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Feb 7, 2017 · Sugar-Sweetened Beverage Consumption Increases NAFLD Risk in Transplant

Nonalcoholic fatty liver disease, also known as NAFLD, takes place when fat accumulates in the liver of people who drink little or no alcohol. At its most severe, NAFLD can progress to nonalcoholic steatohepatitis (NASH), causing cirrhosis and liver failure. NASH is the second most common reason for liver transplant.

When caught early on, NAFLD is reversible. Maintaining a healthy lifestyle and weight is the number one method for mitigating your risk of NAFLD. If you have been previously diagnosed with NAFLD, losing weight and becoming more active are currently the primary treatments for a fatty liver.2017-02-01 Soda Can

Making long-term healthy changes with diet and exercise are key to patients’ success. As you take inventory of your current lifestyle, don’t overlook beverage consumption.  A 2015 study conducted by Tufts University linked the intake of sugar-sweetened beverages to an increased risk of NAFLD.

Questionnaires were sent to 2,634 patients asking how frequently they consumed sugar-sweetened beverages. Participants also underwent a CT scan to screen for fatty liver disease, as well as a test used to assess liver inflammation.

Results showed those who consumed sugar-sweetened beverages daily had an overall 55 percent increased risk of NAFLD compared to those that did not consume sugared beverages. In addition, those who consumed sugared beverages had a significantly higher ALT level, indicating an inflamed liver. The most common beverage consumed was cola (40 percent). There was no relationship between consumption of diet soda and NAFLD.

When sugar enters the body, a complex process of chemical transformations takes place. The liver uses sugar to create fat, a process called lipogensis. When high volumes of sugar enter the body on a continuous basis, the sugar in the blood turns into triglycerides and the liver develops tiny fat droplets in its cells which lead to NAFLD.

What you can do

Considering sugar sweetened beverages offer no nutritional benefit and do contribute to total daily caloric intake, it’s important to be mindful of consumption and consider limiting intake to select occasions. Here are three ideas for refreshing alternatives:

  • Quench your thirst with water. Men should aim for 13 cups (three liters) per day and women should aim for nine cups (2.2 liters) daily. Infuse your water with fresh lemon or lime slices, or another favorite fruit. Get creative! If you have cirrhosis and have been advised to limit your fluid intake, continue to follow the direction of your medical team.
  • Swap sugary soda with sparkling water. Grocers have dozens of flavors to choose from these days.
  • Try unsweetened tea. Here’s a minty-lime ice tea recipe to get you started.

Have you kicked your soda habit? If so, what strategies helped you?


Nov 11, 2016 · Five Habits to Adopt if You Have NASH in Transplant

Up to 75 percent of men, women and children who are obese may be at risk for nonalcoholic fatty liver disease, also known as nonalcoholic steatohepatitis (NASH).  NASH takes place when fat accumulates in the liver of people who drink little or no alcohol. At its most severe, NASH can progress to cirrhosis and liver failure.

Losing weight and becoming more active can help reduce your risk. Research shows that modest reductions in weight (5-10% of total body weight) can help decrease the amount of fat deposited in the liver. Making healthy, long-term changes is key to success.  Make these healthy behaviors habit and you’ll be well on your way to a healthy lifestyle.

  1. Start moving. Get physical activity every day, aiming for 30-35 minutes. Don’t let the idea of exercise intimidate you – walking is a great way to get regular activity! Bring a family member or friend along to make the time pass quickly. 2016-11-11 get moving
  2. Cut back on eating out. Many restaurant meals are oversized and contain more fat, sodium, sugar and calories than similar foods prepared at home. If you eat out regularly, try cutting back slowly and recreate your favorite restaurant meals at home.
  3. Snack smarter. Calories from snacking can add up quickly. Swap out any high fat, salty and sugary snacks with fresh fruits and vegetables. Pair with a low-fat yogurt or handful of almonds.
  4. Stay hydrated. Keep yourself hydrated with water, sparkling or fruit-infused waters, unflavored milks, unsweetened teas (iced or hot) and plain coffee. Reduce your intake of sugar-sweetened beverages and alcohol. Both add empty calories to your diet and alcohol is known to be harmful to the liver when consumed in excess.
  5. Swap your sweets. Avoid desserts and sweets such as cake, ice cream, candy, cookies, pie and pastries. Consider fresh fruits, sugar free gelatin or sugar free popsicles or a small amount of dark chocolate (at least 50% cacao) as desserts instead. For a special, occasional treat, hold onto this recipe for apple-berry cobbler.


Nov 3, 2016 · NASH Patients: Add These Foods to Your Diet in Transplant

The second most common reason for liver transplant is a condition called nonalcoholic fatty liver disease, also known as nonalcoholic steatohepatitis (NASH).  NASH takes place when fat accumulates in the liver of people who drink little or no alcohol. At its most severe, NASH can progress to cirrhosis and liver failure.

2016-11-04-almond crusted chicken

If you have NASH, losing weight and becoming more active are currently the primary treatments for a fatty liver. If your condition has progressed to liver failure and you need a transplant, your physician may recommend weight loss prior to receiving a transplant so you’re healthy enough for surgery.

What you can do

With weight loss, making healthy, long-term changes is key to success. We recommend a modified Mediterranean diet because studies have shown it can help reduce the amount of fat stored in the liver for people with NASH. Even modest reductions in weight (5-10% of total body weight) can help decrease the amount of fat deposited in the liver. Set reasonable goals for yourself as you begin your weight loss journey; a weight loss of 1-2 pounds per week is ideal.

The Mediterranean diet focuses on delicious fruits, vegetables, whole grains, and heart-healthy protein each day. Set yourself up for success by adding these foods to your diet each day:

  • Vegetables: Eat at least three servings of vegetables daily. Try eating vegetables that are in season for extra flavor and nourishment. Sneak vegetables into foods you love, like with this recipe for garlic cauliflower potato mash.
  • Fruit: Eat at least two servings of fruit each day. Serve it on a skewer with a low fat yogurt-based dip for a delicious snack.
  • Protein: Choose a good source of protein, like fish, shellfish, legumes or beans, white meat, lean red meat or eggs, with every meal. Try this almond crusted chicken for a filling and flavorful entrée.
  • Grains: Choose whole grains such as 100% whole-grain or whole wheat bread, 100% whole grain cereals, brown or wild rice. Experiment with grains such as quinoa, barley, bulgar, farro and whole-grain pastas. Give these protein-packed quinoa cakes as an appetizer or side dish.
  • Dairy and Dairy Alternatives: Choose up to 3 servings of dairy or dairy alternatives daily. Choose low fat or fat free milk, yogurt and cheese. Pass on sugar-sweetened dairy products such as yogurt or flavored milks or sweetened milk alternatives. This strawberry banana milkshake uses soy milk and fresh fruit to satisfy your sweet tooth.
  • Healthy fats: Eat healthy fats daily, like walnuts, hazelnuts and almonds. Be sure to count your calories for added fats and nuts into your daily allotment. Use “extra-virgin” or virgin olive oil in place of other fats such as vegetable oil or butter in low temperature cooking.  Here’s a savory and superfood-packed recipe using walnuts to add healthy fat and a tasty crunch.

If you have NASH, how have you changed your diet? What are your go-to healthy recipes?


Sep 27, 2016 · Unpasteurized Foods and Raw Honey in Transplant


Significant progress has been made over time in reducing the side effects of immunosuppressive therapy; however one side effect that remains is transplant recipients are more likely to develop infections, like those brought on by foodborne illness. Learning about food safety will empower you to shop, handle, prepare and consume foods in a way that reduces your chance of developing a foodborne illness. Let’s dive in to the topic of unpasteurized foods and raw honey.

Pasteurization is a heating process used in some foods to kill harmful bacteria like salmonella, E. coli and listeria. Some commons foods that are typically pasteurized include milk, juices, cheese and eggs. Consuming raw or unpasteurized milk, juices, cheese and eggs can pose extreme danger to transplant patients. A recent report from the Centers for Disease Control and Prevention (CDC) found that older adults, pregnant women, newborns and persons with compromised immune systems accounted for at least 90 percent of the listeriosis cases between 2009 and 2011. CDC reported that 21 percent of the people with listeriosis died.

While dairy foods and juices have a clear definition from the Food and Drug Administration for what pasteurized versus raw means, this is not the case for other foods like raw nuts and raw honey. “Pasteurization” of honey actually has no technical meaning, and heating honey doesn’t provide any food safety advantage. Producers may heat honey to keep it from crystalizing but there is nothing safer about honey calling itself “pasteurized” honey versus “raw” honey.

Therefore, you will not find any research or government advice indicating the need for immune compromised patients to use “pasteurized” honey. Foodborne pathogens actually do not survive in honey, so there is no additional risk in consuming it raw. Yeast can survive and grow in honey, but this fermentation will turn honey into mead, and a consumer would know this easily with visual inspection. Remember that infants under one year of age should never consume honey.

What you can do

Lower your risk of developing a foodborne illness by following these shopping tips:

  • Always check the “Sell-By” date before putting any food in your grocery cart.
  • Don’t buy food displayed in unsafe or unclean conditions.
  • Buy only pasteurized milk, soft cheeses made with pasteurized milk, and pasteurized or juices that have been otherwise treated to control harmful bacteria.
  • When buying eggs, purchase refrigerated shell eggs. If your recipe calls for raw eggs, purchase pasteurized, refrigerated liquid eggs.
  • Buy honey from a trusted source, and as with all foods, avoid honey with particulate matter that shouldn’t be there.