The hidden factor increasing heart disease in lean people

When most of us think about being overweight, we picture the stereotypical body that carries extra fat around the middle, belly and thighs.

I’ve been guilty myself of seeing a man or woman with very noticeable belly fat and thought to myself — because of my family history of heart problems — now, there goes a heart attack waiting to happen.

I’m not fat-shaming or body-shaming. My concerns stem from knowing that certain kinds of fat — and where it’s carried — can do real damage. But there’s another type of fat we never see that can lead to serious health dangers…

It’s the fat that accumulates in the liver — and surprisingly, the leanest among us may be most at risk…

Known as non-alcoholic fatty liver disease, or NAFLD, this condition represents the most common liver disorder, affecting approximately one in four people worldwide. And the majority of people with this excess liver fat die from cardiovascular disease.

But what most people, even those familiar with the disease, don’t know, however, is that you don’t have to be overweight or obese to end up with NAFLD and the risks to your heart may be even higher…

Fatty liver in a lean body

While obesity is a risk factor for NAFLD, even lean people can experience a health-destroying buildup of fat in their livers. And according to a study by a team of researchers at the University of Michigan, these people are at particular risk of the heart complications NAFLD can bring.

When digging through the health records of more than 10,000 adults diagnosed with NAFLD at from 2012 to 2021, they saw that compared to overweight or obese patients, those with lean bodies benefitted from a lower risk of cirrhosis, diabetes, hypertension and cholesterol issues — but that’s where the rosy picture ended.

“In further analysis, we found that lean patients with NAFLD also had a significantly higher prevalence of cardiovascular disease, independent of age, sex, race, smoking status, diabetes, hypertension, and dyslipidemia,” said Karn Wijarnpreecha, MD, MPH, lead researcher of the study.

“Our team had expected to see that those with a normal BMI would have a lower prevalence of any metabolic or cardiovascular conditions, so we were very surprised to find this link to cardiovascular disease. Too often, we overlook NAFLD patients with a normal BMI because we assume their risk for more serious conditions is lower than those who are overweight. But this way of thinking may be putting these patients at risk.”

Guard your liver and protect your heart

So, when it comes to your liver, staying thin may not be enough to keep you safe.

This means that it’s vital to not only know the early signs of the disease, so that you can ask your doctor for help, but to also take daily steps to support your liver health.

Early signs of the condition include:

• Constant tiredness and fatigue
• Feeling hungry all the time or craving sugar
• Pain in the upper right abdomen
• High blood pressure
• Increased cholesterol

How can you prevent a fatty liver?

#1 – Follow a Mediterranean-styled diet

That means eating plenty of fruits, vegetables, whole grains and healthy fats — like olive oil. Previous research has shown that hydroxytyrosol, a polyphenol found in extra-virgin olive oil, reduced the signs of fatty liver disease, as well as the negative effects seen in other organs, including the heart and brain.

#2 – Stay active

Researchers at the University of Tsukuba found that when it comes to NAFLD, getting regular exercise provides significant benefits to the liver unrelated to weight loss, helping to prevent liver steatosis and fibrosis.

#3 – Eat more protein

Researchers conducted a two-year study to determine the long-term impact of dietary protein on a fatty liver. After two years of maintaining weight loss, an increase in dietary protein in study groups was associated with reduced liver fat content in the volunteers. Even better, more than half of the participants who were previously diagnosed with NAFLD no longer had a fatty liver.

#4 – Support your liver

Certain nutrients have been studied over the years for their liver-supporting benefits:

• N-Acetyl Cysteine (NAC) 
• Milk Thistle 
• Turmeric 
• Alpha Lipoic Acid (ALA) 

Sources:

More cardiovascular disease found in lean people with non-alcoholic fatty liver disease than in those who are overweight with the same condition – EurekAlert!

Non-alcoholic fatty liver disease – NIH

Early Signs of Non-Alcoholic Fatty Liver Disease (NAFLD) – Liver Health UK