Non-alcoholic fatty liver disease (NAFLD) is a chronic disease where fat accumulates in the liver, and can progress to inflammation (non-alcoholic steatohepatitis or NASH), and hardening of the liver (cirrhosis). It is a silent disease, often completely symptomless, however, trying to catch it early is important due to its progressive nature.

Nutrition Pearls for NAFLD & The Gut Microbiome:

  • NAFLD is the accumulation of fat in the liver which can progress to inflammation in the liver and progressive liver disease – and it occurs without significant alcohol intake.
  • Risk factors to developing NAFLD include: diabetes, high cholesterol, insulin resistance, and metabolic syndrome.
  • The cornerstone to NAFLD management is lifestyle modifications including diet changes and physical activity.
  • Studies have shown that implementing a plant-based diet and increasing physical activity have reduced NAFLD – independent of weight loss.
  • Low carbohydrate diets can actually worsen NAFLD.
  • Disruptions in the gut-liver axis may contribute to the development of NAFLD.
  • NAFLD also overlaps with a broad variety of gastrointestinal diseases.
  • Patients with GI diagnoses have been seen to develop NAFLD down the line – but the development of gut issues after a fatty liver diagnosis is less common.

Non-alcoholic fatty liver disease is the most common liver disorder worldwide. This week I interview RD Neha Shah on what NAFLD is, how it may be reversed and the overlap between gut issues and NAFLD.

Neha has been specializing in gastroenterology and hepatology for the past 16 years. She initially began her career as an inpatient dietitian at Stanford Health Care, counseling patients by bedside recovering from gastrointestinal surgery. She later came into the Digestive Health Center there to inaugurate and build Nutrition Services for all programs within the GI and Liver Clinics. She is now at UCSF, specializing in GI, IBD, and intestinal rehabilitation. Neha also owns a GI and liver nutrition private practice, Neha Shah Nutrition, with the intent to bring specialized GI and liver nutrition care to the community. 

In addition to patient care, Neha has authored over 20 articles in reputable journals related to GI nutrition. She is co-founder and is Director of Operations of the international South Asian IBD Alliance and is a member of the Crohn’s and Colitis Medical Advisory Committee of Northern California. Her goal is to continue to be involved with GI initiatives to advance nutrition care to improve outcomes. 

Neha Shah and I talk about:

  • How she got involved as a dietitian in gastroenterology
  • What NAFLD is
  • How NAFLD develops and how prevalent NAFLD is
  • What some of the risk factors are for developing NAFLD
  • What the standard treatment is for NAFLD 
  • What the gut-liver axis is and how it relates to NAFLD
  • If probiotics or prebiotics play a role in NAFLD management 
  • Why NAFLD often overlaps with other gut conditions – and how to manage both at the same time

Connect with Shah on her website at on Instagram @nehagastrord or on her Twitter here as well!

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