Professor Yusuf Yılmaz, Marmara University Faculty of Medicine and Head of the Turkish Liver Research Association (TKAD) Fatty Liver Study Group, made important statements to Demirören News Agency (DHA) about liver health.
“LIVER LUBRICATION MAY BE A NEW PUBLIC HEALTH CRISIS”
Stating that there are two types of fatty liver disease, one of them is simple lubrication and the other is NASH. Dr. Yılmaz said, “In simple fattening, there is an abnormal accumulation of fat in the liver, but there is no inflammation and swelling in the liver cells. Fortunately, 80-90 percent of all liver fats fit this situation. The other one is called NASH if the liver is fatty and inflamed. 1-2 out of 10 liver fats are actually NASH. If you have liver fat, it cannot be understood by simple blood tests and ultrasound whether it is a simple fat or NASH. You should contact a gastroenterologist who is experienced in this field. Improvements in medication and treatment methods are continuing. Fatty liver may be a new public health crisis. ”
“IT DOES NOT PROVIDE ANY SYMPTOMS UNTIL THE FORWARD CYBEROSIS CREATE”
Stating that NASH, a liver disease that can progress to cirrhosis, is caused by inflammation in the liver, does not have an association with alcohol use, “In most cases, NASH is the result of a high-sugar, high-fat diet and sedentary life. NASH obesity is closely related to type 2 diabetes and insulin resistance. 32 percent of adults in Turkey unfortunately fat, most obese country of the European continent, Type 2 diabetes is very high in our the incidence of disease states (20 percent today) unfortunately fatty liver prevalence is also thought we are the highest in the world. NASH obesity is closely related to type 2 diabetes and insulin resistance. It usually does not show any symptoms until advanced stage cirrhosis occurs. One of every 5 liver fats is NASH. Blood tests, ultrasound, Fibroscan and liver biopsy may be required for diagnosis. The causes of death in NASH disease are heart, cancers and cirrhosis in order of frequency. The most useful treatment method until drug treatment is diet and exercise. ” said.
“FORECAST IS 4 MILLION IN TURKEY BEING PATIENT NASH”
NASH patients where 4 million 150 thousand persons in Turkey and also emphasized that currently estimated to be advanced cirrhosis due to NASH Prof. Dr. Yusuf Yılmaz said, “One in every 4 adults have liver fat. Liver blood tests are normal in 4 out of 5 patients with liver fat on ultrasound. There is NASH in one out of every 5 patients with liver fat. One in every 3 people with type 2 diabetes has NASH. Approximately 80 percent of NASH patients have obesity, 70 percent have metabolic syndrome, and 50 percent have type 2 diabetes. There is liver fat in 85 percent of those with obesity, 65 percent of people with type 2 diabetes and 50 percent of those with metabolic syndrome. The most common cause of death in NASH disease is from the heart. Especially if there is metabolic syndrome coexistence, cardiovascular disease has the highest risk of heart attack, stroke / stroke. The frequency of a disease with such important consequences is increasing in parallel with the dramatic increase in the frequency of obesity and diabetes in our country. Our new data indicate that the frequency of liver fattening has reached the eerie levels in our country. Therefore, urgent measures should be taken to prevent and treat this disease. Otherwise, in the next decades, our country expects heavy economic costs commensurate with the consequences of this insidious disease. ”
HOW IS NASH DIAGNOSED?
Prof. Dr. Yusuf Yılmaz said the following about how NASH diagnosis is made: “Fatty liver disease usually occurs with an increase in liver blood tests (AST and ALT) or fatty liver on ultrasound for another reason. To show that there are no other liver diseases that can lead to elevated liver tests, your doctor will ask if you are using alcohol, your current illnesses, medications, whether there is a liver disease in the family, and will request additional blood tests. A liver biopsy may be required to make a definitive diagnosis of NASH and to determine which stage it is in, or to make sure you do not have other diseases that can lead to disruption in your tests. Biopsy can be performed if necessary, by measuring the fibrosis stage of the liver, as well as the amount of fat. Liver biopsy is the procedure of taking a very small tissue (50 thousandth of the liver) from the liver by needle. This tissue is examined by another doctor under a microscope to tell you whether you have NASH disease and the stage of scar tissue that accompanies the accompanying fibrosis. ”
“WHAT IS NASH TREATMENT METHODS”
Professor Yusuf Yılmaz, Marmara University Faculty of Medicine and Head of the Turkish Liver Research Association (TKAD) Fatty Liver Study Group, made the following advice regarding NASH treatment:
“Weight loss and physical activity are the best treatment methods proven to date. However, weight loss should be gradual and slow (no more than 1.6 kg per week), because faster weight loss can also lead to fat. Contrary to dietitians who boast on social media because they lose weight to their clients far above these values, they should be ashamed. In order to eliminate NASH, at least 7 percent of body weight should be lost within a period of 1 year, and at least 10 percent of weight should be lost in order to eliminate fibrosis (For example, a 100 kg patient should at least 7 kilos to correct NASH, In order to correct the liver fibrosis caused by NASH, you should lose at least 10 kg.) It is recommended that your diet, accompanied by a dietician, be rearranged as a lifestyle change. Losing weight and maintaining this effort in the long run is difficult, and patients may feel powerless against such a big change. Only one of 10 patients can achieve more than 10 percent weight loss in a year, even in this case, a 45 percent reduction in fibrosis can be achieved. ”
“WHAT TO DO AGAINST LIVER LUBRICATION”
Professor Dr. Yusuf Yilmaz also listed the items on what to do against liver fat:
1. COOK YOUR OWN MEALS
“It is recommended to cook from scratch as much as possible so that you will be familiar with what is on your plate. Instant foods contain very high levels of fat, salt and sugar, even in snack products.
2. REDUCE OIL PURCHASE
It is recommended to use grills of meats, fish and shellfish, and preferably fats rich in unsaturated fats (olive oil, flaxseed).
3 KEEP YOUR PORTIONS UNDER CONTROL
A balanced meal should occur as shown here.
4: FOR WATER
Meeting the body’s water needs is essential. Natural flavors: fresh lemon, mint or cucumber will give the water a fresh and delicious taste. Hot sugar-free beverages: Tea or coffee (sugar or sweeteners should be avoided) may also be preferred.
5. HEALTHY SHOOT
If you can, it’s best to avoid snacks. However, this cannot always be achieved, and therefore it is important to choose the right snacks: Almonds, walnuts and hazelnuts: it is a good source of protein and keeps you full for longer. Fruits: they are good choices, but note that they do not contain high enough sugar that can exceed your recommended intake of sugar. Good to know: Eat slowly! Your stomach sends a message of satiety to your brain, at least 20 minutes after you start eating. If you eat fast, you can overeat.
6. RED FOODS
When shopping for groceries, be sure to carefully read the labels on the foods you buy. These are important sources of information about the nutrient content of the products you put in your basket. In the ingredients list, the ingredients are defined in order of weight: The main components of the product always come first. If the first ingredient on the list is butter or oil, the oil content of the product is probably too high. For example: A product with more than 20 g sugar in 100 grams is a very high sugar product. A product containing over 3g of fat in 100 grams is a product with a very high content of fat. Avoid processed meat (such as sausage, salami) and prepackaged foods as much as possible.
7. DO EXERCISE AS YOU CAN, BUT DO NOT EXTRACT YOURSELF!
Exercise both makes the person feel good and shapes the body: Weight, diabetic control for diabetics, reducing the risk of heart disease… Exercise is any movement that causes energy consumption: Light exercise: walking, gardening… Moderate violence: swimming, brisk walking, pilates High violence: tennis, cycling, running
8. LEAVE CIGARETTE
In our scientific research, we showed that smoking significantly increases liver damage in fatty liver disease. In a study conducted abroad, it was shown that recycling may occur in this negative effect upon smoking cessation. Considering that the most common cause of death in NASH is cardiovascular diseases, it is mind-blowing that the NASH patient smokes. NASH patient is afraid of cirrhosis, but the risk of dying from heart diseases is many times higher than cirrhosis.
8. STAY AWAY FROM ALCOHOL
NASH disease is the disease seen in people who do not drink alcohol, but NASH can also be seen in those who consume a small amount of alcohol (usually defined as a social drinker). There were studies with contradictory results on the effects of non-significant alcohol use on fatty liver. However, a great scientific research published in Lancet, a very prestigious magazine, put an end to the discussions on this issue: The safe amount of alcohol use is zero. So don’t even use a drop of alcohol!
9. FOR COFFEE
Studies have shown that drinking 2 cups of filter coffee a day has a positive effect on all chronic liver diseases (including NASH). We anticipate that the similar effect may be for plain Turkish Coffee. Studies have shown that coffee consumption reduces the risk of liver fat, even as a protective factor against liver fat. The mechanism by which coffee provides this protection is still a subject of research today. Although current research focuses on caffeine in coffee, we can say that other substances such as coffee, caffetol, or antioxidants contained in coffee have positive effects on the liver. However, other products containing caffeine such as tea and green tea have not been shown to have similar effects on the liver. This takes us away from the idea that caffeine has an effect here. In addition, studies have shown that coffee acts on our microbiota in the intestine and prevents fat storage in the liver with the intestinal-liver relationship and increases the release of fat from the liver. In addition, coffee has been shown to facilitate the repair of permeability proteins in the intestine, thereby preventing the passage of harmful substances into the liver through the intestine and regulating lipid and energy metabolism. As a result, coffee is good for the liver, reducing the risk of advanced fibrosis (liver damage in the form of scar tissue) and cirrhosis. Moreover, even in those with cirrhosis, it lowers the risk of developing liver cancer. We should not use sugar while drinking coffee, if possible we should drink without milk or with very little milk. If it is not banned due to another disease, 2-3 cups of filter coffee ideal per day, neither less nor more.
10. STAY AWAY FROM THE CURES
There is no cure or herbal product that has proven to work in NASH disease and can be offered to patients. Some of them may even harm your liver. During the artichoke season, eat parsley and lemon with your salad. Gastroenterologists, who are experts in this liver disease, do not see the liver toxicity caused by these recommendations. If you are interested in herbal nutrition, contact your dietician and follow the “ Mediterranean Diet ”.
11. SHOW EFFORT FOR QUALITY SLEEP (AT LEAST 5-6 HOURS, MOST 8-9 HOURS)
Not having a regular sleep rhythm also increases the risk of liver fat. Sleep, which is not in a regular, sufficient time, in pitch dark, in a quiet environment, disrupts our circadian rhythm, that is, our body clock. Our body clock controls our sleep-wakefulness, eating-drinking habits, metabolism and hormonal release cycles. The metabolism of leptin hormone, which is disturbed by irregularities in the circadian rhythm, causes impairment in our perception of satiety. Melatonin is a hormone (80 percent) synthesized especially in the night brain in accordance with the circadian rhythm. Melatonin has a preventive effect on our lubrication and insulin resistance as we get older. However, the disruptions in our biological clock also cause disorders in the secretion of melatonin. Insomnia has been associated with eating more, moving less, insulin resistance, and weight gain. Accordingly, the risk of developing fatty liver increases. Studies show that individuals with sleep disorders are also in a more risky group for liver damage and liver cancer. In other words, insomnia has a negative effect on both liver disease formation and worsening of the course of liver disease. Another important issue is sleep time and sleep quality. Individuals who sleep less than five hours are at an increased risk of developing liver fat. Again, individuals who remain awake at night due to various reasons are also at risk for developing liver fat. Recent studies have shown that individuals working at night shifts are at risk for liver fattening. These individuals have an increased risk for NASH in the future. Therefore, we recommend our patients a regular diet for less than five hours, as well as a regular diet for lifestyle changes. Of course, away from technological tools, in a pitch-dark and quiet environment.
12: do exercise
Control of NASH-related conditions (such as obesity, type 2 diabetes, hypertension, hyperlipidemia, insulin resistance) is also facilitated by weight loss and physical activity. If it is remembered that the most common cause of death in fatty liver disease is cardiac origin, it is understood that the risk of cardiovascular disease will decrease not only with fatty liver weight loss and physical activity. Those with fatty liver should never consume alcohol. In addition, ready-made fruit juices containing fructose, as well as soft drinks (juices, cola, fanta, sodas etc.) should also be avoided. It should be remembered that foods expressed with the words ‘organic’, ‘herbal’, ‘natural’ do not always mean ‘healthy and safe’ for your liver. No herbal medicine, various cures, vitamins or medicines should be used without doctor’s approval. Obesity surgery can correct NASH disease in overweight patients. Liver transplantation can be performed in patients who develop cirrhosis-related liver failure or liver cancer. ” (DHA)
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https://www.sozcu.com.tr/2020/saglik/karaciger-yaglanmasini-onleyen-12-oneri-5604059/
