
"My doctor says I have a fatty liver and I should stay away from fat," writes this week's house call. "Are high-fat foods the culprit here? Any tips to help with a fatty liver?"
Indeed, your doctor is right to feel concern: Fatty liver is a dangerous yet misunderstood disease. In America, it affects 90 million of us and 17 percent of our children.
Think about foie gras, the French delicacy made from duck or goose liver. It is made by force-feeding the animals a combination of sugar with corn and starch (a really sad, horrible practice), intentionally creating a fatty liver.
So if you're gorging on sugar and starch, you're essentially doing the same thing with your own liver. Fatty liver literally means your liver fills with fat, paving the path for chronic disease and inflammation.
You might be surprised to learn the primary culprit here. Research shows that carbs (and not fat) produce more fat in your belly and liver.
Sugar switches on fat production in your liver, creating an internal process called lipogenesis, which is your body's normal response to sugar.
Fructose, the most detrimental sugar that heads directly to your liver, actually ramps up lipogenesis. That explains why sugar, especially fructose, becomes the chief cause of liver disease and the leading cause of liver transplants.
What's so bad about having a fatty liver? Well, among its numerous repercussions include inflammation, which triggers insulin resistance and pre-diabetes, meaning your body deposits fat in your liver and organs including your belly (called visceral fat).
It gets worse. Excess sugar and starch creates more serious problems including high triglycerides, low HDL (“good" cholesterol) and high amounts of small LDL (dangerous cholesterol particles that cause heart attacks). Fatty liver also increases your heart attack risk.
Sadly, most people have no idea they have a fatty liver. Today we're even seeing 12-year-old boys with fatty livers because they guzzled soda for years and now need liver transplants. Fructose, the primary sweetener in sodas, is a key player in the ever-increasing rates of nonalcoholic fatty liver disease (NAFLD).
We're feeding children fructose and other highly toxic substances, setting the dismal stage for liver transplants, high blood pressure, diabetes, heart disease and abnormal cholesterol. Doctors then prescribe numerous medications to alleviate these and other issues. Overall, it becomes a bleak picture.
I mentioned earlier sugar, not fat, creates fatty liver. Here's where it gets interesting: Dietary fat actually turns offthe fat production factory in your liver.
You see, unlike carbohydrates and protein, dietary fat does not trigger your pancreas to secrete insulin or stress out your liver. Your body prefers to burn rather than store dietary fat, unless you combine it with carbs. When you eat the right fats, you increase your metabolism, stimulate fat burning and decrease hunger.
One of my favorite fats is medium-chain triglycerides or MCTs, either in coconut oil or as a stand-alone oil.
To prevent or reverse fatty liver, you'll want to cut processed carbs and increase healthy fat intake, especially saturated—yes, saturated—fats from healthy foods like coconut and grass-fed beef.
I realize all of this might sound confusing. After all, our government tells us to limit saturated fats to 7 to 10 percent of our calories even with the updated dietary guidelines (which science doesn't support, by the way). We've demonized saturated fat for so long that we've missed the purple elephant in the room: sugar.
Thankfully, newer guidelines tell us to limit sugar intake, however, they don't go far enough. These guidelines should be fine-tuned to include whole grains, which also break down into sugar in your body. According to current guidelines, you're still supposed to get one-quarter of your calories from sugar to be healthy. Crazy, right?
I discuss how fat can benefit your liver and many other dietary fat issues in Eat Fat, Get Thin, but the take-home message here is that healthy saturated fats lower inflammation when you eat them as part of a low-carb, high-fiber, omega 3 fatty acid-rich diet.
So how do you know if you have a fatty liver? If you eat lots of sugar and flour, have a little bit of belly fat or if you crave carbs, you probably have a fatty liver. To heal that fatty liver and avoid its vast detrimental repercussions, you want to get to the root of those problems.
Blood tests and an ultrasound can both detect fatty liver. If your blood test comes back abnormal, you must take it seriously. Even if your test comes back normal, don't think you're off the hook. A liver function test doesn't always detect a fatty liver. An ultrasound is more sensitive.
Fortunately, you can employ some simple but powerfully effective strategies to reverse or prevent fatty liver. I've found these diet, exercise and supplement strategies greatly benefit my patients.
1. Eliminate all high-fructose corn syrup (HFCS). Even when it comes in so-called healthy foods like salad dressings, don't eat it. To put things into perspective, one serving of commercially made tomato sauce can have more fructose than a serving of Oreo sandwich cookies!
2. Get rid of white, processed flour and eliminate or greatly reduce starch. Even whole grain flours can be a problem. They increase your blood sugar levels, stressing your liver and resulting in high triglycerides, which promotes a fatty liver.
3. Add healthy fats. Functional Medicine becomes so simple: To heal the body, you remove the bad stuff and add in the good stuff. Incorporate anti-inflammatory, liver-healing foods like low-sugar fruit, vegetables, nuts, seeds, lean animal protein like chicken and fish and good, healthy fats like olive oil, macadamia nut oil, avocados, coconut oil, grass-fed butter and fish oil. A great way to combat sugar damage is to eat plenty of these healthy fats. You can get a powerful 21-day plan to easily incorporate healthy fats in Eat Fat, Get Thin.
4. Improve your metabolism through exercise. Routine, daily exercise improves insulin resistance and reduces fatty liver. Start out with something simple like walking 30 minutes. More seasoned exercisers might incorporate high-intensity interval training (or burst training) and weight lifting.
5. Supplement intelligently. The right supplements can help bring your body back into balance while it heals. Herbs like milk thistle are great for supporting the liver. I also use nutrients like lipoic acid and N-acetyl-cysteine, which make powerful antioxidants to heal and rejuvenate your liver while increasing the powerful antioxidant glutathione. Other liver-healing nutrients include B vitamins and magnesium. You can find these and other quality supplements in my store.
6. Eat detoxifying, liver-repairing super foods. Regularly eat foods from the cruciferous family—like broccoli, cauliflower and Brussels sprouts, as well as leafy veggies like kale, collards, cabbage, arugula and watercress. At least a cup or two every day can help repair and heal the liver. Garlic and onions are amazing sulfur-rich foods that help detox the body. You'll find amazing recipes and more ways to incorporate these amazing foods in The Blood Sugar Solution 10-Day Detox Diet.
7. Power up with protein. Protein at every meal, especially breakfast, becomes key to balancing blood sugar and insulin, cutting cravings and providing your liver the raw materials it needs to detoxify optimally. Start the day with farm fresh eggs or a protein shake. I recommend my Whole Food Protein Shake. Include nuts, seeds, eggs, fish, chicken or grass-fed meat for protein at every meal. A serving size is four to six ounces or about the size of your palm.
You need a healthy liver to combat toxic junk and chemicals in your environment. A healthy liver means your body stays healthy, you don't get sick and you maintain plenty of energy.
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Cities Can Help Migrating Birds on Their Way By Planting More Trees and Turning Lights Off at Night
By Frank La Sorte and Kyle Horton
Millions of birds travel between their breeding and wintering grounds during spring and autumn migration, creating one of the greatest spectacles of the natural world. These journeys often span incredible distances. For example, the Blackpoll warbler, which weighs less than half an ounce, may travel up to 1,500 miles between its nesting grounds in Canada and its wintering grounds in the Caribbean and South America.
Blackpoll warbler abundance in breeding, non-breeding and migration seasons. Cornell Lab of Ornithology / CC BY-ND
<p>For many species, these journeys take place at night, when skies typically are calmer and predators are less active. Scientists do not have a good understanding yet of how birds navigate effectively at night over long distances.</p><p><span></span>We study bird migration and how it is being affected by factors ranging from <a href="https://scholar.google.com/citations?user=S04C3UMAAAAJ&hl=en" target="_blank">climate change</a> to <a href="https://scholar.google.com/citations?user=pPk38-8AAAAJ&hl=en" target="_blank">artificial light at night</a>. In a recent study, we used millions of bird observations by citizen scientists to document the <a href="https://doi.org/10.1016/j.envpol.2020.116085" target="_blank">occurrence of migratory bird species in 333 U.S. cities</a> during the winter, spring, summer and autumn.</p>Blackpoll warbler. PJTurgeon / Wikipedia
<p>We used this information to determine how the number of migratory bird species varies based on each city's level of <a href="https://www.britannica.com/science/light-pollution" target="_blank" rel="noopener noreferrer">light pollution</a> – brightening of the night sky caused by artificial light sources, such as buildings and streetlights. We also explored how species numbers vary based on the quantity of tree canopy cover and impervious surface, such as concrete and asphalt, within each city. Our findings show that cities can help migrating birds by planting more trees and reducing light pollution, especially during spring and autumn migration.</p>Declining Bird Populations
<p>Urban areas contain numerous dangers for migratory birds. The biggest threat is the risk of <a href="https://doi.org/10.1650/CONDOR-13-090.1" target="_blank">colliding with buildings or communication towers</a>. Many migratory bird populations have <a href="http://dx.doi.org/10.1126/science.aaw1313" target="_blank">declined over the past 50 years</a>, and it is possible that light pollution from cities is contributing to these losses.</p><p>Scientists widely agree that light pollution can <a href="https://doi.org/10.1073/pnas.1708574114" target="_blank">severely disorient migratory birds</a> and make it hard for them to navigate. Studies have shown that birds will cluster around brightly lit structures, much like insects flying around a porch light at night. Cities are the <a href="https://doi.org/10.1002/fee.2029" target="_blank" rel="noopener noreferrer">primary source of light pollution for migratory birds</a>, and these species tend to be more abundant within cities <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/gcb.13792" target="_blank" rel="noopener noreferrer">during migration</a>, especially in <a href="https://doi.org/10.1016/j.landurbplan.2020.103892" target="_blank" rel="noopener noreferrer">city parks</a>.</p>Composite image of the continental U.S. at night from satellite photos. NASA Earth Observatory images by Joshua Stevens, using Suomi NPP VIIRS data from Miguel Román, NASA's Goddard Space Flight Center
The Power of Citizen Science
<p>It's not easy to observe and document bird migration, especially for species that migrate at night. The main challenge is that many of these species are very small, which limits scientists' ability to use electronic tracking devices.</p><p>With the growth of the internet and other information technologies, new data resources are becoming available that are making it possible to overcome some of these challenges. <a href="https://doi.org/10.1038/d41586-018-07106-5" target="_blank">Citizen science initiatives</a> in which volunteers use online portals to enter their observations of the natural world have become an important resource for researchers.</p><p>One such initiative, <a href="https://ebird.org/home" target="_blank" rel="noopener noreferrer">eBird</a>, allows bird-watchers around the globe to share their observations from any location and time. This has produced one of the <a href="https://doi.org/10.1111/ecog.04632" target="_blank" rel="noopener noreferrer">largest ecological citizen-science databases in the world</a>. To date, eBird contains over 922 million bird observations compiled by over 617,000 participants.</p>Light Pollution Both Attracts and Repels Migratory Birds
<p>Migratory bird species have evolved to use certain migration routes and types of habitat, such as forests, grasslands or marshes. While humans may enjoy seeing migratory birds appear in urban areas, it's generally not good for bird populations. In addition to the many hazards that exist in urban areas, cities typically lack the food resources and cover that birds need during migration or when raising their young. As scientists, we're concerned when we see evidence that migratory birds are being drawn away from their traditional migration routes and natural habitats.</p><p>Through our analysis of eBird data, we found that cities contained the greatest numbers of migratory bird species during spring and autumn migration. Higher levels of light pollution were associated with more species during migration – evidence that light pollution attracts migratory birds to cities across the U.S. This is cause for concern, as it shows that the influence of light pollution on migratory behavior is strong enough to increase the number of species that would normally be found in urban areas.</p><p>In contrast, we found that higher levels of light pollution were associated with fewer migratory bird species during the summer and winter. This is likely due to the scarcity of suitable habitat in cities, such as large forest patches, in combination with the adverse affects of light pollution on bird behavior and health. In addition, during these seasons, migratory birds are active only during the day and their populations are largely stationary, creating few opportunities for light pollution to attract them to urban areas.</p>Trees and Pavement
<p>We found that tree canopy cover was associated with more migratory bird species during spring migration and the summer. Trees provide important habitat for migratory birds during migration and the breeding season, so the presence of trees can have a strong effect on the number of migratory bird species that occur in cities.</p><p>Finally, we found that higher levels of impervious surface were associated with more migratory bird species during the winter. This result is somewhat surprising. It could be a product of the <a href="https://www.epa.gov/heatislands" target="_blank">urban heat island effect</a> – the fact that structures and paved surfaces in cities absorb and reemit more of the sun's heat than natural surfaces. Replacing vegetation with buildings, roads and parking lots can therefore make cities significantly warmer than surrounding lands. This effect could reduce cold stress on birds and increase food resources, such as insect populations, during the winter.</p><p>Our research adds to our understanding of how conditions in cities can both help and hurt migratory bird populations. We hope that our findings will inform urban planning initiatives and strategies to reduce the harmful effects of cities on migratory birds through such measures as <a href="https://www.arborday.org/programs/treecityusa/index.cfm" target="_blank" rel="noopener noreferrer">planting more trees</a> and initiating <a href="https://aeroecolab.com/uslights" target="_blank" rel="noopener noreferrer">lights-out programs</a>. Efforts to make it easier for migratory birds to complete their incredible journeys will help maintain their populations into the future.</p><p><em><span style="background-color: initial;"><a href="https://theconversation.com/profiles/frank-la-sorte-1191494" target="_blank">Frank La Sorte</a> is a r</span>esearch associate at the </em><em>Cornell Lab of Ornithology, Cornell University. <a href="https://theconversation.com/profiles/kyle-horton-1191498" target="_blank">Kyle Horton</a> is an assistant professor of Fish, Wildlife, and Conservation Biology at the Colorado State University.</em></p><p><em></em><em>Disclosure statement: Frank La Sorte receives funding from The Wolf Creek Charitable Foundation and the National Science Foundation (DBI-1939187). K</em><em>yle Horton does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</em></p><p><em>Reposted with permission from <a href="https://theconversation.com/cities-can-help-migrating-birds-on-their-way-by-planting-more-trees-and-turning-lights-off-at-night-152573" target="_blank">The Conversation</a>. </em></p>EcoWatch Daily Newsletter
By Lynne Peeples
Editor's note: This story is part of a nine-month investigation of drinking water contamination across the U.S. The series is supported by funding from the Park Foundation and Water Foundation. Read the launch story, "Thirsting for Solutions," here.
In late September 2020, officials in Wrangell, Alaska, warned residents who were elderly, pregnant or had health problems to avoid drinking the city's tap water — unless they could filter it on their own.
Unintended Consequences
<p>Chemists first discovered disinfection by-products in treated drinking water in the 1970s. The trihalomethanes they found, they determined, had resulted from the reaction of chlorine with natural organic matter. Since then, scientists have identified more than 700 additional disinfection by-products. "And those only represent a portion. We still don't know half of them," says Richardson, whose lab has identified hundreds of disinfection by-products. </p>What’s Regulated and What’s Not?
<p>The U.S. Environmental Protection Agency (EPA) currently regulates 11 disinfection by-products — including a handful of trihalomethanes (THM) and haloacetic acids (HAA). While these represent only a small fraction of all disinfection by-products, EPA aims to use their presence to indicate the presence of other disinfection by-products. "The general idea is if you control THMs and HAAs, you implicitly or by default control everything else as well," says Korshin.</p><p>EPA also requires drinking water facilities to use techniques to reduce the concentration of organic materials before applying disinfectants, and regulates the quantity of disinfectants that systems use. These rules ultimately can help control levels of disinfection by-products in drinking water.</p>Click the image for an interactive version of this chart on the Environmental Working Group website.
<p>Still, some scientists and advocates argue that current regulations do not go far enough to protect the public. Many question whether the government is regulating the right disinfection by-products, and if water systems are doing enough to reduce disinfection by-products. EPA is now seeking public input as it considers potential revisions to regulations, including the possibility of regulating additional by-products. The agency held a <a href="https://www.epa.gov/dwsixyearreview/potential-revisions-microbial-and-disinfection-byproducts-rules" target="_blank">two-day public meeting</a> in October 2020 and plans to hold additional public meetings throughout 2021.</p><p>When EPA set regulations on disinfection by-products between the 1970s and early 2000s, the agency, as well as the scientific community, was primarily focused on by-products of reactions between organics and chlorine — historically the most common drinking water disinfectant. But the science has become increasingly clear that these chlorinated chemicals represent a fraction of the by-product problem.</p><p>For example, bromide or iodide can get caught up in the reaction, too. This is common where seawater penetrates a drinking water source. By itself, bromide is innocuous, says Korshin. "But it is extremely [reactive] with organics," he says. "As bromide levels increase with normal treatment, then concentrations of brominated disinfection by-products will increase quite rapidly."</p><p><a href="https://pubmed.ncbi.nlm.nih.gov/15487777/" target="_blank">Emerging</a> <a href="https://pubs.acs.org/doi/10.1021/acs.est.7b05440" target="_blank" rel="noopener noreferrer">data</a> indicate that brominated and iodinated by-products are potentially more harmful than the regulated by-products.</p><p>Almost half of the U.S. population lives within 50 miles of either the Atlantic or Pacific coasts, where saltwater intrusion can be a problem for drinking water supplies. "In the U.S., the rule of thumb is the closer to the sea, the more bromide you have," says Korshin, noting there are also places where bromide naturally leaches out from the soil. Still, some coastal areas tend to be spared. For example, the city of Seattle's water comes from the mountains, never making contact with seawater and tending to pick up minimal organic matter.</p><p>Hazardous disinfection by-products can also be an issue with desalination for drinking water. "As <a href="https://ensia.com/features/can-saltwater-quench-our-growing-thirst/" target="_blank" rel="noopener noreferrer">desalination</a> practices become more economical, then the issue of controlling bromide becomes quite important," adds Korshin.</p>Other Hot Spots
<p>Coastal areas represent just one type of hot spot for disinfection by-products. Agricultural regions tend to send organic matter — such as fertilizer and animal waste — into waterways. Areas with warmer climates generally have higher levels of natural organic matter. And nearly any urban area can be prone to stormwater runoff or combined sewer overflows, which can contain rainwater as well as untreated human waste, industrial wastewater, hazardous materials and organic debris. These events are especially common along the East Coast, notes Sydney Evans, a science analyst with the nonprofit Environmental Working Group (EWG, a collaborator on <a href="https://ensia.com/ensia-collections/troubled-waters/" target="_blank">this reporting project</a>).</p><p>The only drinking water sources that might be altogether free of disinfection by-products, suggests Richardson, are private wells that are not treated with disinfectants. She used to drink water from her own well. "It was always cold, coming from great depth through clay and granite," she says. "It was fabulous."</p><p>Today, Richardson gets her water from a city system that uses chloramine.</p>Toxic Treadmill
<p>Most community water systems in the U.S. use chlorine for disinfection in their treatment plant. Because disinfectants are needed to prevent bacteria growth as the water travels to the homes at the ends of the distribution lines, sometimes a second round of disinfection is also added in the pipes.</p><p>Here, systems usually opt for either chlorine or chloramine. "Chloramination is more long-lasting and does not form as many disinfection by-products through the system," says Steve Via, director of federal relations at the American Water Works Association. "Some studies show that chloramination may be more protective against organisms that inhabit biofilms such as Legionella."</p>Alternative Approaches
<p>When he moved to the U.S. from Germany, Prasse says he immediately noticed the bad taste of the water. "You can taste the chlorine here. That's not the case in Germany," he says.</p><p>In his home country, water systems use chlorine — if at all — at lower concentrations and at the very end of treatment. In the Netherlands, <a href="https://dwes.copernicus.org/articles/2/1/2009/dwes-2-1-2009.pdf" target="_blank">chlorine isn't used at all</a> as the risks are considered to outweigh the benefits, says Prasse. He notes the challenge in making a convincing connection between exposure to low concentrations of disinfection by-products and health effects, such as cancer, that can occur decades later. In contrast, exposure to a pathogen can make someone sick very quickly.</p><p>But many countries in Europe have not waited for proof and have taken a precautionary approach to reduce potential risk. The emphasis there is on alternative approaches for primary disinfection such as ozone or <a href="https://www.pbs.org/wgbh/nova/article/eco-friendly-way-disinfect-water-using-light/" target="_blank" rel="noopener noreferrer">ultraviolet light</a>. Reverse osmosis is among the "high-end" options, used to remove organic and inorganics from the water. While expensive, says Prasse, the method of forcing water through a semipermeable membrane is growing in popularity for systems that want to reuse wastewater for drinking water purposes.</p><p>Remucal notes that some treatment technologies may be good at removing a particular type of contaminant while being ineffective at removing another. "We need to think about the whole soup when we think about treatment," she says. What's more, Remucal explains, the mixture of contaminants may impact the body differently than any one chemical on its own. </p><p>Richardson's preferred treatment method is filtering the water with granulated activated carbon, followed by a low dose of chlorine.</p><p>Granulated activated carbon is essentially the same stuff that's in a household filter. (EWG recommends that consumers use a <a href="https://www.ewg.org/tapwater/reviewed-disinfection-byproducts.php#:~:text=EWG%20recommends%20using%20a%20home,as%20trihalomethanes%20and%20haloacetic%20acids." target="_blank" rel="noopener noreferrer">countertop carbon filter</a> to reduce levels of disinfection by-products.) While such a filter "would remove disinfection by-products after they're formed, in the plant they remove precursors before they form by-products," explains Richardson. She coauthored a <a href="https://pubs.acs.org/doi/10.1021/acs.est.9b00023" target="_blank" rel="noopener noreferrer">2019 paper</a> that concluded the treatment method is effective in reducing a wide range of regulated and unregulated disinfection by-products.</p><br>Greater Cincinnati Water Works installed a granulated activated carbon system in 1992, and is still one of relatively few full-scale plants that uses the technology. Courtesy of Greater Cincinnati Water Works.
<p>Despite the technology and its benefits being known for decades, relatively few full-scale plants use granulated active carbon. They often cite its high cost, Richardson says. "They say that, but the city of Cincinnati [Ohio] has not gone bankrupt using it," she says. "So, I'm not buying that argument anymore."</p><p>Greater Cincinnati Water Works installed a granulated activated carbon system in 1992. On a video call in December, Jeff Swertfeger, the superintendent of Greater Cincinnati Water Works, poured grains of what looks like black sand out of a glass tube and into his hand. It was actually crushed coal that has been baked in a furnace. Under a microscope, each grain looks like a sponge, said Swertfeger. When water passes over the carbon grains, he explained, open tunnels and pores provide extensive surface area to absorb contaminants.</p><p>While the granulated activated carbon initially was installed to address chemical spills and other industrial contamination concerns in the Ohio River, Cincinnati's main drinking water source, Swertfeger notes that the substance has turned out to "remove a lot of other stuff, too," including <a href="https://ensia.com/features/drinking-water-contamination-pfas-health/" target="_blank" rel="noopener noreferrer">PFAS</a> and disinfection by-product precursors.</p><p>"We use about one-third the amount of chlorine as we did before. It smells and tastes a lot better," he says. "The use of granulated activated carbon has resulted in lower disinfection by-products across the board."</p><p>Richardson is optimistic about being able to reduce risks from disinfection by-products in the future. "If we're smart, we can still kill those pathogens and lower our chemical disinfection by-product exposure at the same time," she says.</p><p><em>Reposted with permission from </em><em><a href="https://ensia.com/features/drinking-water-disinfection-byproducts-pathogens/" target="_blank">Ensia</a>. </em><a href="https://www.ecowatch.com/r/entryeditor/2649953730#/" target="_self"></a></p>Trending
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