A disease in which fat invades the liver is on the rise in Singapore, but there is a straightforward way to fight it - by losing weight.
Non-alcoholic fatty liver disease (NAFLD), the build-up of extra fat in the liver that is not caused by alcohol, is one of the most prevalent liver diseases in the world.
In Asia, an estimated 20 to 30 per cent of the adult population has it. It is the leading cause of chronic liver disease and the third-most-common reason for liver transplants in the United States.
In Singapore, a recently released study on more than 60,000 Chinese Singaporeans found that diabetics are three times more likely to die from severe liver disease than those without the condition.
This came after news broke late last year that Punggol East MP Charles Chong had a severe form of the disease and needed to undergo a liver transplant.
In NAFLD, fat gradually infiltrates the healthy liver areas, so that less healthy liver tissue remains. This can progress to non-alcoholic steatohepatitis (Nash), with varying degrees of inflammation and scarring (fibrosis) of the liver.
It can worsen to cirrhosis (permanent scarring and hardening of the liver), which can then lead to liver failure. Fatty liver and Nash are reversible, but cirrhosis is not.
Fatty liver is usually associated with abdominal obesity, insulin resistance and Type 2 diabetes.
Unsurprisingly, the leading cause of NAFLD is being overweight or obese. Weight loss is therefore considered fundamental in treating the disease.
Dr Lim Su Lin, chief dietitian at the National University Hospital, said research has shown that a weight loss of 7 to 10 per cent can reverse fatty liver and Nash.
Diet and lifestyle modifications can help prevent or reverse NAFLD. Here are her suggestions.
REDUCE FOOD PORTIONS
Start by cutting your usual portions by a quarter and gradually work towards reducing it by half.
CUT FAT INTAKE
Limit your intake of deep-fried foods as these are high in calories. Before cooking or eating meat, remove the skin and trim the fats. Avoid pastries such as curry puffs and pies as they are high in fat, especially saturated fat and trans fat.
CUT BACK ON REFINED SUGAR
Skip sweetened beverages and desserts such as fizzy drinks, puddings, ice cream, ice kachang and chendol. Instead, go for plain water or unsweetened beverages, and end your meal with a slice of fruit.
Read food labels and avoid foods with an excessive sugar content.
EAT ENOUGH VEGETABLES, FRUIT AND PROTEIN
Ensure that you get two servings of fruit and two servings of vegetables a day. Also, include a palm-sized portion of protein-rich foods in main meals. Go for lean protein such as fish, tofu, beans, lentils and lean meat.
GO FOR WHOLE GRAINS INSTEAD OF REFINED GRAINS
Whole grains contain more fibre, so you will feel fuller. As they are rich in Vitamin Bs, which help convert food into energy, you will also feel less tired, even with a lower calorie intake.
KEEP TO THREE MAIN MEALS A DAY
Most people tend to overeat when they snack. If you really need to snack, have a piece of fruit.
INTEGRATE EXERCISE INTO YOUR ROUTINE
A weight-loss programme is more effective if regular exercise is included. If you are not used to exercising, start with 15 minutes a day and gradually increase it to 30 to 45 minutes in the next few weeks.
AVOID ALCOHOL USE
It can result in inflammation and damage to your liver cells. It is also high in calories which contribute to weight gain.