The liver is a resilient organ that’s easy to ignore – until something goes wrong.

Fatty liver disease is closely associated with the growing problems of obesity, type 2 diabetes and metabolic syndrome.

Here’s is an interview Olwethu did with Lara Jagwanth, Africa Head of Medical at Sanofi Consumer Healthcare.

Olwethu: Good Afternoon Lara & Welcome to The Sit Down where will be having a conversation around World Liver day, which has been commemorated on the 19^th April 2021. There is a conversation that is often neglected around changing perspective of proactive liver care as oppose to reactive, can you share your thoughts on this.

Lara: Good afternoon Olwethu – thank you for having me on your platform, April is what we call Liver Month, with World Liver day being recognised on 19^th April, as you mentioned,  with the aim of spreading awareness about liver-related conditions and diseases. One of which being Non-alcoholic Fatty Liver Disease (NAFLD) – a disease that is fast becoming a global epidemic (global prevalence of NAFLD is 25%)¹. Research indicates that one in four European adults may suffer from NAFLD, whilst studies show this prevalence being slightly lower in Africa, around 13-14%, we need to take into consideration the impact of rising obesity and type-2 diabetes mellitus (T2DM) prevalence in Africa, the burden of NAFLD is expected to increase, a disease commonly diagnosed in patients suffering from metabolic syndrome, those with obesity or type 2 diabetes. Based on this, we need to raise the awareness of NAFLD in Africa, South Africa and take action.

Olwethu: What exactly is Non-alcoholic fatty liver disease (NAFLD) and who is at risk?

Lara: Non-alcoholic fatty liver disease or NAFLD, as it is more commonly referred too, is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.

Non-alcoholic fatty liver disease, or NAFLD for short, is one of the biggest challenges facing modern hepatology. The cause of non-alcoholic fatty liver disease (NAFLD) is unknown. Even with its amazing regenerative capabilities, the liver is susceptible to the many negative effects of today’s modern lifestyle, which often includes an unhealthy diet, a lack of physical activity, excessive alcohol consumption or toxins from the surrounding environment. So, our modern lifestyle is a contributory factor, as well as, obesity, age – due to the attack and accumulation over the years, high cholesterol, and type 2 diabetes.

We have prepared a special NAFLD risk questionnaire, a tool that will help you check whether you’re at risk of NAFLD.  If you go online, you could take a NAFLD risk questionnaire, to start your discovery journey of your liver health.

Olwethu: Are there symptoms I should look for, it’s important to know the symptoms to effectively manage or seek help early?

Lara: Tiredness, irritability or malaise are often mistaken for an ordinary “bad day”. However,

these may be indications that there is something going on. Your liver does not show any immediate signs and symptoms of deterioration unless it is severely damaged. Starting with the mildest ones – a noticeable drop in energy and general feeling of being ill or having no energy almost every day, other classic symptoms of liver disease include loss of appetite, nausea, vomiting, upper abdominal pain, and jaundice. NAFLD is difficult to diagnose as, in most cases, it does not show specific symptoms related only with liver issues that would get consumers to consult a medical doctor. Routine blood test, when liver enzymes are elevated, might suggest existence of NAFLD. However, liver enzyme tests are not enough, and physicians may use an ultrasound to check whether a liver contains too much fat.

Olwethu: What is actually the importance of a healthy liver, I mean we always talk about every organ in our body, but we never really know the importance of each organ?

Lara: The liver is the largest internal, and most metabolically complex, organ in humans. It’s pretty incredible. The liver performs over 500 different functions including fighting off infection, neutralizing toxins, manufacturing proteins and hormones, controlling blood sugar and helping to clot the blood. The liver is the only internal organ that can regenerate itself.

Olwethu: What should I pay attention to maintain a healthy liver?

Lara: Although the liver is one of the most important organs in our body (it converts sugars, fats, proteins, hormones, nutrients, drugs and toxins!), it doesn’t let you know about its problems. In many cases, a fatty liver develops over the span of years, and patients are often not even aware of the fact that they’re suffering from a disease. That is why it’s worth remembering the risk factors which are again:

• being overweight and suffering from obesity
• comorbidities: type 2 diabetes, metabolic syndrome, hypertension
• an unhealthy lifestyle (poor diet, lack of physical activity, frequent alcohol consumption)
• excessive accumulation of fat around the abdomen
• pre-peri and menopausal age

Also, our lifestyle under the pandemic environment and in general, people are more stressed¹⁰

• Physical activity dropped worldwide,
• People’s diets have changed¹²
• Overindulgence became a past time and habit for some of us

So, look out for these and make adjustments.

Olwethu: What should I pay attention to, for prevention is better than cure and I believe the more informed we are we are better placed to look after ourselves and live a healthy lifestyle?

Lara: Your best defence against fatty liver disease includes these strategies:

• Work with your health care team to achieve good control of your blood sugar.
• Lose weight if you need to and try to maintain a healthy weight.
• Take steps to reduce high blood pressure.
• Keep an eye on your cholesterol levels
• Don’t drink too much alcohol.

Sounds familiar right? Same advice you are given to manage many conditions.

Adopting a healthy lifestyle pattern requires a series of long-term behavioural changes, but evidence to date indicates low long-term adherence to diet and physical activity recommendations. I’ll use myself for an example; week 1 rocking it; week 2 still rocking it;  then week 3: clothes start to fit better, and my cheeks look slimer so I start my cheat days and skip morning gym!!

So, what could be done, we all need a crutch to help in the self-care and wellness space to assist, consider adding a liver supplement, to the exercise and weight management mix, one with Essential phospholipids like the ones contained in Essentiale.

Essential Phospholipids have demonstrated that in patients with lone NAFLD or NAFLD with comorbidities like type 2 diabetes and high cholesterol, early management or use with essential phospholipids significantly improves liver function, liver integrity and liver responsiveness.

Olwethu: How should NAFLD be managed?

Lara: We strongly recommended to consult a medical doctor or pharmacist for health and medication advice, ask your healthcare professionals the following questions to raise your and their awareness of the vital role the liver plays in your overall health:

• Can you help me reach a healthy weight?
• Can you check me for fatty liver disease?
• Is there fat on my liver?
• Are my liver enzymes elevated?

Making some lifestyle changes can control or reverse the fat build-up in your liver. These may include:

• Losing weight (make better food choices and increase physical activity)
• Lowering your cholesterol and triglycerides
• Controlling your diabetes
• Avoiding alcohol

And adding an essentiale phospholipids supplement, like Essentiale to your wellness plan.

Your overall health and wellness needs a healthy liver, so you love your liver from today for tomorrow.

Grateful to Sanofi and Essentiale for an insightful conversation and for taking the time to educate us about the importance of looking after our liver and the importance of its optimal health.

(This article and video was originally published 0n 5 May 2021)