Dealing with health conditions and diseases


Dear nutritionist,

My husband was diagnosed with non-alcoholic fatty liver disease. His doctor told him to lose weight and he tries, but in the end he gets discouraged and goes off his diet. I am worried about his health, but what can I do?


Dear Lauren,

One of the greatest challenges in life is watching someone struggle with a state of health. It may be more difficult than fighting ourselves. Of course, you are concerned about your husband’s health and there are many ways you can offer love and support. When you cook, you prepare tasty, healthy meals that fit into his health plan. Encourage him to join a support group as these are associated with higher success rates. These groups meet in person and online, and you can find one near you at

Alcohol-free fatty liver disease (NAFLD) is a condition in which fat builds up in the liver. It is estimated that around 100 million Americans live with this disorder (1). At one time, fatty liver almost always occurred as a result of excessive alcohol consumption. With the obesity rate increasing in today’s society, the condition now occurs in non-alcoholics. If left untreated, it can cause inflammation and liver damage, a condition known as non-alcoholic steatohepatitis (NASH). Since these conditions often have no symptoms, an annual physical exam is important. At this time, your doctor may order blood tests to monitor levels of liver enzymes.

Most people with NAFLD or NASH live normal lives with stable illness. However, these conditions can lead to cirrhosis of the liver, which increases liver failure and the risk of liver cancer.

Risk factors for NAFLD include obesity, type 2 diabetes, insulin resistance, and metabolic syndrome. While most of us are familiar with obesity and diabetes, insulin resistance and metabolic syndrome are lesser known conditions. Insulin resistance occurs when the pancreas secretes insulin but cannot reach the cells where it is needed. As a result, blood sugar levels rise. When blood sugar levels are high, fat cannot be broken down efficiently, which leaves high levels of fatty acids in the bloodstream. These fatty acids get into the liver but cannot be effectively metabolized, so they accumulate.

Metabolic syndrome is a group of health conditions that increase the risk of cardiovascular disease (heart attack and stroke). To get this diagnosis, you must have three or more of the following conditions: high blood pressure (or taking medication for this condition), obesity, insulin resistance, low HDL (good cholesterol), or high triglycerides (or taking medication for this condition).

There are no drugs to treat fatty liver disease and NASH, but the conditions are treatable. The most successful plan is weight loss and exercise. Reducing total body weight by 7 to 10% has been shown to improve results (2). It is important not to lose weight too quickly as this can make the situation worse. Your husband’s doctor will have him work with a nutritionist to develop a nutrition plan that will result in slow, steady weight loss. My blessings to you and your husband. Please let me know how it goes.

References 1. NASH Definition and Prevalence (nd) Retrieved from

2. Chalasani N., Younossi Z., Lavine JE, et al. Diagnosing and Treating Non-Alcoholic Fatty Liver Diseases: Guide from the American Association for the Study of Liver Diseases, the American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012; 55 (6): 2005-2023.

Be healthy until next time!

Dear nutritionist

Leanne McCrate is an award-winning nutritionist based in Missouri. Their mission is to educate the public about informed, evidence-based nutrition. Do you have a nutrition question? Email at [email protected]


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