Friday 19 May 2017

Protocol for non-alcoholic fatty liver disease (NAFLD)

More than 25% of the Dutch population suffers from NAFLD. The disorder is characterised by the accumulation of abdominal fat, dyslipidaemia, insulin-resistance, impairments in the production of transaminases and low-grade inflammations. Fortunately, a universal, nutritional treatment protocol is in place.


The occurrence of NAFLD is a universal process. This is also known as the ‘2-hit theory’. The first ‘hit’ consists of the consumption of excessive amounts of carbohydrates, saturated fatty acids and trans fatty acids. All of these factors increase the activity of CYP2E1. Overactivity of CYP2E1 generates large numbers of free radicals and induces lipogenesis. The liver then becomes fatty. The second ‘hit’ can consist of (a combination of) the following:


Deficiency of SAMe

SAMe is responsible for the production of glutathione peroxidase (GPX) a universal intracellular antioxidant. Initially, SAMe deficiency will result in a GPX deficiency and secondly a loss of methylation capacity. Intracellular detoxification of xenobiotics can only take place if toxins are methylated.


Mitochondrial diseases

Detoxification is an expensive process and therefore consumes large quantities of ATP. ATP production impairments (for example, through a lack of magnesium) can result in the development of even more free radicals and therefore damage to the functional liver cells.


Insulin resistance

Insulin resistance is very common in NAFLD. Fatty liver disease can be diagnosed at an early stage of insulin resistance. 


Excess linoleic acid in the diet  

Linoleic acid is present in many foods, including grains, plant-based oils, margarines and animals fed on grains and who have had little exercise. Linoleic acid is the fatty acid with the highest pro-inflammatory effect. An excess of linoleic acid results in linoleic acid being less likely to be converted into arachidonic acid and hyperactivation of CYP2C9 occurs, as a result of which large amounts of free radicals and leukotoxins are produced.



The diagnosis of NAFLD is made based on a list of symptoms:

-   Exhaustion

-   Nausea, vomiting

-   Abdominal pain in the right upper quadrant

-   Loss of appetite

-   Low-grade fever

-   Dark urine

-   Muscle pain

-   Itchiness


Universal protocol

A universal protocol is in place for treating people who suffer from NAFLD:


Weight loss of 10% within a 3-month period results in an 80% decrease of the fatty liver. Weight loss must be achieved by reducing carbohydrates in the diet and physical exercise.


Use of hepatoprotective compounds which are present in garlic, artichokes, tomatoes, rhubarb, fish, liquorice, mushrooms, ginger, cumin, onions, leeks and certain fibrous foods.


Use of garlic oil, ginger oil and sources of silymarin, to regenerate the liver structure.


Use of salvestrols with regeneration capacity and a potent effect on the restoration of insulin sensitivity of both the liver, fat cells and the hypothalamus.



The amount of fibres within the diet has been found to be of crucial importance for the detoxification capacity of the liver, the intestines and the kidneys. Fibres are long-chain carbohydrates that are difficult to digest. Bacteria grow on fibres, such as bifidobacteria which have a detoxification function. An important fibrous food is inulin. Inulin is a lignan that occurs in fruit, vegetables, nuts and seeds. Inulin can increase up to 5 times in volume and has the following effects: increase in thermogenesis, increase in digestion time, resulting in satiety, reduction in the production of insulin.


NAFLD and pancreatitis

NAFLD forms the basis for the development of pancreatic disorders, including diabetes and pancreatitis. Other factors for the development of pancreatitis are excessive use of alcohol, gall stones, hypoxia, insulin-resistance and a high-calorific diet. Pancreatitis is a commonly occurring (unidentified) disorder which can result in death through the occurrence of multiple organ failure. Treatment is very similar to that for NAFLD, with the additional element that the use of medication is absolutely contra-indicated.


Summary and conclusion

The detoxification process at both hepatic and extra-hepatic level is multi-phased, expensive (ATP) and essential in order to maintain the health. Especially inadequate lifestyles undermine the liver’s, in principle, endless detoxification capacity. Fruit and vegetables are the main sources for liver detoxification substances. Sugar and other refined carbohydrates, linoleic acid, alcohol, tobacco, a lack of exercise and stress overburden the detoxification capacity of all human tissues and this can lead to the development of disorders such as arteriosclerosis and NAFLD.


The diet forms the basis of treatment of people who suffer from toxic overload. There are no magic bullets; it is all about the combined effect of various active substances on both phase I and phase II enzymes. Detoxification can only take place if there is optimal function of the excretory organs the intestines, the kidneys, the lungs and the skin. It is therefore always a total therapy.

The knowledge in this article originates from our Nutritional Therapy in accordance with clinical PNI course. This course enables you to create a basis of essential knowledge in relation to diet, exercise and supplementation in relation to chronic disorders within today’s Western society.

More information about Nutritional Therapy in accordance with clinical PNI  for Dutch speaking. 


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