Category: mediterranean diet

6 Key Strategies for the Prevention and Treatment of Non-Alcoholic Fatty Liver Disease

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Non-Alcoholic Fatty Liver Disease (NAFLD) is becoming increasingly common but yet remains underdiagnosed, and is the most common liver disease in Canada. It is diagnosed in women who consume less than 20g/day of alcohol and in men who consume less than 30g/day of alcohol, and other causes for liver disease are ruled out. NAFLD is on a spectrum from mild fat (triglyceride) accumulation to inflammation and scarring (non-alcoholic steatohepatitis or NASH), and eventually liver cirrhosis or even cancer (hepatocellular carcinoma)[1].

NAFLD is commonly an incidental finding on ultrasound or suspected when an elevated ALT is noted on routine lab work.

There is a strong relationship between cardiovascular diseases (CVD), particularly coronary artery disease (CAD, disease of the arteries of the heart) and NAFLD. CVD is the most common cause of death in those with this disease. Insulin resistance, diabetes, endothelial dysfunction, hypertension and hyperlipidemia are commonly found in those with NAFLD[2]. Excess caloric intake, obesity, and sedentary lifestyle create the perfect storm to develop NAFLD.

First line treatment for NAFLD includes lifestyle interventions with an emphasis on exercise and weight loss. The following are key strategies to reduce liver fat and prevent the progression of NAFLD1 [1,3]:

  1. Weight loss. 5-10% weight loss goal depending on severity, achieved by a loss of 0.5-1kg/week. Severe caloric restriction and rapid weight loss can have a detrimental impact on liver health. An activity goal of 150 minutes/week of moderate intensity aerobic activity should be achieved.
  2. Mediterranean diet. A plant-based dietary pattern provides antioxidants and helps to reduce oxidative stress and inflammation. It also helps to manage insulin resistance, and elevated cholesterol reducing risk of NAFLD as well as cvd and diabetes. Choose plant-based proteins such as beans, lentils, a variety of vegetables, healthy fats found in nuts, flax seed, and olive oil and choose more poultry and fish.
  3. Low saturated fat, no trans fats with an emphasis on polyunsaturated and monounsaturated fats. Diets high in saturated fats and trans fats increase oxidative stress, inflammation and accumulation of fat in the liver, also increasing risk for cardiovascular diseases. While healthy fats, such as those found in fish and extra-virgin olive oil, can help to reduce triglycerides, LDL, and cholesterol, reduce inflammation and fat accumulation in the liver.
  4. High fibre, whole grains. Choosing more whole grains instead of starchy and high glycemic foods will help to balance blood sugar, keep you feeling full longer and helps to reduce cholesterol. Not only that, it also helps to maintain healthy gut bacteria which is important for liver health
  5. Avoid processed foods, and foods high in fructose. Process foods are often high in saturated and trans-fat and excess sugar contributing to excess calories and accumulation of liver fat. By eliminating highly processed and sweetened foods and beverages can help you achieve your weight loss goals.
  6. Reduction/elimination of alcohol.

 

 

[1] Jeznach-Steinhagen, A., Ostrowska, J., Czerwonogrodzka-Senczyna, A., Boniecka, I., Shahnazaryan, U., & Kuryłowicz, A. (2019). Dietary and Pharmacological Treatment of Nonalcoholic Fatty Liver Disease. Medicina (Kaunas, Lithuania), 55(5). https://doi.org/10.3390/medicina55050166

[2] Arslan, U., & Yenerçağ, M. (2020). Relationship between non-alcoholic fatty liver disease and coronary heart disease. World journal of clinical cases, 8(20), 4688–4699. https://doi.org/10.12998/wjcc.v8.i20.4688

[3] Elena S George, Adrienne Forsyth, Catherine Itsiopoulos, Amanda J Nicoll, Marno Ryan, Siddharth Sood, Stuart K Roberts, Audrey C Tierney, Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults, Advances in Nutrition, Volume 9, Issue 1, January 2018, Pages 30–40, https://doi.org/10.1093/advances/nmx007

 

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

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5 Mediterranean Grocery Staples To Keep Stocked In Your Kitchen

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The famous Mediterranean diet – although I consider it more of a lifestyle than a diet – is one that is shared by the people living along the Mediterranean Sea. We tend to associate this eating style with those living in Italy, France, and Greece, but it includes many other countries such as Morrocco, Egypt, Spain, and Turkey, just to name a few. It is no surprise to me that this way of eating is one of the healthiest, if not THEEEE healthiest – full of variety, antioxidants, healthy fats, anti-inflammatory ingredients and not to mention packed full of flavour. Not everyone is familiar with the Mediterranean eating style and it is not difficult to start. Here are 5 essentials to get you started and help you reap the benefits of the Mediterranean Way:

  1. Olive Oil. This healthy monounsaturated fat is a key staple of the Mediterranean diet. It’s tremendous health benefits can be attributed to the high polyphenol content and anti-inflammatory action of this oil. Regular intake can help improve lipid parameters, support the function of blood vessels and a healthy blood pressure. Don’t over do it though as like any fat, eating too much olive oil can increase your caloric intake fast if you are trying to lose weight. A good place to start is incorporating 1-2 tbsp daily in the form of salad dressing or adding flavour to meals.

Pro Tip – purchase in dark glass bottle in smaller quantities and look for the symbol of the North American Olive Oil Association to ensure quality

  1. Eat more legumes such as beans, lentils, chickpeas. They are high in fibre and protein and low in fat, making a great meat substitute and helping you feel full longer. They are also a great source of folate, iron, magnesium, and potassium which is essential for healthy blood pressure.

Pro Tip – soaking beans overnight and changing the water once or twice can help make them easier to digest.

  1. Snack on nuts and seeds. They also provide a great source of unsaturated fats as well as a variety of minerals, fibre and a little bit of protein. They can help 1-2 small handfuls daily is all you need. They have a cholesterol-lowering effect as well as helping to reduce inflammation, improve insulin sensitivity and blood vessel health. Walnuts, almonds, pistachios, pecans and macademia nuts are good choices. Also, don’t forget sesame seeds and tahini, as well as flax and chia to boost your fibre intake.

Pro Tip – choose raw, unsalted, and keep stored in the refrigerator or freezer to preserve the healthy fats. Nuts and nut butter (such as almond butter) pair well with a piece of fruit or spread on some celery for a light snack.

  1. Incorporate more fish and seafood at least twice/week. They contain long chain omega fats important for heart and brain health.

Pro Tip – choose small cold water fish and wild caught if possible. Salmon, sardines, herring and mackerel are the best options for their omega 3 content.

  1. Tomatoes! (and of course other Fruits and vegetables) – Tomato sauce and tomato paste are excellent sources of lycopene, a key antioxidant for health, as well as other vitamins and minerals, phytosterols, amino acids, fibre and many other antioxidants. Lycopene is a carotenoid that gives tomatoes their bright red colour. Tomatoes have numerous health benefits such as protection against eye disease, diabetes, cancer and cardiovascular disease to name a few.

Pro Tip – cooked tomatoes with olive oil increases the bioavailability of the lycopene. Be sure to look for low sodium versions. And if you suffer from heart burn, you may want to limit or avoid tomato based products.

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

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Is wine good for my heart?

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Is wine good for my heart? I get asked this question a lot by my patients. And the research is mixed, as it is for our beloved coffee! One day it's good and the next a new study says it may not be. That's because we are all different. Our physiology is different. How our body metabolizes is different. So there isn't a straight answer here, but I can share a few things that I do know. Although red wine (not white) is NOT a health elixir, it does have some health benefits owing to the polyphenols in it. One in particular you may have heard of is resveratrol. Resveratrol which is found in the deeply pigmented skin of red grapes does have some wonderful health benefits:

  • It acts as an antioxidant preventing free radical cell damage leading to chronic diseases and cancer
  • It can help to lower inflammation
  • Helps prevent diabetes
  • Helps prevent cognitive decline
  • Helps to reduce heart disease risk by reducing inflammation and clotting

(HACK: thick-skinned grapes have higher levels of resveratrol like in a Malbec)

There is research that shows it can reduce hsCRP levels which is a marker of inflammation and can significantly raise your risk for a heart attack (FYI, a very cheap test that I routinely run with my patients). But keep in mind, there are better ways to lower inflammation than drinking wine so you can't use that excuse for your habit 😉 Resveratrol is not only found in red grapes but also in deep purple coloured fruits like blueberries and blackberries as well as raw cocoa powder. Although there may be some health benefits to drinking red wine, if you are struggling with any of the following conditions, you may want to re-evaluate your relationship with it and reduce the time you spend together:

  • perimenopause/menopause- It can worsen those dreadful 'tropical moments' - by affecting the body's temperature and cooling systems wine can exacerbate hot flashes and night sweats
  • insomnia, unrefreshing sleep - wine can interfere with the production of hormones that help with sleep, it can disrupt deep sleep, and increase trips to the bathroom, leaving you feeling less rested in the morning
  • Anxiety or depression - alcohol acts as a depressant in the body, but also can disrupt blood sugar and can lead to dehydration triggering symptoms that can exacerbate anxiety like headaches, fatigue, increased heart rate
  • gas, bloating or any digestive concerns - wine, and alcohol in general can muck up your gut and oral bacteria and messed up bacteria can contribute to more inflammation and heart attacks, so you may want to consider a probiotic

Remember, moderation is always key but that does NOT mean a few glasses throughout the week with dinner and more on the weekends.

So, for those of you who are considering working with me to reduce your risk of a heart attack, rest assured you can still enjoy your wine but I will help you to choose wisely 🙂

 

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Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

References:

https://www.sleepfoundation.org/articles/how-alcohol-affects-quality-and-quantity-sleep