is effective in treating NAFLD and NASH. A2024 study shows that vitamin E can prevent NAFLD and improve NASH.
However, you should not increase vitamin E in your diet or take supplements before consulting your doctor.Studies indicate that using vitamin E for treating NASH may not be suitable for everyone, such as diabetic patients.
Fiber offers arange of health benefits and can improve liver health. Here is how dietary fiber improves liver health:
So, if you want to improve your liver health in NASH, adding fiber to your diet can help significantly. You can get dietary fiber from plant-based foods orpowdered fiber products.
See Also: The Crucial Need for Fiber in Our Diets and How Fiber Powders Can Help!
If you have NASH, powdered fiber will help you keep track of your daily fiber dosage.
If you have NASH, try avoiding foods that can trigger the risk factors for NASH or progress the disease further. This includes avoiding foods that promote weight gain, type 2 diabetes, high triglyceride and high cholesterol levels. These include:
Fried foods are rich in fat andincrease the risk of weight gain.Studies show that deep-fried foods also cause high blood cholesterol.
Processed meats are high in salt and fat. These canincrease the risk of weight gain.Studies show that a salty diet negatively influences liver defense and can cause liver inflammation and fibrosis.
Evidence shows that increased consumption of refined sugarpromotes weight gain. A 2023 study in Nutrients shows that refined sugar increases the risk of type 2 diabetes.
See Also: The Shocking Truth about Processed Sugar!
A2022 study shows that higher salt consumption is associated with obesity and insulin resistance. As mentioned above, salty foods alsopromote liver inflammation and fibrosis by compromising liver defense.
Consuming excessive alcohol can cause fat buildup in the liver, a condition calledalcohol-related fatty liver. This fat buildup from alcohol consumption can worsen already present NASH.
Non-alcoholic steatohepatitis (NASH) is a severe stage of fatty liver disease. In NASH, excess buildup of fat in the liver causes liver inflammation. The inflammation can progress into liver scarring or cirrhosis which is incurable.
Weight loss and lowering blood cholesterol are among the most effective treatment options for NASH. So, dietary and lifestyle changes remain crucial to the recovery of NASH patients.
One important and beneficial dietary modification for NASH is adding fiber to your diet. You can get the required fiber from plant-based foods but you can alsobuy powered fiber for effective dosages and results.
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