The liver is one of the largest organs in the body, second only to the skin.  The liver is vital to life and functions to filter the blood, make proteins used in the clotting of blood, produce digestive enzymes and metabolize and break down medications.  It is also a storage facility for vitamins and glucose.

Fatty liver is a condition in which fat is deposited in the liver in abnormal amounts.  This can be a benign condition.  In others, fatty liver can lead to inflammation called steatohepatitis.  In severe cases the inflammation can result in scarring and cirrhosis.

There are several causes of fatty liver. A major cause of fatty liver is excessive alcohol intake.  The exact amount of alcohol consumption required to produce this varies from person to person. 
In patients who have fatty liver in the absence of alcohol the condition is referred to as nonalcoholic fatty liver disease or NAFLD.  The spectrum of NAFLD ranges from benign fatty deposition in the liver, to fat plus inflammation and scarring (steatohepatitis) to cirrhosis.  NAFLD affects 20% of adults.  The incidence in children is unknown but there is 5 percent.

The most common cause of fatty liver is eating excess calories causing fat to build up in the liver.  However fatty liver usually is due to a combination of risk factors.

Risk factors for fatty liver: obesity
    diabetes
    alcohol abuse  
    rapid weight loss
    malnutrition
   
Some people develop fatty liver even though the have none of these conditions.  For this reason it is important to know about fatty liver.

There are usually no symptoms of fatty liver disease.  The most common way patients discover they have fatty liver is while having blood work performed during a physical exam.  There may be an elevation in certain enzymes found in the blood.  Sometimes the liver is slightly enlarged.  Ultrasound of the abdomen can show fat in the liver.  Diagnosis can be made based on blood work and imaging studies.  Sometimes a liver biopsy is needed.

There is no medical or surgical treatment for fatty liver.  There are several recommendations concerning lifestyle modification and diet.  These are going to seem very familiar to you.  We seem to find ourselves “back to the basics” with eating healthy and exercising.  The recommendations for management of fatty liver are:
  
1. lose weight in a safe and controlled manner, no more than 2 pounds per week
2. lower your triglycerides with dieting and or medications
3. avoid alcohol
4. control your diabetes
5. eat a balanced and healthy diet
6. increase physical activity

If fatty liver is diagnosed you should see a liver specialist. Other underlying liver diseases need to be excluded.  Medications, viral hepatitis, autoimmune liver disease and metabolic or inherited liver disease can be associated with fat deposition in the liver. 

NAFLD can improve with dietary management, weight loss and control of diabetes and lowering of  triglycerides.  It is possible to reverse these changes in the liver and see a  return of blood chemistries to normal levels.

Eating healthy and maintaining a healthy weight is important for many reasons.  There is an increasing number of patients with liver disease caused by NAFLD.  The impact on children has yet to be seen.  We know that this can be prevented with taking the proper steps in managing our diet and lifestyle.