The liver is really a miraculous organ, performing more than 500 functions necessary to life. It rids our bodies of toxins, regulates hormones, breaks down nutrients and stores energy, metabolizes alcohol and medications, among many other things.

It is also the body’s fat factory and warehouse. When we take in more calories than we expend, the excess is stored as fat, an energy source in case, pardon the pun, times are lean.

But in Canada times are rarely lean anymore, and many of us regularly take in more calories than we expend. The resulting weight gain slowly becomes obvious in fat buildup in hips, thighs and belly, but a not-so-obvious buildup simultaneously occurs in the liver.

When between five and 10 per cent of the liver’s weight is fat, the result is fatty liver disease, now the most common liver disease in North America, says Billie Potkonjak, director of health promotion and patient services for the Canadian Liver Foundation. It’s estimated 1.4 million Canadians have fatty liver disease, and that`s expected to rise along with obesity, the major cause of non-alcoholic fatty liver disease (though thin people can also develop it). The other major cause is alcohol abuse.

Fatty liver disease often produces no symptoms, but as fat builds up, the liver becomes vulnerable to inflammation. Up to six per cent of Canadians have NASH (non-alcoholic steatohepatitis), inflammation and swelling of the liver, according to the University Health Network website www.uhn.ca. Up to 20 per cent of them develop liver scarring, better known as cirrhosis. As scar tissue replaces liver cells, risk of liver failure and liver cancer rises.

Nearly one in five Canadians—4.7 million adults—are obese, reports Statistics Canada, having a body mass index higher than 30. The Dietitians of Canada website, www.dietitians.ca, has a BMI calculator to help you determine if you are obese. The liver foundation’s website, www.liver.ca, notes three quarters of obese people are at risk of fatty liver. The disease also affects nearly half of obese children.

Non-alcoholic fatty liver disease goes hand-in-glove with metabolic syndrome, the combination of weight gain, insulin resistance, and high levels of cholesterol and triglycerides that leads to type 2 diabetes. A Stanford University study of 11,091 people found people with fatty liver were five times more likely to develop type 2 diabetes.

The root cause of fatty liver is not well understood. People who store fat around their abdomens are more likely to develop fatty livers than those who store fat on their buttocks, hips and thighs. Researchers in Germany have found a genetic connection—switching off of a gene involved in regulation of fat storage and insulin resistance.

The bad news is there is no medical treatment for fatty liver disease, through ongoing research is looking into effects of vitamins and minerals, herbs and spices, pharmaceuticals and the use of probiotics and omega-3 fatty acids, says the Mayo Clinic website www.mayoclinic.org.

The good news is that the disease is reversible, and there are easy things to do to reduce the amount of fat in the liver. “Look at diet,” said Potkonjak, “and increase exercise.”

Losing weight helps. A study at St. Louis University found a weight loss of nine per cent helped reverse NASH.

Watching what you eat is also important. Cutting down or cutting out alcohol and refined sugar (including fruit juices and sugared soft drinks) is recommended, as is a balanced diet low in saturated fats and high in fibre. Animal studies at the University of Colorado School of Medicine show a link between the disease and the way the liver converts carbohydrates like bread and rice into fuel for the body, so following a low glycemic diet is wise. The website www.nutritiondata.self.com lists nutrient and glycemic load of natural and processed foods.

Exercise need not be overly strenuous, but it should be regular, said Potkonjak. “It’s enough to just be walking.”

Should someone with non-alcoholic fatty liver disease drink alcohol? “As far as your liver is concerned, the safest amount of alcohol is no alcohol at all,” says the Canadian Liver Foundation. However, some research shows moderate drinkers with non-alcoholic fatty liver disease have a lower risk of developing NASH. But alcohol puts a strain on the liver and can compound liver damage, points out the foundation.

So, the prescription for a healthier liver is to get out your walking shoes, use them regularly, and watch what you eat and drink.

Odd Body Fact

The liver of an adult weighs just over a kilogram and is about the size of a football. It is the only internal human organ that can regenerate. When someone donates part of their liver for transplantation, their own liver will grow back to its original size, and the transplanted portion will grow to the appropriate size for the recipient.