THE ASSOCIATION BETWEEN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD), OBESITY and TYPE 2 DIABETES.

Non-alcoholic fatty liver disease (NAFLD) is a condition whereby fat is accumulated in the liver of drinkers who consume little to no alcohol. Both obesity and diabetes are risk factors for NAFLD.

Obesity is the next stage of overweight as indicated by the body mass index(BMI) of an individual. It is a metabolic syndrome in which excess calories mostly from SIMPLE SUGARS are converted to fat and subsequently stored in the body.

Type 2 diabetes arise when the body cells including muscle cells do not respond to the signal of INSULIN (insulin resistance) to take up sugars present in the blood. Consequently, there is sugar buildup in the blood. Obesity is a risk factor for type 2 diabetes and both obesity and type 2 diabetes are risk factors for non-alcoholic fatty acid disease (NAFLD) .

Intrahepatic triglycerides (IHTGs) i.e liver fat is commonly associated with insulin resistance but more important is the link between hepatic ceramides and insulin resistance. It has been shown that hepatic (liver) ceramides confer insulin resistance independent of liver fat (IHTGs) and obesity.

Where are intahepatic triglycerides(IHTGs) and hepatic ceramides got from?
Intahepatic triglycerides are obtained from 3 sources viz.
1. Dietary fat
2. Adipose fat lipolysis ( splitting of lipids/fat) which can be aggravated by SATURATED FATS.
3. Hepatic( liver) de novo lipogenesis ( production of fat) from substrates such as SIMPLE SUGARS.

Ceramides are synthesized de novo (from the beginning) from SATURATED FATS.
The principle by which ceramides confer insulin resistance is as follows:
1. Inhibits insulin signaling and
2. Stimulate hepatic gluconeogenesis which means production of glucose in the liver.

The interpretation of the above stated is that body cells do not respond to the call of insulin to take up sugars from the blood and at the same time more glucose is produced into the blood stream by the liver. This is the sugar traffic we are talking about as regards type 2 diabetes.
SIMPLE SUGARS are the bane because they lack fibre which plays the role of controlling the release of sugar into the blood stream. Hence, there will usually be sugar spike in the blood. Unfortunately, the sugar remains there.
From this review it can be seen that the implicated components of our daily diets are SIMPLE SUGARS AND SATURATED FATS, most often they form the bulk of the foods we buy at fast food outlets when we choose to stay away from the kitchen and eat out.

RECOMMENDATIONS

1. Take little saturated fat about 10% of your total daily calories.

2.Avoid simple sugars, those present in sugar sweetened beverages, table sugar added to tea and elsewhere.

3.Consume whole grains ( wheat, maize, brown rice, sorghum, millet) and not their refined flours which have little to no fibre as used in baked products.

4. If fat should be present in your meal let it be unsaturated ones such as olive oil, sesame seed oil, avocado oil, soybean oil. etc..

5. Avoid binge eating or eating too much at once

6.Consume adequate fruits and vegetables

7. Engage in physical activities.

REFERENCE

Luulkonen et al. 2018

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