Facts About Choline and Non-Alcoholic Fatty Liver Disease (NAFLD)
Why is the Liver Important?
The liver is the second largest organ, after skin. It performs more than 500 functions
including:
o Fighting infections/disease
o Detoxifying, including drugs and poisons
o Filtering and cleaning blood
o Controlling amounts of cholesterol
o Producing/maintaining hormone balance
o Producing enzymes/proteins responsible for blood clotting and repairing
tissue
o Producing bile to help break down food in gut
o Storing energy that can be used rapidly when needed
o Storing sugars, vitamins, minerals including iron
o Repairing damage and renewing itself.
Why is Choline Important for Liver Health?
Choline is an essential nutrient that supports normal liver function and helps
prevent fatty liver and NAFLD. Choline functions in the liver to maintain normal
membrane integrity and manage the normal metabolism of cholesterol, including
Low Density Lipoproteins (LDL) and Very Low Density Lipoproteins (VLDL).
What is NAFLD?
NAFLD is defined as a build-up of extra fat in liver cells that is not caused by alcohol.
Although the liver normally contains some fat, if more than 5 percent to 10 percent
of the organ’s weight is fat, then it is called a fatty liver (steatosis). NAFLD may
cause the liver to swell—steatohepatitis—and over time a swollen liver may cause
scarring (cirrhosis) and may lead to liver cancer or liver failure.
How Prevalent is NAFLD?
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As much as 25% of the population may have NAFLD (American Liver
Foundation).
Those more likely to develop a fatty liver, according to the Center for Disease
Control & Prevention, include individuals in the following categories:
o Overweight or obese; 154 million American adults are overweight and
78.4 million are obese (American Heart Association Statistics, 2014)
o Have diabetes; 20.1 million have diabetes; In 2012, the National Diabetes
Association reported there were 1.7 million new cases of diabetes
o Have a large waist circumference
o Have high cholesterol (99 million have cholesterol levels > 200 mg/dL,
according to the American Heart Association)
o Have high blood pressure (the American Heart Association reports that 78
million people have high blood pressure)
o Have been diagnosed with insulin resistance
o Have been diagnosed with Metabolic Syndrome
Men are more likely to get NAFLD than women; the incidence increases with age
Mexican-American men have the highest incidence of NAFLD
11 percent of adolescents and half of obese males have NAFLD.
Is the incidence of NAFLD increasing?
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The incidence of NAFLD more than doubled in the past 20 years. If current
trends continue for another 20 years, prevalence is expected to increase by 50
percent.
Liver disease was among the top 10 causes of deaths for U.S. Hispanics in 2012,
and #12 for the total population. Liver disease is the # 4 cause of death for ages
45 to 54.
Causes of Death in the U.S. (Centers for Disease Control, 2012)
1.
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5.
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7.
8.
9.
Heart disease
Cancer
Stroke
Chronic lung disease
Accidents
Alzheimer’s
Diabetes
Influenza/Pneumonia
Kidney disease
10. Blood poisoning
11. Suicide
12. Liver disease/cirrhosis
What are symptoms of NAFLD? How is it diagnosed?
While NAFLD often has no symptoms, its symptoms may include fatigue, weakness,
weight loss, loss of appetite, nausea, abdominal pain, spider-like blood vessels,
yellowing of the skin and eyes (jaundice), itching, fluid build-up and swelling of the
legs (edema) and abdomen (ascites), and mental confusion.
NAFLD is initially suspected if blood tests show high levels of liver enzymes.
However, other liver diseases are first ruled out through additional tests. Often, an
ultrasound is used to confirm the NAFLD diagnosis.
Facts About Choline Deficiency
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About 90 percent of the U.S. population is not consuming enough choline.
Reports from the 2007-2008 NHANES (National Health and Nutrition
Examination Survey) Evaluation showed that only 10 percent or fewer had
usual intakes at or above the Adequate Intake (AI) level; only young children
typically consumed the AI.
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Choline intakes also decrease with age. Adults over 71 years of age consumed
on average 264 mg/day, or about half of their requirement.
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Reports from dietary surveys (2007-2008 NHANES Evaluation) showed the
average choline intake for the population was 302 mg/day. The Adequate
Intake for choline is 550 mg/day for men and 425 mg/day for women. The
average for men over 20 years of age (396 mg) and women (260 mg) were
well below their recommended intake; pregnant women consumed on
average 337 mg/day (2005-2006 NHANES Evaluation), with intake ranging
from less than 300 mg to over 550 mg/day.
International Governments: Draw Attention to Growing Liver Crisis
In 2013, three first-time-ever major government-funded reports were released on
liver health in Canada, the UK and the European Union. All of these reports were
intended to draw attention to the growing crisis in liver health. Data support
exponential growth in a wide variety of liver issues in these countries, ranging from
NAFLD to cirrhosis.
Resources
American Liver Foundation www.liverfoundation.org
www.thecholineinformationcouncil.com