脂肪肝比你意识到的更危险, 但是有逆转或预防它的方法
Fatty Liver is More Dangerous than You Might Realize. Here’s How to Heal It
By Mark Hyman
马克·海曼（Dr. Mark Hyman）博士
Mark Hyman MD是克利夫兰诊所功能医学中心(Cleveland Clinic’s Center for Functional Medicine)的主任，他是超健康中心(UltraWellness Center)的创始人，同时也是纽约时报的畅销书作者。
“我的医生说我有脂肪肝，我应该远离脂肪，”这周的家庭电话写道。“高脂肪食物是罪魁祸首吗?”有什么方法可以帮助脂肪肝吗?
的确，你的医生感到担忧是正确的:脂肪肝是一种危险却被误解的疾病。在美国，它影响着9000万美国人和17%的孩子。
想想鹅肝酱，这是由鸭鹅肝制成的法国美食。它是通过强制喂食动物，将糖与玉米和淀粉结合在一起(这是一种非常糟糕的做法)，故意制造脂肪肝。
所以如果你在吃糖和淀粉，你实际上是在用你自己的肝脏做同样的事情。脂肪肝的字面意思是你的肝脏充满脂肪，为慢性疾病和炎症铺平道路。
你可能会惊讶地发现这里的罪魁祸首。研究表明，碳水化合物(而非脂肪)会在你的腹部和肝脏中产生更多的脂肪。
糖会影响肝脏脂肪的生成，形成一种叫做脂肪生成（Lipogenesis or DNL）的内部过程，这是你身体对糖的正常反应。
果糖(Fructose)，直接进入肝脏的最有害的糖，实际上会增加脂肪生成(DNL)。这就是为什么糖，尤其是果糖，成为肝脏疾病的主要原因和肝移植的主要原因。
脂肪肝有什么不好? 在众多的影响中包括炎症、引发胰岛素抵抗(INSULIN RESISTANCE)和糖尿病前期，这意味着你的身体在肝脏和器官中储存脂肪，包括你的腹部(称为内脏脂肪)。
还有更差的情况。过量的糖和淀粉会造成更严重的问题，包括高甘油三酯、低HDL(“好”胆固醇)和高LDL(低密度脂蛋白)（LDL）(坏的胆固醇颗粒导致心脏病发作)。脂肪肝也会增加你的心脏病发作风险。
可悲的是，大多数人都不知道自己有脂肪肝。今天，我们甚至看到了12岁的男孩，因为他们喝了很多年的苏打水，现在需要肝脏移植。果糖是苏打水的主要甜味剂，它是非酒精性脂肪性肝病(NAFLD)发病率不断上升的关键因素。
我们给儿童喂食果糖和其他剧毒物质，为肝脏移植、高血压、糖尿病、心脏病和异常胆固醇打下基础。然后，医生们会开出大量的药物来缓解这些和其他问题。总的来说，这是令人忧虑的景象。
我之前提到过糖，而不是脂肪，会产生脂肪肝。这是有趣的地方:膳食的脂肪实际上关闭了你肝脏中的脂肪生产工厂。
你看，不像碳水化合物和蛋白质，膳食脂肪不会刺激你的胰腺分泌胰岛素或加重肝脏的负荷。你的身体喜欢燃烧而不是储存脂肪，除非你把它和碳水化合物结合在一起。当你摄入正确的脂肪，你会增加你的新陈代谢，刺激脂肪燃烧和减少饥饿。
我最喜欢的一种脂肪是中链甘油三酯或MCTs，可以是椰子油，也可以是独立的油。
为了预防或逆转脂肪肝，你需要减少加工过的碳水化合物，并增加健康的脂肪摄入量，尤其是饱和脂肪，从健康食品如椰子和草饲牛肉中摄入饱和脂肪。
我知道所有这些听起来可能有些令人困惑。毕竟，我们的政府告诉我们，即使有最新的膳食指南(顺便提一下，科学也不支持)，我们还是要将饱和脂肪限制在我们卡路里的7%到10%。我们已经把饱和脂肪妖魔化了这么久，以至于错过了房间里的紫色大象:糖。
幸运的是，新的指导方针告诉我们限制糖的摄入量，但是，他们做得还不够。这些指导方针应该包括全谷物，也可以分解成你身体里的糖。根据目前的指导方针，你仍然应该从糖中获得四分之一的卡路里来保持健康。疯狂的,对吗?
在吃脂肪，变瘦（EAT FAT, GET LEAN）, 我讨论了脂肪对你的肝脏有什么好处，还有很多其他的饮食脂肪问题，但是这里的关键信息是健康的饱和脂肪降低炎症，当你把它们作为低碳水化合物，高纤维，欧米加3脂肪酸丰富的饮食的一部分。
那么你怎么知道你有脂肪肝呢? 如果你吃大量的糖和面粉，有一点腹部脂肪，或者如果你想吃碳水化合物，你可能有脂肪肝。为了治疗脂肪肝并避免其巨大的有害影响，你想要找到这些问题的根源。
血液检查和超声波都可以检测脂肪肝。如果你的血液检查出现异常，你必须认真对待。即使你的测试恢复正常，也不要认为你已经摆脱了困境。肝功能测试并不总是检测脂肪肝。超声波更敏感。
幸运的是，你可以使用一些简单但有效的策略来逆转或预防脂肪肝。我发现这些饮食、锻炼和补充策略对我的病人大有裨益。
1. 消除所有高果糖玉米糖浆(HFCS)。即使是所谓的健康食品，如沙拉酱，也不要吃。从某种角度来说，一份商业制作的番茄酱可以比一份奥利奥三明治饼干含有更多的果糖!
2. 去除白色、加工过的面粉，消除或大幅减少淀粉。即使是全谷物面粉也有问题。它们会增加你的血糖水平，使你的肝脏受到压力，导致高甘油三酯，从而促进脂肪肝。
3. 添加健康脂肪。功能医学变得如此简单:为了治愈身体，你去掉了坏的东西并加入了好的东西。加入抗炎、护肝的食物，如低糖水果、蔬菜、坚果、种子、瘦肉蛋白，如鸡肉和鱼，以及有益健康的脂肪，如橄榄油、澳洲坚果油、鳄梨、椰子油、草饲黄油和鱼油。对付食糖损害的一个好办法就是多吃这些健康的脂肪。
4. 通过运动来改善你的新陈代谢。日常锻炼可以改善胰岛素抵抗，减少脂肪肝。从简单的事情开始，比如步行30分钟。更老练的锻炼者可能会采用高强度间歇训练（HIIT）(或爆破训练)和举重。
5. 善用营养补充剂。适当的补品可以帮助你的身体恢复平衡。像牛奶蓟这样的草药对肝脏有很大的帮助。我还使用了像硫辛酸和N -乙酰半胱氨酸这样的营养物质，它可以使强大的抗氧化剂在增强抗氧化剂谷胱甘肽的同时，使你的肝脏恢复活力。其他的肝修复营养素包括B族维生素和镁。
6. 饮食解毒，修复肝脏的超级食品。经常吃十字花科的食物，如花椰菜、花椰菜和球芽甘蓝，还有甘蓝、羽衣甘蓝、卷心菜、芝麻菜和豆瓣菜等绿叶蔬菜。每天至少喝一两杯可以帮助修复和治愈肝脏。大蒜和洋葱是令人惊奇的富含硫的食物，可以帮助排毒。
7. 补充优质蛋白质。每顿饭，尤其是早餐，蛋白质成为平衡血糖和胰岛素的关键，减少对食物的渴望，并为你的肝脏提供最理想的解毒所需的原料。用农场的新鲜鸡蛋或蛋白质奶昔开始一天的生活。我推荐我的全食物蛋白奶昔。包括坚果、种子、鸡蛋、鱼、鸡肉或食草肉类，每顿饭都含有蛋白质。一份分量是4到6盎司，或者是手掌大小。
8. 你需要一个健康的肝脏来对抗环境中有毒的垃圾和化学物质。健康的肝脏意味着你的身体保持健康，你不会生病，你会保持充沛的精力。
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Fatty Liver is More Dangerous than You Might Realize. Here’s How to Heal It
by Dr. Mark Hyman
“My doctor says I have a fatty liver and I should stay away from fat,” writes this week’s house call. “Are high-fat foods the culprit here? Any tips to help with a fatty liver?”
Indeed, your doctor is right to feel concern: Fatty liver is a dangerous yet misunderstood disease. In America, it affects 90 million of us and 17 percent of our children.
Think about foie gras, the French delicacy made from duck or goose liver. It is made by force-feeding the animals a combination of sugar with corn and starch (a really sad, horrible practice), intentionally creating a fatty liver.
So if you’re gorging on sugar and starch, you’re essentially doing the same thing with your own liver. Fatty liver literally means your liver fills with fat, paving the path for chronic disease and inflammation.
You might be surprised to learn the primary culprit here. Research shows that carbs (and not fat) produce more fat in your belly and liver.
Sugar switches on fat production in your liver, creating an internal process called lipogenesis, which is your body’s normal response to sugar.
Fructose, the most detrimental sugar that heads directly to your liver, actually ramps up lipogenesis. That explains why sugar, especially fructose, becomes the chief cause of liver disease and the leading cause of liver transplants.
What’s so bad about having a fatty liver? Well, among its numerous repercussions include inflammation, which triggers insulin resistance and pre-diabetes, meaning your body deposits fat in your liver and organs including your belly (called visceral fat).
It gets worse. Excess sugar and starch creates more serious problems including high triglycerides, low HDL (“good” cholesterol), and high amounts of small LDL (dangerous cholesterol particles that cause heart attacks). Fatty liver also increases your heart attack risk.
Sadly, most people have no idea they have a fatty liver. Today we’re even seeing 12-year-old boys with fatty livers because they guzzled soda for years and now need liver transplants. Fructose, the primary sweetener in sodas, is a key player in the ever-increasing rates of nonalcoholic fatty liver disease (NAFLD).
We’re feeding children fructose and other highly toxic substances, setting the dismal stage for liver transplants, high blood pressure, diabetes, heart disease and abnormal cholesterol. Doctors then prescribe numerous medications to alleviate these and other issues. Overall, it becomes a bleak picture.
I mentioned earlier sugar, not fat, creates fatty liver. Here’s where it gets interesting: Dietary fat actually turns off the fat production factory in your liver.
You see, unlike carbohydrates and protein, dietary fat does not trigger your pancreas to secrete insulin or stress out your liver. Your body prefers to burn rather than store dietary fat, unless you combine it with carbs. When you eat the right fats, you increase your metabolism, stimulate fat burning and decrease hunger.
One of my favorite fats is medium-chain triglycerides or MCTs, either in coconut oil or as a stand-alone oil.
To prevent or reverse fatty liver, you’ll want to cut processed carbs and increase healthy fat intake, especially saturated – yes, saturated – fats from healthy foods like coconut and grass-fed beef.
I realize all of this might sound confusing. After all, our government tells us to limit saturated fats to 7 to 10 percent of our calories even with the updated dietary guidelines (which science doesn’t support, by the way). We’ve demonized saturated fat for so long that we’ve missed the purple elephant in the room: SUGAR.
Thankfully, newer guidelines tell us to limit sugar intake, however, they don’t go far enough. These guidelines should be fine-tuned to include whole grains, which also break down into sugar in your body. According to current guidelines, you’re still supposed to get one-quarter of your calories from sugar to be healthy. Crazy, right?
I discuss how fat can benefit your liver and many other dietary fat issues in Eat Fat, Get Thin, but the take-home message here is that healthy saturated fats lower inflammation when you eat them as part of a low-carb, high-fiber, omega 3 fatty acid-rich diet.
So how do you know if you have a fatty liver? If you eat lots of sugar and flour, have a little bit of belly fat, or if you crave carbs, you probably have a fatty liver. To heal that fatty liver and avoid its vast detrimental repercussions, you want to get to the root of those problems.
Blood tests and an ultrasound can both detect fatty liver. If your blood test comes back abnormal, you must take it seriously. Even if your test comes back normal, don’t think you’re off the hook. A liver function test doesn’t always detect a fatty liver. An ultrasound is more sensitive.
Fortunately, you can employ some simple but powerfully effective strategies to reverse or prevent fatty liver. I’ve found these diet, exercise and supplement strategies greatly benefit my patients.
Eliminate all high-fructose corn syrup (HFCS). Even when it comes in so-called healthy foods like salad dressings, don’t eat it. To put things into perspective, one serving of commercially made tomato sauce can have more fructose than a serving of Oreo sandwich cookies!
Get rid of white, processed flour and eliminate or greatly reduce starch. Even whole grain flours can be a problem. They increase your blood sugar levels, stressing your liver and resulting in high triglycerides, which promotes a fatty liver.
Add healthy fats. Functional Medicine becomes so simple: To heal the body, you remove the bad stuff and add in the good stuff. Incorporate anti-inflammatory, liver-healing foods like low-sugar fruit, vegetables, nuts, seeds, lean animal protein like chicken and fish and good, healthy fats like olive oil, macadamia nut oil, avocados, coconut oil, grass-fed butter and fish oil. A great way to combat sugar damage is to eat plenty of these healthy fats. You can get a powerful 21-day plan to easily incorporate healthy fats in Eat Fat, Get Thin.
Improve your metabolism through exercise. Routine, daily exercise improves insulin resistance and reduces fatty liver. Start out with something simple like walking 30 minutes. More seasoned exercisers might incorporate high-intensity interval training (or burst training) and weight lifting.
Supplement intelligently. The right supplements can help bring your body back into balance while it heals. Herbs like milk thistle are great for supporting the liver. I also use nutrients like lipoic acid and N-acetyl-cysteine, which make powerful antioxidants to heal and rejuvenate your liver while increasing the powerful antioxidant glutathione. Other liver-healing nutrients include B vitamins and magnesium. You can find these and other quality supplements in my store.
Eat detoxifying, liver-repairing super foods. Regularly eat foods from the cruciferous family – like broccoli, cauliflower and Brussels sprouts, as well as leafy veggies like kale, collards, cabbage, arugula, and watercress. At least a cup or two every day can help repair and heal the liver. Garlic and onions are amazing sulfur-rich foods that help detox the body. You’ll find amazing recipes and more ways to incorporate these amazing foods in The Blood Sugar Solution 10-Day Detox Diet.
Power up with protein. Protein at every meal, especially breakfast, becomes key to balancing blood sugar and insulin, cutting cravings and providing your liver the raw materials it needs to detoxify optimally. Start the day with farm fresh eggs or a protein shake. I recommend my Whole Food Protein Shake. Include nuts, seeds, eggs, fish, chicken or grass-fed meat for protein at every meal. A serving size is four to six ounces, or about the size of your palm.
You need a healthy liver to combat toxic junk and chemicals in your environment. A healthy liver means your body stays healthy, you don’t get sick and you maintain plenty of energy.
I’d love to hear from you. Do you or someone you know have a fatty liver? What steps are you taking to prevent or reverse this problem? Comment below or on my Facebook page.
Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman MD is the Director of Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.
If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.
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