HEALTHWISE: Avoiding Fatty Liver Disease by Lucinda Porter, RN
When I had hepatitis C, I worked hard to care for my liver. I didn’t think much about other health problems that might occur, especially liver-related ones. Once I cleared hep C, I figured I was good to go. My lifestyle was healthy, so I thought I’d skate along for awhile. However, I was fooling myself.
Earlier this year, my primary care provider and I had “the talk.” Many of you know what I mean. It’s when your weight has crept up, your lab results are heading in the wrong direction, and if you don’t change the course you are on, you are going to suffer some consequences. In my case, my weight had crossed over a line and I was now one of the 70 percent of adults in the U.S. who are overweight.
Quite frankly, I wanted to “yes but” my way through the conversation with my doc. Yes but, I eat a healthy diet. Yes but, I exercise. Yes but, I don’t drink.
However, this time I didn’t try to rationalize my way out. My doctor showed me the data and nothing I could say would change the truth. Then I thought, I didn’t work hard to get cured of hepatitis C in order to die of a heart attack or stroke. Worse, live a poor quality of life because of fatty liver disease (medically called nonalcoholic fatty liver disease or NAFLD). I could imagine type 2 diabetes chipping away at my toes and eyesight.
My concern about NAFLD is probably the most real threat. In the March 2018 World Journal of Gastroenterology, Mazen Noureddin and team reporting study results found that nearly half the patients with hepatitis C who achieved a sustained virologic response after treatment with direct-acting antivirals (DAAs) had NAFLD. (Fatty Liver Prevalence in Hepatitis C patients after Sustained Virological Response with Direct-Acting Antivirals )
If that isn’t enough motivation to get healthier, there is the simple fact that the prevalence of NAFLD is increasing. (Healthcare Cost and Utilization in Nonalcoholic Fatty Liver Disease: Real-World Data from a Large US Claims Database – Alina M. Allen, et al. Hepatology May 18, 2018) The incidence of NAFLD has risen a staggering 6-fold in less than 20 years.
I don’t want to acquire any medical condition that is avoidable. I can’t read these studies and think they don’t apply to me. Let’s be frank. Would you read my column if I ignored the warnings that I write about?
So, I made the decision to get healthier. I tapped in to the courage, determination, and willingness that helped me live with and overcome hepatitis C, and began a long, slow journey to reclaim my health.
I started by collecting data. How much was I eating? What was I eating? What forms of exercise was I doing, how often, and for how long? What did I weigh, what was my Body-Mass Index (BMI), what was my waist-to-hip ratio? Then I began to experiment with some options.
Initially it was trial and error. I tried many things that didn’t work. Gimmicks didn’t work. Sitting for long stretches on rainy days and hoping I would not have any consequences didn’t work. Deprivation didn’t work.
What ended up working was simple; I eat less and exercise more. Here are some more details.
I eat less. I tried two methods in order to understand how much I was eating and how to adjust my intake. One method uses portion control containers. This system provides colored containers and helps with portion control. An equation helps you determine what your basic calorie needs are and how many containers of each type of food you can have. Amazon sells a variety of these systems for about $10.
The other method uses an app to track food, water and exercise. Lose It and My Fitness Pal are two popular apps. I preferred the app, but the container system helped me see how out-of-control my portion sizes had been. I could see that although I had been eating healthy foods, I was eating too much.
I avoid sugar, high fructose corn syrup, and trans fats. Mostly I eat food that hasn’t been processed.
I don’t deprive myself. No food is forbidden. I plan my treats and my cheat days.
I increased the variety and intensity of my physical activity. I vary my fitness routine. I aim for 6 days, with 3 days dedicated to strengthening. Although initially hard, I am now doing high intensity interval training (HIIT). Research shows that HIIT is a great way to reduce risk of NAFLD. For those new to HIIT, check out the CDC’s website.
I drink at least half my body weight in ounces of water. For example, 75 ounces is a good target for someone weighing 150 lbs. I make water enticing by flavoring it with lemon, lime, ginger, berries, cucumber, etc. I also drink hot and cold unsweetened tea. And yes, I drink coffee. It’s good for the liver.
I am committed to at least 8 hours of sleep a night. I don’t necessarily get 8 hours, but I am in bed with the lights off for that amount of time.
I depend on others. My head can be an unhealthy place. It tells me to take it easy and to avoid pain. I attend classes, walk with friends, and hang out with people who encourage healthy habits. The internet provides tips and motivation, such as this YouTube clip, Never, Ever Give Up. Arthur’s Inspirational Transformation!
I foster enthusiasm. Instead of working out, I play. If something looks hard, I try it even if it looks impossible. When I began, I just wasn’t into pain. Planks and burpees hurt, so I didn’t do them. However, I learned how to modify these and now I can do a few.
I stay honest by measuring my food, water, and activity. Left to my own devices, I am not trustworthy. If I don’t measure my food, my portions will get bigger.
I set small, measurable, obtainable goals. Here’s a goal that didn’t work: Lose 5 lbs. Here’s one that did: Today I am going to eat 1600 calories, including 4 servings of vegetables, 2 servings of fruit, a serving of nuts, 3 servings of lean protein, 2 servings of carbohydrates and avoid all sugar and trans fats. This is clear and I can do that for one day.
I keep a log of what I do. Data is my friend. If I don’t see results, I can look at my data and figure out why. It’s not rocket science. I don’t get good results when I eat lasagna or a big juicy burger. I get great results when I stick to the food I plan to eat.
I am on the slow track. I am not on a diet; I am on a plan for living. This is permanent. If I think for one moment that I will lose weight, go off this plan, and stay at a lower weight, then I am deluded. I got this way because I got off track. Now I am back on track.
I am still collecting data, but the results have been astonishing. I am officially one of the 30 percent of adults in the U.S. with a healthy weight. I am stronger that I thought possible. I have more endurance and energy. I look forward to strenuous activity. And yes, I’ve lost weight. I have not had my lab tests done, so I don’t know what the effect will be, but if how I feel matters, I feel great.
Next month I will explore the relationship between sugar and the liver. Stay tuned…