Retrospective #333: NAFLD, Fructose and PUFAs

A friend recently asked me to look over a list of supplements suggested as “interventions” for a diagnosis of NAFLD (Non-alcoholic fatty liver disease). So, she sent me a link from Life Extension (LE), a supplement seller recommended by her doctor. Can you believe that? Doctors are now shilling for supplement sellers!

Life Extension’s “suggestions” include eight (8) “supplements,” all but one of which – a drug, metformin – they sell. All “have been shown to boost liver health and help manage NAFLD,” and “prevent progression to the more deadly NASH, which is a precursor of liver failure.” Pretty scary stuff! “Which of these supplements should I buy,” she asked? Then, at the bottom of the page, I saw that the tab on the link my friend sent was pg. 2. I clicked on pg. 1.

“Roughly one-third of the American population suffers from nonalcoholic fatty liver disease or NAFLD. NAFLD can go undetected for years and may eventually progress to inflammation and scarring of the liver (cirrhosis) and, in some cases, full-blown liver failure.” More scary stuff. “A formerly rare condition, its rapid emergence has been linked to skyrocketing rates of metabolic syndrome and diabesity, the term many experts use for co-occurring diabetes and obesity.”

My friend is not obese, but her IR and abnormal lipid profile puts her squarely in the Metabolic Syndrome box.

“While POOR DIETARY CHOICES are often to blame, cutting-edge research suggests that hidden genetic factors may also play a role, and some people do not metabolize polyunsaturated fats properly, resulting in fatty deposits in the liver.”

Life Extension’s “fix,” of course, is supplements: They offer to sell you a passel of supplements. That’s their business.

“As mainstream medicine continues to struggle in the search for drugs to manage this widespread condition, emerging scientific evidence has shed light on effective natural interventions that may halt or even reverse its progress.”

But wait, these “interventions” are just surrogates for drugs, THE BEST “TREATMENT” FOR A CONDITION CAUSED BY POOR DIETARY CHOICES, INCLUDING POLYUNSATURATED FATS, IS GOOD DIETARY CHOICES AND HEALTHY FATS.

And, Life Extension has identified the likely causes of NAFLD: poor dietary choices and polyunsaturated fats.

What are those “poor dietary choices”? Life Extension hones in on the main one, a simple sugar, fructose. Fructose is half of every cane (i.e. table sugar) molecule, and, being toxic in big slugs, fructose goes directly to the liver to be detoxified. If the liver is already full of stored carbs (glycogen), via de novo lipogenesis, the liver makes new fat molecules IN THE LIVER from the fructose. And, ipso facto, there you have the beginnings of NAFLD.

“Of course, what we eat is as important as the calories it contains. One of the major bad actors in today’s world is fructose, found in high quantities in high-fructose corn syrup. Fructose promotes formation of new fat molecules in the liver, blocks breakdown of existing fats, stimulates free radical production, and promotes insulin resistance. Increasing numbers of studies are linking increased fructose consumption with NAFLD, and even with its deadlier consequence, NASH. Patients with NAFLD consume 2-3 times as much fructose as do control patients, even corrected for body weight.”

Okay, LE focuses on HFCS, which is 55% fructose, but remember, table (cane) sugar is 50% fructose, which is just as bad!

The other dietary choice Life Extension cites as a probable cause of NAFLD is “polyunsaturated fats,” or PUFAs, the highly processed vegetable oils, soybean and corn oil being the most prevalent. These are unnatural food oils that did not exist before technology developed to extract them. I have written about the harm of PUFAs many times, but Life Extension’s citation was refreshing because these liquid fats are still recommended by the Dietary Guidelines.

A small amount of PUFAs are “essential,” i.e., the body can’t make them. However, the ratio of the “essential” fatty acids (n6s and n3s) is important because they compete to be taken up by the cells. Historically this ratio has been 2:1 but with the proliferation of “industrial” food oils over the last century, and the USDA’s advocacy of them (and Cargill’s and ADM’s production and marketing of them), the ratio for most Americans is now 20:1 to 30:1.

You can’t fix this ratio by just supplementing with fish oil (n3s). You need to cut bac on fried foods, commercial baked goods and bottled salad dressings. Replace PUFAs with monounsaturated fat (olive oil) and healthy saturated fats from coconut oil and butter, lamb, beef, pork, chicken and full-fat dairy and wild-caught fish. All Real Foods!