Dear Dr. Roach: I am 59 years old and am having problems with my lower abdomen. After colonoscopy and ultrasound, my doctor called to say I have a fatty liver. When asked what that means, I was told to lose weight. I weigh 170 pounds, and am 5 feet, 6 inches tall.
Research online suggests that alcohol is an issue, but I don’t drink. I may have a drink or a beer when I go out, but most times I am the designated driver, so I don’t drink. The only medication I take is Estradiol-Norethindrone 0.5-0.1; I take one daily. Diabetes does not run in my family, and I have not been tested for it.
Can you give me information on “fatty liver” and treatment?
Dear J.A.: Nonalcoholic fatty liver disease is an increasingly common problem; in fact, it is the most common liver disorder in industrialized countries. Recent studies have suggested that 30 percent to 46 percent of people in the U.S. have NAFLD. Most people are diagnosed in their 40s or 50s.
Obesity, particularly abdominal obesity (as opposed to fat around the hips and thighs) is common in fatty liver disease. People with suspected NAFLD should have other possible causes evaluated, especially viral hepatitis (types B and C), hemochromatosis and autoimmune hepatitis.
Simple fatty liver is a benign condition; however, some people will develop the more serious condition nonalcoholic steatohepatitis (NASH). Seventy percent of people with NASH are obese, and up to 75 percent have Type 2 diabetes. NASH without treatment can lead to fibrosis and even cirrhosis of the liver.
Your body mass index is 27, so you are considered overweight, not obese. Still, I would recommend gradually losing 10 pounds or so. I also would recommend that you continue to drink very moderately or not at all. Exercise also can help.
Dear Dr. Roach: I am 81 years old and in good health. I am 5 feet, 11 inches tall and weigh 168 pounds, the same as in 1950. My blood pressure and cholesterol are good on treatment, and my pulse is 62. I drink an energy drink three or four times a week after the noon meal, when I don’t take a nap and need to keep going. I am a farmer, and am active every day. Are these energy drinks harmful to me?
Dear L.M.W.: The caffeine in one energy drink is about 160 mg per 16-ounce can, the equivalent of somewhere around a cup or two of regular coffee, depending on how strong you make it. That much caffeine doesn’t cause problems for most people, especially for those who are used to it. However, it also has 52 grams of sugar — about 14 teaspoons. My advice is to stick with coffee. You will save money and reduce your sugar intake a lot.
Email questions to ToYourGoodHealth@med.cornell.edu.