Being overweight or obese is one of the main risk factors for fatty liver disease. So don’t people with a BMI less than 25 have to worry about non-alcoholic fatty liver disease? Answer with Angélique Houlbert, dietician-nutritionist.
- Obesity and being overweight are risk factors for fatty liver disease. However, relying solely on BMI is not enough to assess this risk.
- Waist measurement is a better indicator.
- The dietitian calls for caution if the waist circumference is greater than 94 cm for men and 80 cm for women.
Obesity – that is to say a body mass index (BMI) greater than 30 – as well as being overweight – BMI greater than 25 – considerably increases the risk of suffering from non-alcoholic fatty liver disease. It is estimated that nearly 80% of obese people have a fatty liver.
However, having a BMI of 24 or less does not protect against pathology, warns Angélique Houlbert, dietician-nutritionist and author of the book “The NASH diet against fatty liver disease” (Thierry Souccar Éditions).
Fatty liver disease: thin people can also have fatty liver
Indeed, fatty liver disease does not only affect people with extra pounds. According to estimates, 5 to 10% of individuals with normal weight (BMI between 18.5 and 25) suffer from non-alcoholic fatty liver disease (or NAFLD for Non Alcoholic Fatty Liver Disease). What do these thin patients have in common? If they have a “normal build”, they have a significant amount of visceral fat, stored adipose tissue around the internal organs of the abdomen. This phenomenon is particularly observed among young women.
“In a Spanish study, almost 30% of people considered thin based on their BMI had the same percentage of body fat as obese people”notes Angélique Houlbert in her work.
NAFLD: waist circumference is a better indicator
“BMI is not an indicator of good liver health. Waist circumference is more revealing, especially if it increases. This may be a sign that the liver is starting to be overwhelmed by fat”, specifies the expert during an interview with Quelle Docteur. So for the specialist, having a waist circumference beyond 94 cm for a man and 80 cm for a woman should be a warning sign.
“For example in women, fat located at the level of the thighs or saddlebags may appear unsightly, but they are not really problematic for health. On the other hand, when it comes to intra-abdominal fat, either around size, it becomes “adds Angélique Houlbert.
Indeed, when abdominal fat accumulates – sometimes without us realizing it – adipose tissue becomes dysfunctional. Infiltrated by white blood cells, it produces substances called adipokines which promote insulin resistance. The tissues then respond less and less to this hormone. This is the start of a real vicious circle which leads to fatty liver, if it is not interrupted by lifestyle changes (diet or physical activity).
“As the muscle cells no longer accept glucose, we are no longer able to correctly synthesize glycogen (a form close to glucose which serves as a reserve fuel, Editor’s note); after a meal rich in carbohydrates, this glucose, abandoned by the cells muscles, is therefore directed to the liver, where it is transformed into fats.
