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Diet Plan for Non-alcoholic Fatty Liver Disease

Leslie Beck wrote . . . . . . .

You may not have heard of fatty liver disease, or non-alcoholic fatty liver disease to be specific. But chances are, you know someone who has it.

As a dietitian in private practice, it’s becoming increasingly common for me to tailor diets for clients who’ve been diagnosed with a build-up of fat in their liver.

If your doctor has told you that you have a fatty liver, take action to reverse it. If left untreated, the condition can be more harmful than you think.

What is fatty liver disease?

Non-alcoholic fatty liver disease (NAFLD) is a progressive disease that develops in people who drink little or no alcohol.

It begins with its mildest form, simple fatty liver, an accumulation of fat in liver cells that, by itself, usually doesn’t lead to liver damage.

However, a liver infiltrated with fat is more susceptible to further injury.

NAFLD can progress over time to a more severe form called non-alcoholic steatohepatitis (NASH), which is fatty liver accompanied by inflammation and death of liver cells. (Steato means fat and hepatitis means liver inflammation.)

About 15 per cent of people with NAFLD will go on to develop irreversible advanced liver scarring called cirrhosis, which makes it difficult for the liver to carry out its essential tasks.

NAFLD also increases the risk of developing heart disease, stroke and Type 2 diabetes.

Prevalence is growing fast

NAFLD is the most common chronic liver disease in Canada and in other western countries. It’s estimated that one in five Canadians has NAFLD, a number that’s escalating in conjunction with the increasing incidence of obesity and Type 2 diabetes. Many people don’t even know they have a fatty liver.

Fatty liver disease isn’t only an adult health problem, it’s showing up in children, too.

According to the Canadian Liver Foundation, one in 10 Canadian children may have NAFLD. And the organization estimates that as many as 53 per cent of obese children have the condition.

What causes fatty liver?

The most common cause of NAFLD is obesity. It’s estimated that 75 per cent of obese individuals are at risk of developing simple fatty liver and nearly one-quarter (23 per cent) are at risk for fatty liver with inflammation.

Having diabetes, high blood cholesterol and high triglycerides (blood fats) also increases the likelihood of developing fatty liver disease. Some people, though, don’t have a clear predisposing cause.

The underlying mechanism for fat build-up in the liver is believed to be insulin resistance, often a consequence of obesity and excess belly fat. Insulin resistance means the body’s cells are unable to use insulin properly. As a result, the body needs higher levels of insulin to clear sugar (glucose) from the bloodstream.

Do certain foods cause NAFLD?

A diet that’s too high in fat contributes to excess fat stored in the liver. So does one that’s high in refined carbohydrates and sugars. Liver cells convert excess glucose – the sugar that’s absorbed into the bloodstream after digestion – into fat.

Fructose, in particular, is tied to fatty liver. Studies suggest that fructose consumption not only increases fat production in the liver, it also creates a metabolic environment that favours the development of NAFLD and NASH.

A study published last month in the Journal of Hepatology found that, among 271 children and teenagers with fatty liver disease, fructose consumption was significantly higher in children who had NASH compared with simple fatty liver.

Fructose is a simple sugar found naturally in fruits, some vegetables, honey, agave syrup and sucrose (table sugar). As high-fructose corn syrup (“glucose-fructose” on ingredient lists), it’s also present in many soft drinks, sweetened fruit drinks, breakfast cereals, baked goods and condiments.

How do you know if you have a fatty liver?

Fatty liver rarely causes symptoms. When it does, symptoms are vague and may include right-sided abdominal pain, fatigue and/or a general feeling of unwellness.

NAFLD is usually detected when routine blood tests show elevated liver enzyme levels. It can also be discovered by an ultrasound examination of the abdomen.

How can you get rid of a fatty liver?

Lifestyle modification is the cornerstone to treating – and preventing – non-alcoholic fatty liver disease. Gradual weight loss, dietary modification and exercise are required to effectively remove fat deposits in the liver.


A diet plan for fatty liver disease:

Lose excess weight

Weight loss is the most effective treatment for NAFLD. A 5-per-cent weight loss can reduce liver fat deposits and a 10-per-cent loss is required to improve fatty liver with inflammation (NASH).

Lose weight gradually at a rate of one to two pounds a week. Rapid weight loss (four pounds a week or more) can worsen fatty liver.

Restrict refined grains

Limit your intake of high glycemic foods such as white breads and crackers, refined breakfast cereals and white rice. These foods spike glucose and insulin levels and may contribute to a fatty liver.

Choose fibre-rich whole grains such as brown rice, quinoa, whole wheat pasta, 100-per-cent whole grain breads and cereals and oatmeal, foods that raise blood glucose gradually, not quickly.

As a source of prebiotics (fibrous carbohydrates), whole grains also help feed beneficial gut bacteria. Some evidence suggests that an altered gut microbiome plays a role in fatty liver disease.

Don’t overdo carbohydrates, though. A lower carbohydrate diet is beneficial for fatty liver disease.

Reduce sugars

Keep your intake of added sugars to no more than 5 per cent of daily calories, about 24 grams (6 teaspoons worth) for women and 36 grams (9 teaspoons worth) for men.

Avoid sugar-sweetened beverages, whether they’re made with high-fructose corn syrup (fructose-glucose) or not.

Limit use of all caloric sweeteners including honey and agave syrup that are high in fructose. Read labels and, as much as possible, avoid foods sweetened with glucose-fructose.

Choose healthy fats

A diet that’s lower in total fat and saturated (animal) fat will help improve fatty liver. Diets high in saturated fat have also been shown to induce insulin resistance.

Emphasize monounsaturated fat, the type found in olive oil, peanut oil, canola oil, avocado, almonds, cashews and pecans. Monounsaturated fat has been shown to increase fat breakdown and it may have anti-inflammatory benefits.

Eat fatty fish (e.g., salmon, trout, sardines) twice a week to get anti-inflammatory omega-3 fatty acids. If you have high blood triglycerides, speak to your dietitian or doctor about fish oil supplementation.

Boost antioxidant foods

Free radical damage, or oxidative stress, plays a key role in liver cell damage. Eat foods rich in dietary antioxidants such as citrus fruit, berries, mango, leafy green vegetables, carrots, sweet potato and nuts and seeds.

Avoid alcohol

If you have NAFLD or NASH, avoid drinking alcohol as it puts extra stress on your liver.

Increase exercise

Include at least 30 minutes of aerobic exercise five times a week and resistance training twice weekly. Doing so can improve fatty liver, lower blood sugar and reduce the risk of heart disease regardless of weight loss.

Source: The Globe and Mail

Chocolate and Cinnamon Rolls

Ingredients

2 cups warm milk
1/4 cup sugar
4-1/2 teaspoons (2 envelopes) active dry yeast
1-3/4 sticks unsalted butter, melted, plus extra for greasing
2 teaspoons vanilla paste or extract
1 egg, plus 1 egg, beaten
8 cups all-purpose flour, plus extra for dusting

Filling

3 ounces semisweet chocolate, grated
1 stick unsalted butter, melted and cooled
1 cup firmly packed dark brown sugar
3 tablespoons ground cinnamon

Glaze

2/3 cup confectioners’ sugar
1 teaspoon vanilla extract
1 tablespoon water

Method

  1. Start by making the dough. Put the milk, sugar, yeast, melted butter, vanilla, and whole egg into the bowl of a freestanding mixer fitted with a dough hook, then mix together until smooth. Sift the flour, then gradually add to the bowl, mixing until the dough comes away from the side of the bowl. Place the dough in a large, lightly floured bowl and cover with plastic wrap or a damp dish towel. Let rise for 45 minutes-1 hour at room temperature, or until the dough has almost doubled in volume.
  2. To make the filling, beat the grated chocolate, cooled melted butter, sugar, and cinnamon in a bowl to a smooth, spreadable paste and put to one side.
  3. When the dough has risen, punch it down to release the air, then turn out onto a lightly floured surface. Roll out the dough to a 1/2-inch thick rectangle, about 11 x 27 inches. Using a spatula, spread the filling all over the dough. Starting at a long edge, roll the dough into a long log shape without stretching it. Using a sharp knife, cut into slices about 2-1/2 inches wide. Place them on two greased and floured baking sheets. Cover with plastic wrap or a damp dish towel and let rise for 30 minutes.
  4. Preheat the oven to 400°F. Meanwhile, add the water to the beaten egg to make an egg wash. Use a pastry brush and lightly brush the tops of the rolls with the egg wash.
  5. Bake the rolls in the oven for 10 minutes, then reduce the heat to 350°F and cook for another 15-20 minutes, or until golden brown, cooked in the center, and the rolls sound hollow when tapped on the bottoms.
  6. Meanwhile, to make the glaze, mix together the confectioners’ sugar, vanilla, and water in a bowl. As soon as the rolls are cooked, brush them generously with the glaze and let cool. These are fantastic served with coffee or hot chocolate.

Makes 11 rolls.

Source: Chocolat

The Real Reason We Like Chocolate So Much

Ever wondered why you simply can’t get enough of chocolate? The pure taste is one thing, but surely there has to be something more than just a serious lack of self control that keeps you reaching for your favourite bar? According to a new television series, that reason might be… breast milk.

BBC Two’s new series, ‘The Secrets Of Your Food’, which launches tonight, sees Dr Michael Mosley visiting the some of the country’s leading food science laboratories to find the secrets behind some of our favourites foods.

In one of the episode, Dr Mosley discovers that our obsession with chocolate is due to a combination of chemicals, flavours and texture which reminds us of breast milk.

Dr Mosley says that a combination of fermented raw cocoa beans and pulp and other aroma molecules create a chemical signature that our brains react positively to when eating chocolate.

Writing for the BBC, he said: “Chocolate contains a number of interesting psychoactive chemicals. These include anandamide, a neurotransmitter whose name comes from the Sanskrit – ‘ananda’, meaning ‘joy, bliss, delight’. Anandamides stimulate the brain in much the same way that cannabis does.

“For a while, some food scientists got very excited about the discovery but to be honest, although chocolate contains these substances, we now know they are only there in trace amounts.

“Your brain is not going to get much of a chemical rush from eating a few squares. None the less, they may play a part in seducing our senses.”

Dr Mosley says there are other factors that contribute to our universal love of chocolate, including its creamy viscosity: “When you take it out of its wrapper and put a bit in your mouth without biting, you will notice that it rapidly melts on your tongue, leaving a lingering sensation of smoothness.

“Special touch receptors on our tongues detect this textural change, which then stimulates feelings of pleasure.”

But, Dr Mosley says one of the more intriguing reasons for our addiction to chocolate could be its resemblance to breast milk.

Chocolate has unnaturally high levels of both fat and sugar (around 11 and 22 per cent respectively) which are rarely found in nature together, though milk is a rare exception: “Human breast milk is particularly rich in natural sugars, mainly lactose.

“Roughly 4 per cent of human breast milk is fat, while about 8 per cent is made up of sugars. Formula milk, which is fed to babies, contains a similar ratio of fats to sugars.

“This ratio, 1 g of fat to 2 g of sugars, is the same ratio of fats to sugars that you find in milk chocolate. And in biscuits, doughnuts, ice cream. In fact this particular ratio is reflected in many of the foods that we find hard to resist.

“So why do I love chocolate? For a whole host of reasons. But it may also be that I, and chocoholics like me, are trying to recapture the taste and sense of closeness we got from the first food we ever sampled; human breast milk.”

Source: The Telegraph

Soy Safe, Even Protective, for Breast Cancer Survivors

Kathleen Doheny wrote . . . . . .

The pros and cons of soy for breast cancer patients have been debated for years.

Now, research involving more than 6,200 breast cancer survivors finds that those who ate the most soy had a lower risk of death from all causes during the nearly 10-year follow-up period.

“We didn’t find any harmful effects of women diagnosed with breast cancer consuming soy in terms of mortality,” said study leader Dr. Fang Fang Zhang. She’s an assistant professor of epidemiology at Tufts University’s Friedman School of Nutrition Science and Policy in Boston.

“Overall, consuming higher levels of soy is associated with a 21 percent reduction in the risk of death compared to women who consumed soy at a lower level,” she said.

Concerns around soy’s “risk/benefit” profile have arisen because the food has estrogen-like compounds called isoflavones. That’s important, experts says, because in so-called hormone-receptor positive breast cancers — the most common tumor type — higher estrogen levels may spur cancer cells’ growth.

But the new study should settle the soy controversy once and for all, said Dr. Omer Kucuk, a professor of medical oncology and director of the Integrative Medicine Center at Emory University’s Winship Cancer Institute, in Atlanta.

He wrote an editorial accompanying the study, which was published online March 6 in the journal Cancer.

Kucuk said the study’s large population is one point in its favor. The new findings also echo the results of a prior study that found higher soy intake lowered the odds of breast cancer’s return.

“When you have decreased recurrence, you have decreased mortality,” Kucuk noted.

“I think now we can say women with breast cancer should not worry about going out to eat edamame, miso soup, tofu and other soy products, and [to] drink soy milk,” Kucuk said.

All of the participants in the new study were enrolled in the Breast Cancer Family Registry, which began in 1995. At the study’s start, the women averaged 52 years of age.

During the study, just over 1,200 of the participants died. Zhang’s team tracked data on all the women’s diets, some obtained even before they had received their diagnosis of breast cancer.

The researchers found an association between higher soy intake and better survival after breast cancer diagnosis. However, the study wasn’t designed to prove cause-and-effect.

Still, Zhang’s team noted that the benefit was strongest for women who did not have hormone-receptor positive cancers — the type that’s sensitive to estrogen. These women had a 50 percent reduced risk of dying from any cause during the follow-up.

Women who had never taken hormone therapy for menopause also appeared to gain a substantial benefit from high soy intake — they had a 32 percent reduced risk of death during the follow-up period.

How much soy was needed to see an effect? According to the researchers, women in the “low-soy” group ate less than 0.3 milligrams (mg) of soy isoflavones daily, while those in the highest took in 1.5 mg or more. Most women ate more than 1.5 mg/day, with the average intake being 1.8 mg of soy isoflavones daily.

But even that amount is not a lot of soy, Zhang said. An intake of 1.8 mg, she noted, is equal to about one-half to one full serving of soy foods, such as soy beans or tofu, per week.

The experts could only speculate as to why soy might be protective against breast cancer death.

“The plant-based estrogen, once it attaches to the surface of the cell, makes estrogen less likely to be able to attach to the same cell,” Zhang pointed out. In essence, the soy isoflavone bumps estrogen out of its preferred spot on the cancer cell, keeping its effects at bay.

Another idea, Zhang said, is that the soy components may inhibit the growth of nutrient-rich blood vessels that help feed a tumor.

Most women — especially those in the United States, where soy consumption is lower — don’t need to worry about taking in too much soy, Kucuk noted. In Asian countries, intakes of 20 to 25 mg a day are not unusual, he said.

“If you drink a glass of soy milk, that is about 27 mg of soy,” he said.

Source: HealthDay


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Isoflavones in food associated with reduced mortality for women with some breast cancers . . . . .


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