Nonalcoholic Fatty Liver Disease and Bariatric Surgery. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Surgical treatment of nonalcoholic steatohepatitis and nonalcoholic fatty liver disease. Adipokines and melanocortins in the hepatic manifestation of metabolic syndrome: nonalcoholic fatty liver disease. Gene expression of leptin, resistin, and adiponectin in the white adipose tissue of obese patients with non-alcoholic fatty liver disease and insulin resistance. Gene expression patterns in hepatic tissue and visceral adipose tissue of patients with non-alcoholic fatty liver disease. Dietary composition and nonalcoholic fatty liver disease. Roux-en-Y gastric bypass improves liver histology in patients with non-alcoholic fatty liver disease. Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease.
Liver Concerns Remain After Weight Loss Surgery. Weight loss surgery might be beneficial for the liver of certain obese individuals, but it also poses some surprising liver specific dangers. Weight loss surgery is a medical procedure that is gaining popularity for obese individuals, especially if they have a fatty liver. Although weight loss surgery can help relieve liver inflammation and scarring related to obesity, it also harbors some unwanted liver implications. In some cases of extreme obesity, weight loss surgery may be an option. Weight Loss Surgery. Weight loss surgery involves making structural changes to the stomach and/or small intestine. Obese people with non-alcoholic fatty liver disease have improved liver health, including a possible reversal of fibrosis, following weight loss surgery. Weight Loss Surgery Liver Warnings. Knowing that weight loss surgery can help those with non-alcoholic fatty liver disease may serve as a substantial motivation for those affected. For the individuals who are actually candidates for weight loss surgery, the following side effects are common: Gallstones – More than a third of obese patients develop gallstones after weight loss surgery. Recent studies have highlighted two more liver specific weight loss surgery concerns:
Weight loss surgery reverses fatty liver disease symptoms. Researchers have found that weight loss surgery can reverse the symptoms of fatty liver disease. Weight loss surgery reverses fatty liver disease symptoms (Thinkstock photos/Getty Images) The findings are derived from research on liver samples in normal and obese patients—some with fatty liver disease and some without fatty liver disease. Joseph Hampe and his colleagues also found that when they compared patients' liver biopsies before and after weight loss surgery, the NAFLD-associated methylation changes were partially reversible. The findings demonstrate that weight loss surgery changes the chemical properties of DNA, thereby affecting gene expression.
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Researchers at the University of South Florida-Tampa found that bariatric surgery resolved liver inflammation and reversed early-stage liver fibrosis, the thickening and scarring of liver tissue, by reducing fat deposits in the liver. "Our findings suggest that providers should consider bariatric surgery as the treatment of choice for nonalcoholic fatty liver disease in severely obese patients." In examining pre-operative biopsies, researchers identified patients with cellular-level manifestations of nonalcoholic fatty liver disease, specifically, fat deposits and inflammation of the liver. In the post-operative biopsies, researchers found that fat deposits on the liver resolved in 70 percent of patients. In addition to these improvements, 62 percent of patients with stage two liver fibrosis had an improvement or resolution of the fibrosis. "We are in the midst of an obesity epidemic that can lead to an epidemic of nonalcoholic fatty liver disease," said Dr. "As a tool in fighting obesity, bariatric surgery could also help prevent the emergence of widespread liver disease." Michel Murr will present data from the study "Bariatric surgery improves histological features of nonalcoholic fatty liver disease and liver fibrosis," abstract 233, on Sunday, May 4, at 8:30 a.m.
Fatty Liver Disease (NAFLD) How do I know if I have fatty liver disease? Fatty liver disease does not cause symptoms. Obesity and fatty liver disease. Non-alcoholic fatty liver disease is strongly associated with obesity. How much weight do I have to lose so I can cure my fatty liver disease? Can fatty liver disease make it harder for me to lose weight? Fatty liver disease should not make it harder for you to lose weight.
Fatty Liver and Weight Loss. 45,096 conversations around the web about Fatty Liver to help you make a decision. Treato found 5,432 discussions about Weight Loss and Fatty Liver on the web. Symptoms and conditions also mentioned with Fatty Liver in patients' discussions. 12% of the posts that mention Fatty Liver also mention Weight Loss (5,432 posts) Treato does not review third-party posts for accuracy of any kind, including for medical diagnosis or treatments, or events in general. Treato does not provide medical advice, diagnosis or treatment. Usage of the website does not substitute professional medical advice. Treato does not provide medical advice, diagnoses or treatment. Treato is not responsible for promotions validity, application of the promotion code varies among the different Telehealth sites (for example during registration flow).
Fatty Liver and Weight Loss. Weight loss is a crucial part in fatty liver treatment. Why weight loss is important in Fatty Liver.
One group of 14 patients had cirrhosis in their initial biopsy. A second group of 104 patients had re-operations and a second liver biopsy. All patients lost weight and showed improvement in their metabolic syndrome. Of the 104 patients undergoing re-operation with a second liver biopsy, 28 showed a decrease in severe fibrosis, while 42 patients developed mild fibrosis. The eleven patients with cirrhosis in their initial biopsy showed a reduction in their fibrosis grade (mean fibrosis grade from 5 to 3) during nine years of follow-up care. These findings indicate that significant weight loss after biliopancreatic diversion can improve liver histology in patients with advanced fibrosis.
Bariatric Surgery and Non-Alcoholic Fatty Liver Disease: a Systematic Review of Liver Biochemistry and Histology. Non-alcoholic fatty liver disease NAFLD Bariatric surgery Metabolic surgery Body mass index Intervention Surgery Weight loss. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis ( http:/www.worldgastroenterology.org/NAFLD-NASH.html ). Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. The prevalence of non-alcoholic fatty liver disease and metabolic syndrome in obese children. Surgical treatment of non-alcoholic steatohepatitis and non-alcoholic fatty liver disease. Improvement of nonalcoholic fatty liver disease after bariatric surgery in morbidly obese Chinese patients. Nonalcoholic fatty liver disease in severely obese individuals: the influence of bariatric surgery. Effects of bariatric surgery on nonalcoholic fatty liver disease: preliminary findings after 2 years. Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease. Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Role of fatty acids in the pathogenesis of obesity and fatty liver: impact of bariatric surgery.
There have been many studies showing that people who are overweight (obese) have a higher incidence of cancer than those who are not. Research about obesity and cancer is in the early stages. Obese males are four times as likely to die from cancer of the liver, and obese women have six times the death risk from cancer of the uterus. There are more obese patients with the disease than not. Weight loss surgery can reverse cirrhosis of the liver. While fat in the liver is not a problem, it can cause an inflammatory response and ultimately can lead to cirrhosis and even death from liver failure. Fatty liver can occur in patients who have had the weight loss surgery called the jejuno-ileal bypass. The modern surgeries, which are performed for weight loss— including Roux-en-Y gastric bypass, duodenal switch, gastric sleeve, and lap-band surgery, have not been associated with this complication. Weight loss surgery can reverse the fatty infiltration of the liver.
The current evidence suggests that bariatric surgery in these patients will decrease the grade of steatosis, hepatic inflammation, and fibrosis. We have searched the Medline for studies between 1970 and 2012 that looked at the impact of bariatric surgery on NAFLD. A liver biopsy was taken at the point of surgery and a follow-up biopsy was taken 15 ± 9 months later. They showed a reduction in the prevalence of metabolic syndrome from 70% to 14% and an improvement in liver steatosis, inflammation, and fibrosis, with inflammation and fibrosis resolving completely in 37% and 20% of patients, respectively. [ 37 ], the other two being RYGB and biliointestinal bypass, to study the long-term effects of bariatric surgery on NAFLD. Bariatric Surgery and Metabolic Syndrome. [ 75 ] searched “The National Database for the American Society for Metabolic and Bariatric Surgery Centre of Excellence Program” for patients with metabolic syndrome that were undergoing bariatric surgery between 2007 and 2010. There is an agreement in the literature that the majority of well performed bariatric surgery is associated with sustained and significant weight loss [ 21 – 31 ]. Surgically-induced weight loss significantly improves nonalcoholic fatty liver disease and the metabolic syndrome. Gastric bypass surgery improves metabolic and hepatic abnormalities associated with nonalcoholic fatty liver disease. Histological findings in the liver before and after gastric bypass. Effects of surgical treatment of the metabolic syndrome on liver fibrosis and cirrhosis. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Effects of weight loss induced by bariatric surgery on the prevalence of metabolic syndrome.
Fatty Liver Disease. But if it makes up more than 5%-10% of the organ's weight, you may have fatty liver disease . There are two main types of fatty liver disease: Nonalcoholic fatty liver disease (NAFLD) You can also get fatty liver disease during pregnancy . Alcoholic Liver Disease (ALD) You can get alcoholic liver disease from drinking lots of alcohol . Hepatitis C (which can lead to inflammation in your liver) It's not clear what causes this type of fatty liver disease. Some studies show that too much bacteria in your small intestine and other changes in the intestine may be linked to nonalcoholic fatty liver disease.
What is Non-alcoholic fatty liver disease (NAFLD)? What causes fatty liver disease? The most common cause of fatty liver disease in Canada is obesity. Fatty liver disease is the most common cause of liver disease in children. Fatty liver disease affects almost 3% of children and 22 – 53% of obese children. What are the symptoms of fatty liver disease? The treatment of fatty liver disease is related to the cause. Epidemiology of non-alcoholic fatty liver disease. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. GI epidemiology: nonalcoholic fatty liver disease. Non-alcoholic fatty liver disease. Dietary factors in the pathogenesis and care of patients with fatty liver disease. The epidemiology, pathogenesis and histopathology of fatty liver disease. Treatment of non-alcoholic fatty liver disease.
Background: Weight loss was shown to be associated with improvements in liver enzymes and improvements of nonalcoholic fatty liver disease. Objective: The aim was to assess the outcome of liver enzymes after a low-calorie diet (LCD) as well as during a follow-up period and to identify predictors for potential changes in these liver enzymes. In men, a significant decrease in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was observed immediately after the LCD, whereas, in women, these enzymes increased significantly, although mildly; however, this increase was transient. Therefore, many studies were conducted to examine the effect of weight loss on NAFLD and NASH. Improvements in liver enzymes during weight loss were shown by some ( 4 , 9 , 10 ) but not all ( 5 , 11 ) researchers to be positively correlated with improvements in the radiologic or histologic appearance of the liver. To the best of our knowledge, we are the first to address this question in a relatively large cohort of subjects with normal or near normal liver enzymes [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] at baseline. Follow-up data at 32 and 60 wk after the end of the LCD were available for 67 subjects (47 women and 20 men) and 68 subjects (48 women and 20 men), respectively. The proportion of patients with normal liver histology increased after surgery, and the proportion of patients with steatosis decreased. However, the proportion of patients with steatohepatitis increased after surgery (14% before and 26% after surgery; P < 0.05). Andersen et al ( 5 ) studied the effects of weight loss induced by a very-LCD in 41 morbidly obese subjects (35 women and 6 men). The researchers observed a significant increase in portal inflammation (6 patients with portal inflammation before weight loss and 14 patients after weight loss; P = 0.039). However, it is unlikely that this occurred in our subjects, because the observed elevation of hepatic enzymes was transient, and no increase in GGT and ALP was noted. Finally, it may seem surprising that we found no correlation between age and changes in liver enzymes during the LCD. Moreover, we found no study that specifically examined correlations between age and changes in liver enzymes during weight loss.
Obesity, Liver Disease, and Bariatric Surgery. Bariatric surgery can lead to significant improvements in nonalcoholic fatty liver disease (NAFLD), according to results of a recent study. The study was conducted by researchers at the University of South Florida Health Bariatric Center in order to evaluate the effect of bariatric surgery on nonalcoholic fatty liver disease. The researchers said they believe the underlying mechanism for the improvements in nonalcoholic fatty liver disease is the weight loss the patients achieved after bariatric surgery. “We are in the midst of an obesity epidemic that can lead to an epidemic of nonalcoholic fatty liver disease. What is nonalcoholic fatty liver disease? Nonalcoholic fatty liver disease may eventually lead to cirrhosis (scarring of the liver), liver failure, or liver cancer. What are the symptoms of nonalcoholic fatty liver disease? How is nonalcoholic fatty liver disease treated? Study Source: Digestive Disease Week (DDW) 2014, “Bariatric surgery improves histological features of nonalcoholic fatty liver disease and liver fibrosis,” abstract 233, presented May 4, 2014.
Web MD Answers. If you don't find your answer, you can post your question to Web MD Experts and Contributors. This is very unhealthy for your liver and impacts your likelihood of curing HCV with antiviral treatment. In addition to a healthy weight-loss diet and exercise program, studies have demonstrated that the following vitamins may be helpful in treating fatty livers - Vitamin E, Betaine, Vitamin C, Vitamin D. I actually researched and published on this issue over 2 decades ago - and found that losing 10% of your current body weight will significantly impact the amount of fat on your liver. I was diagnosed with fatty liver in about 2005 from my primary care doctor. Much of what I read, pointed toward, and my doctor agreed that weight loss was the main issue. To this day that was the best decision I have made. I have been using milk thistle along with weight loss ever since and am doing very good even today with good blood work ups and so forth. Important: The opinions expressed in Web MD User-generated content areas like communities, reviews, ratings, blogs, or Web MD Answers are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of Web MD. User-generated content areas are not reviewed by a Web MD physician or any member of the Web MD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on Web MD. If you think you may have a medical emergency, call your doctor or dial 911 immediately.
Fatty liver, also known as fatty liver disease (FLD), is a reversible condition wherein large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e., abnormal retention of lipids within a cell). Despite having multiple causes, fatty liver can be considered a single disease that occurs worldwide in those with excessive alcohol intake and the obese (with or without effects of insulin resistance ).  When this process of fat metabolism is disrupted, the fat can accumulate in the liver in excessive amounts, thus resulting in a fatty liver. Accumulation of fat may also be accompanied by a progressive inflammation of the liver ( hepatitis ), called steatohepatitis . By considering the contribution by alcohol, fatty liver may be termed alcoholic steatosis or nonalcoholic fatty liver disease (NAFLD), and the more severe forms as alcoholic steatohepatitis (part of alcoholic liver disease ) and non-alcoholic steatohepatitis (NASH). In this stage, liver cells are filled with multiple fat droplets that do not displace the centrally located nucleus. Acute fatty liver of pregnancy and Reye's syndrome are examples of severe liver disease caused by microvesicular fatty change.  The diagnosis of steatosis is made when fat in the liver exceeds 5–10% by weight. On the other hand, nonalcoholic FLD may begin as excess of unmetabolised energy in liver cells. Liver disease with extensive inflammation and a high degree of steatosis often progresses to more severe forms of the disease. The treatment of fatty liver depends on its cause, and, in general, treating the underlying cause will reverse the process of steatosis if implemented at an early stage.  For the patients with non-alcoholic fatty liver disease with pure steatosis and no evidence of inflammation, a gradual weight loss is often the only recommendation.
Home » Liver Problems » The Liver and Weight Loss. The Liver and Weight Loss. The liver is the major fat burning organ in the body and regulates fat metabolism by a complicated set of biochemical pathways. The liver can also pump excessive fat out of the body through the bile into the small intestines. Thus the liver is a remarkable machine for keeping weight under control, being both a fat burning organ and a fat pumping organ. If the diet is low in fiber, some of the fats (especially cholesterol) and toxins that have been pumped by the liver into the gut through the bile will recirculate back to the liver. A high fiber diet will reduce the recirculation of fat and toxins from the gut back to the liver. If the liver does not regulate fat metabolism efficiently, weight gain tends to occur around the abdominal area and a protuberant abdomen (pot belly) will develop. It can be almost impossible to lose this abdominal fat until the liver function is improved. Once this is done the liver will start burning fat efficiently again and the weight comes off gradually and without too much effort from you. What is effective in the long term is to eat the correct foods and nutrients for the liver to improve its fat burning function. Many middle-aged people with excess fat in the abdominal area have a “fatty liver”. In this condition the liver has stopped burning fat and has turned into a fat storing organ. If you have a fatty liver it is vital to be patient, as it can take between 3 and 12 months, depending upon the amount of fat deposited in the liver, to remove the excess fat from the liver.
A liver biopsy is needed to confirm a diagnosis of NASH, the more severe form of NAFLD. The goal is to manage your risk factors and any health conditions. Your provider will help you understand your condition and the healthy choices that can help you take care of your liver. Getting vaccinated for diseases such as hepatitis A and hepatitis B. Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines. Losing weight and managing diabetes can slow or sometimes reverse the deposit of fat in the liver. Many people with NAFLD have no health problems and do not go on to develop NASH. Fatty liver; Steatosis; Nonalcoholic steatohepatitis; NASH. The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Sleisenger & Fordtran's Gastrointestinal and Liver Disease.
The incidence of NAFLD is rapidly rising and The American Liver Foundation estimates that 10-20% of Americans have Fatty Liver Disease. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly. The only means of proving a diagnosis of NASH and separating it from simple fatty liver is a liver biopsy. NASH is diagnosed when examination of the tissue with a microscope shows fat along with inflammation and damage to liver cells. If the tissue shows fat without inflammation and damage, simple fatty liver or NAFLD is diagnosed. Or NASH can slowly worsen, causing scarring or "fibrosis" to appear and accumulate in the liver. Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH. NASH ranks as one of the major causes of cirrhosis in America, behind hepatitis C and alcoholic liver disease. Thus, NASH is not simply obesity that affects the liver.
CHICAGO — Bariatric surgery may not only lead to weight loss and better metabolic profiles, it can also improve nonalcoholic fatty liver disease (NAFLD), according to the results of a new study. "Bariatric surgery reduced fat deposits in the liver, and it also resolved liver inflammation and reversed early-stage liver fibrosis and scarring," he reported. "These findings suggest that bariatric surgery should be considered a treatment of choice for NAFLD patients with a body mass index (BMI) more than 35 kg/m² and obesity-related comorbidities, or a BMI more than 40 kg/m²," said Dr. The study compared paired biopsy specimens for 152 patients (82% women; mean age, 46 years) taken before surgery and an average of 29 months after surgery. The type of surgery was gastric bypass for the majority. A blinded pathology review identified patients with cellular-level manifestations of NAFLD — fat deposits and inflammation of the liver — on preoperative biopsy. More important, we found that the liver goes from an organ that stores fat to one that burns fat after bariatric surgery," explained Dr. We think that with bariatric surgery, we can impact the prognosis of NAFLD and its natural history. "The current best treatment of NAFLD and nonalchoholic steatohepatitis is weight reduction. "Adding to its advantages, the current study showed that bariatric surgery improves liver histology in severely obese patients and is associated with resolution of steatosis or steatohepatitis in the majority of patients.
The fastest and safest way to reverse a fatty liver is to follow a lower carbohydrate diet, such as in the book Fatty Liver: You Can Reverse It. Can you please advise me on what the healthy diet is and how can I reverse my fatty liver? Dr Cabots book “fatty Liver- You Can Reverse It” is the book for your to read- lifestyle and protocol that addresses those symptoms you mention. Ok- best you can do is not worry- if you have a mild fatty liver, just remember that you can and will reverse it if you simply change your diet. All the best- and thank you for your email. Live sugar and grain free until you have reverse your fatty liver- Depending on the level of tatty liver infiltration you have- you CAN reverse your fatty liver if your follow our guidelines . My book Fatty Liver You Can Revere It explains this well and give you the dietary protocol to follow to reverse a fatty liver. You will need to spend the time reversing your fatty liver and depending on the Fatty Liver Infiltration, that can take anywhere from 2months to 2 years. Fatty Liver You Can Reverse It is a book that will head you in the right direction. The Doctor here told me that I have a fatty liver and advised mo to do diet and exercise. A copy of “Fatty Liver you can reverse it” has the protocol to reverse fatty liver. There is a book titled “Fatty Liver- You Can Reverse It” that book will give you the correct dietary and supplemental protocol you need to follow in the hope of reversing your fatty liver. Id suggest sticking with the protocol out of the book titled “Fatty Liver- You Can Reverse IT” The lifestyle and dietary protocol within that book will do you well.
This is a problem of stuck and stagnant fat congesting your liver. If you are too inactive then your liver is confronted by a huge problem of what to do with all the excess fat and sugar. Friendly flora is important to help protect against the caustic effects of bile, and so are higher amounts of DHA 6 – a natural degreasing compound for your liver that lowers your triglycerides. Each one of these problems stresses out your liver and contributes to the accumulation of fat in your liver. The rest of this article is devoted to strategies that speed up the process of unclogging your liver and improving your metabolism. If you are engaging the weight loss process while employing them, then your liver is improving. While you need to engage and sustain the process of weight loss to solve fatty liver problems over time, various nutrients can play a supportive role either by helping the fat flow or by protecting your liver. This nutrient can help your liver dispose of cholesterol and fat into your digestive tract without making extra bile that burns the lining of your digestive tract. This program is not a long-term strategy, it is more of a corrective strategy that also helps unclog your liver and rebalance your leptin system. Your liver is the brain of your body and it must work right for your metabolic and fat burning ability to be normal and healthy. This can be done by increasing lipotropic nutrients and nutrients that protect your liver.
Fatty Liver? I have a concern, I have elevated liver enzymes due to a fatty liver. Should I start the Liver Reduction diet sooner that the requested 10 days pre-op? Any one else have a fatty liver before going into the process? Most wls patients have fatty liver before surgery, whether they realize it or not. Nearly everyone who is obese has a fatty liver. Good luck to you.
The liver is the second largest organ in your body and is located under your rib cage on the right side. The liver performs many jobs in your body. The liver also removes harmful substances from your blood. Non-alcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. NAFLD affects up to 25% of people in the United States. NAFLD may cause the liver to swell (steatohepatitis). NAFLD is initially suspected if blood tests show high levels of liver enzymes. Often, an ultrasound is used to confirm the NAFLD diagnosis. See a doctor who specializes in the liver regularly.
Bariatric Surgery Conquers Fatty Liver Disease. Home » For Doctors » Bariatric Surgery Conquers Fatty Liver Disease. Bariatric surgery resolves or significantly relieves nonalcoholic fatty liver disease (NAFLD), researchers recently reported at the 2005 annual meeting of the American Surgical Association in Palm Beach, Fla. In 70 patients who had undergone bariatric surgery, liver biopsies taken one year after surgery showed that NAFLD had resolved in 26 patients (37%). “This study is important because NAFLD has become the most common cause of liver disease, and is leading to liver failure in increasing numbers. Incidence of fatty liver disease has been rising over the past decade, along with obesity. Investigators were pleased that no patients in the study showed any worsening of their liver disease, which has been reported in other studies. One year after surgery, 14% of patients had metabolic syndrome, compared with 70% at the start of the study.
The impact of NAFLD on bariatric surgery is of great concern. Enlarged fatty livers increase the operative complications of bariatric surgery and weight loss prior to bariatric surgery has been shown to reduce complications of surgery. Most bariatric surgery programs use a conventional low fat, calorie restricted diet during the preparation phase for surgery. The investigators will compare the effects of the low carbohydrate versus the low fat diets on weight loss, reduction in liver fat content, and liver size. These results will provide new clinical insights into the optimal dietary intervention to make bariatric surgery safe and effective for the increasing numbers of patients opting for this aggressive therapy for morbid obesity. Patients approved for bariatric surgery by the University of Michigan Bariatric Surgery multidisciplinary committee will be randomly assigned to either a 1000 to 1200 calorie low fat or low carbohydrate, 8-week study diet. During the bariatric surgery, a liver biopsy will be performed to assess the impact of the study diet on liver fat content. In this study we propose to compare the clinical effects of a low carbohydrate versus a low fat diet in individuals which can derive an immediate benefit from interventions that have the potential to reduce hepatic fat content: individuals that are preparing for bariatric surgery (laparoscopic Roux-en-Y gastric bypass surgery or adjustable laparoscopic gastric banding). Enlarged steatotic livers increase the operative risk of bariatric surgery and weight loss prior to bariatric surgery has been shown to reduce operative risk. We hypothesize that the use of a 1000 to 1200 kcalorie low carbohydrate diet ( < 15% of total kcaloric intake) during the preparation phase for bariatric surgery will cause a greater reduction in weight, hepatic fat content and hepatic volume compared to a "conventional" 1000 to 1200 kcalorie low-fat diet (30% fat, 60% carbohydrates of total kcaloric intake) and offer clinical advantages by making the technical aspects of surgery easier. These results will provide a basis for larger clinical trials to identify the optimal dietary intervention to make bariatric surgery safe and effective for the increasing numbers of patients opting for this aggressive therapy for morbid obesity.
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. The prevalence of childhood obesity and NAFLD is at similar levels. Overall, morbidity and mortality have been shown to be significantly higher in NASH patients compared with the general population. Primary noninvasive evaluation may be used to confirm the diagnosis of fatty liver disease, given the risks and costs of a liver biopsy. Oxidative stress has been hypothesized to contribute to the progression of NAFLD to NASH and to worsen insulin resistance. In 2010, the Italian Association for the Study of the Liver and in 2012 the American Association for the Study of Liver Diseases in conjunction with the American College of Gastroenterology and the American Gastroenterological Association published evidence-based practice guidelines for the diagnosis and management of NAFLD. Moreover, NAFLD has been shown to recur in the liver allograft, with a possible rapid progression to steatohepatitis and cirrhosis. Nonalcoholic fatty liver disease (NAFLD), a condition associated with obesity and diabetes, is increasingly being recognized in the Western population. Simple fatty liver is the most common form of NAFLD and seems to be a benign condition. Loria P, Adinolfi LE, Bellentani S et al: Practice guidelines for the diagnosis and management of nonalcoholic fatty disease.
Weight loss surgery alters fatty liver disease genes. Now scientists have found that the surgery can also reverse the symptoms of fatty liver disease. The findings, which are to be published online on August 6 in the Cell Press journal Cell Metabolism, are derived from research on liver samples in normal and obese patients—some with fatty liver disease and some without fatty liver disease. Nonalcoholic fatty liver disease (NAFLD)—which includes a spectrum of liver disorders in people with obesity and type 2 diabetes—is the most common chronic liver disorder in industrialized countries. NAFLD has emerged as one of the dominant types of liver disease worldwide and effects one in three Americans. Furthermore, binding sites for proteins that affect gene expression were enriched in the liver disease patients' genes. Joseph Hampe and his colleagues also found that when they compared patients' liver biopsies before and after weight loss surgery, the NAFLD-associated methylation changes were partially reversible. NAFLD (non-alcoholic fatty liver disease) is the most common type of liver disease in the developed world, affecting up to one-third of the US population. More patients could be diagnosed earlier with non-alcoholic fatty liver disease (NAFLD) after a cohort study presented at the International Liver Congress TM 2013 identified variants within four genes significantly associated . Discovery of gene involved in fatty liver disease. An international research consortium led by CIC bio GUNE has discovered the involvement of a gene in the development of non-alcoholic fatty liver disease (NAFLD). A study presented today at the International Liver Congress 2013 – which evaluated the relationship between non-alcoholic fatty liver disease (NAFLD), early predictors of atherosclerosis and the 10-year Framingham risk . Researchers have identified a common variant in a non-coding RNA that may contribute to the intestinal inflammation that occurs in people with celiac disease.