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Akershus County Court – New study: one in three Norwegians has liver fat

Despite a somewhat frightening name, there are relatively few people who have heard of "fat liver". And there is little information about the disease online.

At the same time, we see an increasing prevalence of liver fat in both the US and Europe. Here too the trend is increasing and now the Health Survey in Nord-Trøndelag (HUNT3) shows that one in three Norwegians has the so-called "non-alcoholic liver fat", writes Gemini.

– What we know for sure is that the incidence of liver fat is increasing and is closely related to the overgrowth epidemic, says consultant and researcher Mette Vesterhus to Nettavisen.

She is a specialist in digestive disorders in the Haraldsplass Diaconal Hospital.

Most people don't get any symptoms

First and foremost: what is fatty liver?

There are two different liver fatty acid diseases: liver fat caused by alcohol abuse and non-alcoholic liver fat, the type we refer to in this article.

Fat liver is a condition, as the name implies, where fat accumulates in the liver. Most cases of non-alcoholic fatty liver come from obesity or in connection with type 2 diabetes.

– We call it fatty liver if there is more than five percent fat in the liver. This is usually tested by ultrasound, after which it is seen that the liver is lighter than normal. You can also test for liver fat by performing a blood test, says Vesterhus, head of the Norwegian Gastroenterological Association.

You usually do not get any symptoms of fatty liver.

– Most people with fatty liver live well with it, but this indicates an increased risk of cardiovascular disease, diabetes and high blood pressure.

– Fat liver is associated with fat elsewhere in the body and is part of what we call "metabolic syndrome", along with type 2 diabetes, cardiovascular disease, high blood pressure and cholesterol, Vesterhus says and continues:

– All this goes together, but it is usually a heart condition or stroke in which patients with fatty liver die. Fatty liver, however, can be a warning that lifestyle must be changed to avoid this risk. It is rare for people with a normal weight to have fatty liver and then they must be very unhappy with their genes, says Vesterhus.

However, there are a few who develop serious diseases due to fatty liver.

– In some people fat accumulation leads to liver inflammation, which in turn can lead to scarring and cirrhosis, and in the worst case to liver transplantation. A very small proportion can also develop liver cancer due to fatty liver. That's why there is reason to get a grip on their lifestyle if they get proven liver fat, Vesterhus says.

Liver transplantation and liver cancer

The latest figures that Vesterhus can refer to the following:

20-30 percent of the European population has liver fat. Of these, around three percent get liver infection and 0.2-0.5 percent get liver cancer.

It is nevertheless a staggering number of 200-500,000 people in the EU who are believed to develop liver cancer because of their fat liver.

– In the US, liver fatification is the third most common cause of liver transplants. The British newspaper The Guardian wrote in 2015 that one third of adult Britons have liver fat and British experts believe that most liver transplants in the UK in 2020 will be due to fatty liver disease, Vesterhus says.

In Norway we are slightly behind the US and the UK, but the trend is the same.

– We have had patients in Norway who have had liver transplantation due to fatty liver disease, says Vesterhus.

With the sneakers on

The positive news is that it is possible to get rid of fatty liver – all alone. Good condition is the very best medicine for liver fat.

A new study conducted by researchers from the Cardiac Exercise Research Group (CERG) at NTNU and the University of Queensland in Australia ends with the following:

People with poor condition have multiplied the chance of fatty liver.

Previous research has shown that sedation increases the risk of liver fat, but the research shows that fitness is the most important factor.

– Even people who are a bit quiet during the day have significantly increased the incidence of liver fat when they are in poor condition, says Ilaria Croc, postdoctoral fellow at NTNU, at Gemini.

In the study, the researchers followed 16,000 people in Nord-Trøndelag. They all tested their oxygen uptake at the start of the study, as well as blood tests and body composition tests. Among them there were 36 percent, that is, about 5,600 participants, who had liver fat.

These 5,600 people were followed for nine years, and the risk of death appeared to have increased by more than 50 percent for the fifth who had estimated the worst situation.

Must get sweaty and out of breath

Only one in three Norwegians meets the recommendation of the Norwegian Directorate for Health on physical activity, which is slightly more than 20 minutes of moderate activity every day.

The recommendation is 150 minutes of moderate activity per week, that is, slightly more than 20 minutes per day, or 75 minutes of high intensity.

However, the NTNU study shows that it does not train moderately 150 minutes a week when it comes to protection against liver fat.

– A good deal will not get better condition if they only train with moderate intensity. Strength training improves the condition much more, so my urge is to exercise regularly with such high stress that you get sweaty and out of breath, Croci tells Gemini.

The Health Directorate also writes that you have to train more or harder if you want to achieve even better health:

"To achieve additional health benefits, adults and seniors must have 300 minutes of moderate physical activity per week, or up to 150 minutes of high intensity," says the Health Directorate.

Senior Vesterhus is not surprised by the results of the NTNU study.

– We use to say that someone has to perform a 10 percent weight reduction to get rid of fatty liver, and that is achieved by exercising more and eating healthier. Exercise is particularly important here because we know that exercise helps even if someone doesn't fully achieve the 10 percent weight reduction, Vesterhus says, and continues:

– This is probably because exercise affects both the composition of cholesterol in the blood and the sensitivity of the body to insulin. So the study confirms what we already know, namely that exercise is the best medicine for liver fat.

The more you train, the better your health

That exercise and activity are good for health is undeniable.

But an increasing number of studies show that people prefer to get pretty sweaty and out of breath to have some extra health benefits.

However, the study shows that even a slight increase in fitness will have major health benefits, but health is better, the harder and more often you are trained.

The study confirmed the outcome of an American study that simply concluded the following: the better shape, the longer lifespan. The less you practice, the greater the chance of early death.

Cardiologist Wael Jaber of the Cleveland Clinic in Ohio compared poor condition with other risk factors such as smoking and obesity.

– Being untrained should be seen as an equally strong risk factor, such as high blood pressure, diabetes and smoking, if not stronger than everyone else. It should almost be treated as a disease for which you can get a prescription – and that recipe is an education.

In October 2018, Wael Jaber published a study published published correlation cardiorespiratory exercise and early death.

Here too, the researchers concluded the following: the more you exercise, the longer and healthier it is. The less you practice, the greater the chance of early death.

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