One month in and all the New Year parties are now well and truly over. After all those celebratory drinks and feasts, people will by now have likely begun to question if their excessive consumption of alcoholic beverages, cakes and all that would put them at a higher risk of fatty liver, a disease commonly found in recent years.
Hepatologist Dr Pongjarat Nun-anan admitted that there is a lot of misunderstanding about fatty liver disease, a broad term that describes the accumulation of fat in the liver. One important fact to note is that fatty liver, or steatosis, is actually not associated with alcohol consumption.
"That's why the disease is medically referred to as Non-Alcohol Fatty Liver Disease or NAFLD," explained Dr Pongjarat.
Fatty liver disease has seen an increase in diagnosis, not just among people in Western countries but also those in Thailand too. According to the specialist, approximately 10-15% of the Thai adult population has the illness, which is mainly a cause of patients' poor lifestyle and eating habits.
"When specialists attend and diagnose people as suffering from fatty liver disease, we put heavy alcohol drinkers out of the equation first," said Dr Pongjarat, who is also an gastroenterologist. "In most cases, too much junk food and diets high in fats are found to be responsible for the development of the disease. Other risk factors include lack of exercise and obesity."
Fatty liver disease is also associated with insulin resistance -- resulting in the build-up of fats in the liver cells. Patients with diabetes may subsequently have a higher risk of developing fatty liver disease than normal people, given insulin resistance is common in people with diabetes.
Fatty liver disease is not acute, he added, and in most cases has no signs or symptoms. "People are often diagnosed as having an early stage of fatty liver disease only from a general physical check-up where specialists will detect an abnormal increase of liver enzyme."
But despite no symptoms, the illness is something that should not be overlooked because it means the disease can become chronic and will only be detectable when it turns very serious.
"If left unattended, fatty liver disease can lead to more serious liver-related illnesses including non-alcoholic steatohepatitis [liver inflammation caused by a build-up of fat in the liver], cirrhosis [a condition where the liver does not function properly due to long-term damage] and eventually liver cancer."
"This, fortunately, is not common," he added. "Only 2-3% percent of the Thai population are found to suffer NAFLD-causing liver inflammation."
Recently, news has been circulating, especially on social media that red yeast is one of the cures for fatty liver. But according to Dr Pongjarat, it is hard to pinpoint if such a claim is true.
"There are not enough medical studies to support the effectiveness of red yeast as a treatment for fatty liver disease. However, some studies go for probiotics but again, this is not yet a standard treatment. And therefore, if patients are to opt for these types of products to alleviate their fatty liver disease, it is a must they discuss with their doctors first or wait for more substantial data to back up the products' claims."
Dr Pongjarat added that only 2-3% percent of fatty liver disease patients require medication treatments that usually involve the use of vitamin E. But excessive use of vitamin E has some downsides too. Vitamin E, he said, appears to increase the chance of bleeding in the brain and developing prostate cancer.
Nonetheless, in early stages of fatty liver disease, patients usually require no medication. But just like some other diet-related ailments, the change in lifestyle is key.
"First you should understand the cause of the disease -- that is basically how you live your life," the doctor commented. "Modern people's lifestyles, which involves inadequate or no exercise at all, the consumption of too much greasy food all contribute as the main culprits when it comes to having a lot of fats inside your liver.
"This means that if you are diagnosed as suffering from the early stage of the disease, more exercise, a less fatty diet, more fruit and vegetables, plus weight loss and controlling your diabetes is the best treatment."
