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Overweight teenagers are at of risk developing liver disease in later life. What can we do about it?
The latest evidence suggests that being overweight or obese in your late teens predicts a higher chance of liver disease in later life. The pioneering study spans 27 years and includes 1.2 million men. What can we learn from this? And, given that 1 billion people worldwide are projected to be obese by the year 2030, how can we reduce such health risks for people throughout their lives?
What is this study?
From 1969 to 1996, men who took part in Sweden’s compulsory national service were assessed throughout their lives on their body mass index (BMI), as well as their health problems. BMI is the measurement for a person’s weight relative to their size and the ‘normal’ range for men is 22.5-24.9.
Their BMI data was collected when the men enrolled in the national service programme, when they were aged between 17 and 19. This was correlated with the causes of death for those who passed away during the time period, which is how researchers made the link between overweight or obesity in late adolescence and the likelihood of developing liver disease in later life. Detailed data was available for around 34 million person years, giving researchers unprecedented understanding of the big picture1.
What do we know?
In line with other research, this study suggests that overweight and obesity are indicators of health risks such as liver disease. Underweight, overweight and obese men were much more likely to develop liver disease in later life. Even men in the ‘normal’ BMI range (22.5-24.9) were found to be more likely to develop liver disease in later life, than the lowest risk group (18.5-22.5)2.
Is it conclusive?
There are factors that the study did not take into account, such as:
- The rate of alcohol consumption throughout the men’s lives
- The fluctuation of men’s BMI throughout their lives
- Changes in diet and exercise throughout the men’s lives
However, this does not mean the findings are inaccurate - only that there are a variety of causes for liver disease that could not be factored into this particular study.
Does it mean fat is worse for your liver than alcohol?
Alcohol causes 70% of the 12,000 annual deaths from liver disease in the UK. In moderation, alcohol will not cause harm to the liver. Going beyond the recommended safe limits for alcohol (see below) on a regular basis, will increase the risk of developing liver disease.
What are the symptoms of liver disease?
Unfortunately, cirrhosis - when the liver is repeatedly damaged and builds up scar tissue - can accumulate for 20-40 years before symptoms appear, by which time the chances of successful treatment are lower. Once this cirrhosis has set in, symptoms include:
- Fluid retention: swelling in the legs or abdomen
- Confusion: caused by waste products not being properly removed from the blood
- Risk of internal bleeding from the oesophagus
Luckily, we are now able to use blood tests, liver function tests and ultrasounds to assess liver damage, making early diagnosis - and therefore successful treatment - more likely3.
Preventing liver disease
Since liver disease isn’t always detected early, prevention is definitely better than cure. There are a number of ways to ensure a lower risk of developing liver damage in your later life:
- Drink less alcohol: you don’t need to give up your glass of red with dinner, but drinking less than 14 units per week (equivalent to 6 x 175ml glasses of wine)4 will keep your liver happy
- Eat healthy food: a well-balanced diet, with lots of fruit and veg, and low sugar and processed foods, is a key part of maintaining a healthy weight, as well as preventing type 2 diabetes, both of which increase the risk of developing liver disease
- Exercise: neither healthy eating nor exercise will guarantee a healthy BMI on their own. But sticking to both on a regular basis will bring all kinds of health benefits, including dramatically lowering your risk of liver disease.
Treating liver disease
Treatment for hepatitis C - the third main causes of liver disease, after alcohol and obesity - has improved to an almost 100% success rate, since research began in 1989.
There has also been an improvement in the treatment and support services available for weight loss and reducing alcohol intake, meaning that liver damage caused by obesity or excessive alcohol consumption can also be treated3
Weight loss treatment options
Weight loss surgery is a viable option for some people and, with commitment to diet and exercise, can lead to a healthier, happier lifestyle in the long term.
We have a wealth of information on weight loss treatments, including patient stories and support groups. For further information on liver disease, please read our consultant Q&A here.
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