In recent years, more and more people have been diagnosed with fatty liver during physical examinations. According to the Chinese Guidelines for the Prevention and Treatment of Fatty Liver, the prevalence of adult fatty liver in China has reached 12.5% to 35.4%. There are many "reversal" methods circulating online, which have made patients with fatty liver quite tempted. Among them, the saying "starving for 2 days a week can solve fatty liver" is particularly popular. Can "starving" really solve fatty liver?
Zhang Yujiao, the chief physician of the Infectious Diseases Department of China-Japan Friendship Hospital, told the reporter of the "Global Times Health Client" that "two days a week of hunger" is also called intermittent fasting, which mainly takes three forms: alternate day fasting, 5:2 diet and time limited diet. The weight loss effect of intermittent fasting is comparable to that of traditional dieting methods (eating less). In a short period of time (8-12 weeks), intermittent fasting can not only cause light to moderate weight loss (3%~8%), but also help improve cardiovascular metabolic risk factors such as blood pressure, low-density lipoprotein cholesterol and triglyceride levels, insulin resistance, and glycated hemoglobin. In 2023, a systematic review and meta-analysis published in the Journal of Hepatology Letters confirmed the beneficial effects of intermittent fasting on fatty liver. Our clinical medical guidelines also point out that intermittent fasting can reduce weight and is beneficial for metabolic, cardiovascular, and liver health.
Therefore, relying on hunger to improve fatty liver does have a certain effect, but it also affects individuals. Zhang Yujiao stated that fatty liver is a disease caused by excessive accumulation of fat in liver cells for various reasons, which can be divided into two categories: alcoholic and non-alcoholic fatty liver. Alcoholic fatty liver, as the name suggests, is a disease caused by long-term excessive alcohol consumption leading to abnormal liver cell structure or functional disorders. Non alcoholic fatty liver disease, commonly known as metabolic related fatty liver disease, is related to genetics, metabolic abnormalities, and unhealthy lifestyle habits. If it is alcoholic fatty liver, starving for two days a week cannot solve the problem of fatty liver, and it is necessary to quit drinking. If it is metabolic related fatty liver, starving for 2 days a week can reduce weight, body fat percentage, insulin levels, and have a certain improvement effect on fatty liver. Moreover, not all patients with metabolic related fatty liver disease are suitable for hunger. For patients with diabetes, hypoglycemia, peptic ulcer and other diseases, fasting may bring risks. During fasting, compensatory overeating can actually increase the burden on the liver.
Zhang Yujiao suggested that only by taking multiple measures can the effect be significant.
1. Adjust diet. Eat less foods rich in saturated fat, cholesterol, refined carbohydrates, sugary drinks, and deeply processed foods; Eat more fresh fruits, green vegetables, whole grains, and foods rich in omega-3 polyunsaturated fatty acids.
2. Increase exercise. Engaging in moderate intensity aerobic exercise for 3-5 days a week and accumulating more than 135 minutes can improve cardiovascular function and reduce liver fat content in patients with fatty liver disease; Accumulate 150-240 minutes or more per week, which can reduce weight and waist circumference; Performing high-intensity interval training for 3-5 days per week (including 1-5 high-intensity training sessions within 2-4 minutes, and occasionally 2-3 minutes of low-intensity recovery training) can also reduce liver fat content and improve cardiovascular function. Research has shown that walking fast for 150 minutes per week and persisting for more than 3 months can reduce liver fat content by more than 30% in patients with fatty liver disease. It should be noted that one must choose appropriate exercise and intensity based on their own situation.
3. Quit smoking and limit alcohol consumption. It is recommended to change bad behaviors such as smoking, drinking alcohol, irregular eating (skipping breakfast, eating late nights, eating quickly, and liking sweet drinks), staying up late, and sitting for a long time as soon as possible.
If it is still difficult to lose more than 5% of weight within 1 year after changing lifestyle, and if the BMI is ≥ 28 [BMI=weight (kg) ÷ height (m) squared], patients with metabolic fatty liver disease can apply medication assisted weight loss under the guidance of a doctor. Those who meet the criteria for weight loss metabolic surgery may also consider applying metabolic surgery for the treatment of steatohepatitis and fibrosis.
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