My mother, Geneva Eskridge, was one of the inspirations for this foundation. She passed away, a few days short of her 94th birthday of complications arising from her lung cancer. Her family was there and had been with her during her final days. She was well and truly loved by those who knew her and she rarely met anyone whom she did not befriend. She will be sorely missed by many.

For anyone not familiar with her and for those who knew her well I’d like to offer a brief visit with her indomitable spirit. Geneva exemplified the best of us and we can but hope to approach our lives in the same spirit. When diagnosed with lung cancer at the age of 91 she decided to go skydiving rather than retreat from life. The link below is to her first jump and the second is when she jumped again at 92

https://www.youtube.com/watch?v=iG17sLXxQIU

https://www.youtube.com/watch?v=Z5xGKVLJxxE

I only hope that I can live up to her example with my life and our family offers her memory to you as an example of a life well led. I regret that the role of caregiver, which I worried that I might be unable to perform adequately, was cut tragically short by unforeseen events.

If you want to really understand Fatty Liver Disease, spend some time watching the videos below.  They present a great deal of information, but if knowledge is your goal, this is a great place to start.

Part of dealing with liver disease is to understand it.  In order to help you, we are working with Armando Hasudungan who produces superb short videos to explain complex medical subjects.  We use them throughout the site to help you understand your body and specifically your liver.  The first video gives you a view of the liver overall and the following ones focus on details.

So how does what I eat cause me problems?

OK, but how does Cirrhosis happen?

So what is cirrhosis that is the one that scares me.

I suppose the next question is what are the signs and symptoms and management of liver disease.

Darn, so how bad can it be really?

Causes part 1

Causes part 2

If you would like to explore the science behind the diets click on this link.

We start with the fact that the fundamental problem is the bio-chemical flow between the liver and fat cells. When diet is poorly balanced, over time fat accumulates in the liver and by itself is rather benign but when other chemistries like insulin management begin to degrade you get inflammation which leads to fibrosis and if not stopped progresses to cirrhosis. Since there is no treatment your tool is diet and the question is to avoid anything that stresses the liver and load up on anything that is protective. Easy peasy right. Well let's take a look

• eliminate all alcohol
• eliminate most saturated fat and no red meat
• eliminate all non skim dairy products
• eliminate trans-fat and all hydrogenated oils
• eliminate all high fructose corn syrup
• eliminate most sodium -- the goal 1,500 mg of salt or less.
• eliminate all added dietary sugar
• eliminate processed grains, no white flour or white rice
• Avoid most products hustled by the supplement industry
• Make sure that any medications you take are not harming your liver

Oh my god. That is a terrible list. Not possible to live that way. OK, take a breath. The goal is to take as much pressure off the liver as possible, provide molecules from your diet that are protective and don't stimulate the stellate cells to initiate scaring, but still provide proper nutrition. So what do you do?

• For oil get 60 ml, that's 1/4 cup, a day of extra virgin olive oil
• Take one tablespoon per day of refined fish or salmon oil
• Don't buy prepared foods without reading the label, there isn't actually much that you can buy
• Eat lots of fruits and vegetables but remember the salt limit
• Learn to like kale, lima beans, brussel sprouts, etc.
• Look for fiber like whole wheat bread no white breads and use brown rice
• Eat fatty fish like salmon at least a few times a week
• Eat skinless chicken or turkey and lean pork, fresh pork not processed like ham
• Explore new foods like quinoa as a grain
• Eat plenty of vegetable protein like beans.
• Take 400 mg to 800 mg of vitamin E
• Drink 3 to 4 cups of paper filtered coffee daily
• Be aware that eating out is tough as very little of it is good for you

You get the idea. you might call this a type of Mediterranean diet but the excess olive oil is specifically a medicine. The rest is mostly nutrition. The fish oil is to get a significant source of omega 3 oil to balance the omega 6 you routinely get in food. The salt limitation is good for you and lowers your blood pressure.

So why should you think this might work for you? Without getting too technical your energy systems are built around triglycerides. Any oil can be used by the body to make them but if made with unsaturated oil they are better for the body. More importantly olive oil is mostly an omega 9 fatty acid. Good olive oil is a complex mixture of around 30 oils and phyto chemicals which support liver function and soothe activated stellate cells which cools inflammation. Good olive oil causes a burning feeling at the back of your throat. Those are the phyto chemicals and more is better if you ever go to an oil tasting bar.  The omega 3 reduces the amount of inflammation caused by omega 6 and is required for good health even if you don't have liver disease.

Click here for a more general discussion about diets.

If you are interested in the science of liver disease here is a link to our educational videos.

DISCLAIMER: Be aware that I am not a doctor.  I cannot give medical advice.  I am a cirrhosis patient and I have apparently halted the progression of my disease following this strategy. You must not assume that this advice will necessarily apply to your situation and you must work closely with your physicians as your situation is unique to you.

Please note that everyone has different a different culture and diet preferences.  We cannot provide a diet plan that suits everyone so we offer you the general guidelines but each person has to look at their personal food choices and modify them to be as kind as they can to their liver.  There is no one size fits all plan.

As Shakespeare said “The fault, dear Brutus, is not in our stars, but in ourselves.”

OK, you feel that you are healthy but want to stay that way.  This site just deals with the fat aspects of health so keep that in mind.  We'll assume you are here because you have some concern over your liver's health, you fail at diets, or you just want to take a healthy approach to food. All of those concerns turn on the fact that our modern industrial diet is unhealthy.  Things you probably already know.

• We routinely consume too many calories
• We eat far too much sugar
• High fructose corn syrup is unhealthy
• Trans-fats are bad for you
• Saturated fats are not healthy
• We eat far too much salt
• We consume a lot of additives that may be harmful
• Our diet has far too little fiber

There are other issues but if you managed these it would address most diet problems. When you think about the problem it is clear that there are two fundamental issues.  First, of course, are the personal choices we make and the psychological aspects of diets and food.  The second is the actual contents of the foods we eat and how they have changed over time.

Well, isn't that lovely. I get that same pitch every day. I've tried all kinds of diets and nothing works for me. What a waste of my time this site is.

Yes, we get that all the time don't we?  I personally get really tired of all the diet and lifestyle products being pitched.  So here is the real story.  For most of us we diet repeatedly.  We don't really change our lifestyle or the way we think about food.  If you want to be healthy you do have to be aware that there are consequences for your health if you pay no attention to the quality of your diet long term.  If you live a lifestyle you don't have to diet, your body will respond in a good way.

Here is an eating plan that will help you think about how to approach eating.

Does being fat matter?

Do you care about dying?

How about being ill for years?

• Obesity accounts for 18 percent of deaths among Americans between the ages of 40 and 85
• The incidence of fatty liver disease has increased 20 times since 1983.
• A 5-year-old growing up today is much more likely to be obese than a generation or two ago.
• Once someone is obese, it is very difficult to undo. We won't see the worst of the epidemic until the current generation of children grows old.
• One in five US deaths is associated with obesity. What are your odds?
• Fatty liver disease is epidemic affecting about 100 million Americans.
• The good news, it is possible to take it off and keep it off but you must be serious.

Want to learn about why what you eat can kill you? Learn a lot by clicking on this link.

Did you know that the risk of death when you get to stage 4 fibrosis is 25 times higher than it is at stage 1?

Is there a short explanation about how what I eat can cause me problems?

For a start, watch this short video.

 If this causes you to want to learn more, click on this link for a fuller explanation of liver disease and why you should care if illness and death are not goals for you.

- Does it matter?

- Should you care?

Fatty liver has a long history of being largely ignored except in alcoholics.  It has long been believed that fat in the liver was mostly benign and would not cause most patients a problem so it was perhaps noted in passing but not viewed with concern. As our modern society has fattened it has become clear that obesity is the handmaiden of disease and liver disease is a central player in a host of medical problems.  Are you or someone you love overweight? You need to pay attention. Consider the rate of change of the death rate for the major medical problems.  The scary one is liver. This is British data because they have a national data base, but in fact our situation is probably worse.

As a patient you need to be aware that most primary care physicians and many gastroenterologists fail to identify liver disease before it becomes a serious health problem. Many patients are shocked to learn that they have cirrhosis and their lives are at risk because they have never had a symptom or any warning from their physicians. Liver disease is often silent which makes the huge number of people at risk a very serious concern. Your best defense is to become educated and work to protect your own health.

• 100 million American have a fatty liver.
• 20 million of you will develop liver fibrosis disease as a result.
• 5 million of you will progress to cirrhosis and possible end stage liver failure.  
• Some of you will be lucky enough to be listed for transplant, which is the only cure, but 30% of those who do will die waiting.
• Death by liver failure is often long and a very difficult way for your life to end.  
• Our mission is to help you avoid that kind of death by helping you understand how you are killing yourself slowly and what you can do about it.  If you are already ill we will do our best to help you with that process.

Fatty liver is the accumulation of triglycerides and other fats in the liver cells. The amount of fatty acid in the liver depends on the balance between the processes of delivery and removal. In some patients, fatty liver will be accompanied by hepatic inflammation and liver cell death (steatohepatitis). Potential pathophysiologic mechanisms for fatty liver include the following:

• Decreased mitochondrial fatty acid beta-oxidation
• Increased endogenous fatty acid synthesis or enhanced delivery of fatty acids to the liver
• Deficient incorporation or export of triglycerides as very low-density lipoprotein (VLDL)

No single pathway of cause and effect has been found. However, societal changes in diet and adoption of a a sedentary lifestyle have combined to give us an epidemic of obesity and liver disease is one of the results of those changes.

Despite rising prevalence and clinical significance, NAFLD remains a disease that is not well understood, mainly due to its long and typically asymptomatic course.  It is generally not recognized that it often begins in adolescence or even childhood. In the absence of non-invasive biomarkers that correlate with disease stage, early screening and longitudinal follow-up of patients is not done. Moreover, NAFLD course is not linear with both deterioration and improvement between all categories and severity of disease and lack of the full knowledge of factors that are predictive of disease regression or progression confounds diagnosis.

HOWEVER, you are not helpless and it is clear that obesity is on the critical path for most cases of NAFLD, NASH and cirrhosis. You can have a positive influence on your disease by adopting a mostly plant based diet, the so called Mediterranean Diet, and getting some exercise.

This is a link to the science behind our approach to managing this liver disease.

http://www.fattyliverfoundation.org/science

This is a link to a discussion of diet.

http://www.fattyliverfoundation.org/diet_compare

If you want to learn more about the actual physiology this is a link to short videos which explain liver disease.

http://www.fattyliverfoundation.org/liver-disease

Click here for more information about the foundation or

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