Preventing Fatty Liver

Fatty Liver II.

A couple weeks ago I wrote a little bit about how children as young as five years old are getting Non-alcoholic Fatty Liver Disease (NAFLD) and discussed how fructose appears to be a causative factor (not the only one). It's kind of an important issue considering that as many as 100 million Americans probably have some stage of fatty liver disease.

Chris Masterjohn just published an article on his blog, The Daily Lipid, looking in to the research on what actually causes fatty liver. It's a bit technical, but the information is simply fantastic. In fact, Chris' work in general is some of the best there is on nutrition and health, and I highly recommend his blog. Anyway, I suggest you read his full analysis here, but I'll give a quick summary of his findings. 

Sugar, fat, alcohol and choline. 

In his review of the literature the evidence shows that alcohol, fat, and sugar/fructose intake ALL contribute to fatty liver, but only in the presence of a choline deficiency. It appears that a deficiency of choline impairs the ability of the liver to export the fat it creates from alcohol, fat, or sugar, effectively trapping it in the liver and leading to fatty liver disease. Adequate choline intake prevents this pathogenesis, even in the presence of sugar, fat, or alcohol. Chris wraps it up nicely here:

I have to conclude from all these studies that choline deficiency plays a role in virtually every type of diet-induced fatty liver model. The fat has to be provided to the liver through either dietary fat or dietary lipogenic substrates like ethanol and fructose, and the fat has to be trapped by impaired export of fats from the liver. And choline deficiency seems to be the preeminent cause of this.

Take home points.

• Fatty liver needs a choline deficiency to develop.
  
• Make sure you are getting adequate amounts of choline in your diet, especially if you are consuming large amounts of alcohol, fat, or sugar.
  
• The best food sources of choline are... Egg yolks and liver! Yum!

Any thoughts?