Tag Archives: obesity
Nonalcoholic Fatty Liver Disease: What You Need to Know? Dr. Rashid Khan Explains

Nonalcoholic Fatty Liver Disease: What You Need to Know? Dr. Rashid Khan Explains

Dr. Rashid Khan, Hepatologist at Liver Specialists of Texas, guest edited this blog entry on Fatty Liver Disease.

Obesity and Fatty Liver Disease

Obesity and Fatty Liver

In my 9 years of medical practice, it still does not cease to amaze me, that the public as well as the general physician’s perspective on fatty liver disease could be so wrong.

Every day of the week I see at least 10 patients with fatty liver, who have been told by their family physician that fatty liver is “no big deal”, and it is nothing to worry about. I tell them it is “ absolutely something to worry about”. Let me explain why.

Nonalcoholic fatty liver disease is a condition where there is fat accumulation in the liver of people who drink little or no alcohol.This condition is very common and generally causes no signs or symptoms, and generally no complications. Most people feel “OK” with this condition.

A wide range of diseases and conditions can increase your risk of nonalcoholic fatty liver disease, including: gastric bypass surgery, high cholesterol, high levels of triglycerides in the blood, metabolic syndrome, polycystic ovary syndrome, sleep apnea, diabetes, hypothyroidism, and of course, obesity.

In some people with fatty liver, the fat that accumulates can cause inflammation and scarring in the liver. This form of nonalcoholic fatty liver disease is called nonalcoholic steatohepatitis, commonly called NASH. In its most severe form, fatty liver can progress to liver cirrhosis (scarring), liver failure, and even liver cancer. About 20% of patients with fatty liver disease related steatohepatitis can progress to liver cirrhosis, so the risk is not trivial. In these such cases, liver transplant is discussed, and may be the only option to survive.

Evaluation of fatty liver begins with simple blood tests to assess liver function. These blood tests are the ALT, AST, bilirubin, and possibly alkaline phosphatase.

Unfortunately, many times these liver tests are elevated, and ignored by both physician and patient. These elevated (and abnormal) liver tests may be the first indication that trouble is brewing in the liver. This is almost always followed by some sort of liver imaging test, such as an ultrasound, CT scan or MRI of the liver and abdomen. If I suspect a more advanced stage of fatty liver disease, I will recommend we perform a liver biopsy, a procedure that involves removing a small sample of tissue from the liver, and examining it under a microscope to look for signs of inflammation and scarring.

Unfortunately, despite extensive research in this field, no single standard and targeted therapy exists for fatty liver disease in 2015. In other words , no medication is currently the perfectly effective treatment for fatty liver disease. Almost always my patient will ask me , “Hey Doc, what pill can I take to fix this problem? And I reply there is none.

So we typically work to reduce the risk factors that have caused the fatty liver disease which are well known as I have eluded to above. If the patient is obese, we ask them to lose weight. Weight loss can be tough in the modern day lifestyle, but a committed approach involving caloric reduction and increasing physical activity usually works. Patients with diabetes and or high cholesterol are placed on medications to better control these disorders of their metabolism.

No alternative medicine treatments are proven to cure nonalcoholic fatty liver disease. The use of herbs, and many other widely available over the counter supplements not only don’t work, but can be dangerous. Some studies have shown that natural substances such as Vitamin E and coffee may help to reduce the damage caused by inflammation. However, more research is needed, and patients should discuss the use of these substances with their liver specialist.

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Latest News on Hepatitis C Cures

For tonight’s broadcast of Your Health First, Dr. Rashid Khan joins me to discuss the latest news on fatty liver disease, and the new therapies for hepatitis C, which results in a cure rate of over 95% of the cases. You can listed to the audio from the three segments here.


Dr. Rashid Khan and Dr. Joe Galati Discuss Liver Disease: Part 1 by Your Health First Radio on Mixcloud

Dr. Rashid Khan and Dr. Galati Discuss Fatty Liver Disease: Your Health First Part II by Your Health First Radio on Mixcloud

Hepatitis C: Dr. Rashid Khan and Dr. Joe Galati Discuss-Your Health First Interview Part III by Your Health First Radio on Mixcloud

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Fight Obesity: Dr. Joe Galati’s Great American Produce Giveaway

I have been educating patients for a long time. It’s the best part of my job. Educate, educate, educate. Despite all of my efforts, there are frustrating days where I feel we are losing the war on obesity. The general population is lax on what they eat, and settle for junk. Everyone is too busy to cook a fresh meal at home. Children grow up eating highly processed foods, get fat, and develop diabetes, fatty liver disease, heart disease, and lots more. Why? People can’t pick out a cucumber from a zucchini, let along how to cook the darn thing.

The Great American Produce Giveaway is my answer to all this. Some may laugh (and I hope it puts a smile on your face), and some may just not get it. Yes, it is a naive way to stimulate conversation, but it’s a start. Share it with your friends and family, and buy a vegetable for your neighbor.

Dr. Joe Galati
Houston, Texas

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Childhood Obesity: A Close Up Look

Which that said, my estimate is that 35% of these young women are overweight or obese. This is consistent with the national trend.

One of the players had a very obvious “spare tire” that was visually obvious with every swing. The gravity if this adipose tissue flung forward with the twist of her swing. With each peak, I thought to myself, “this poor kid will be diabetic by age 30 if nothing is done.”

Surrounded by fast-food advertisements, junk snacks, and sugar charged drinks, this teenage generation is doomed. It has been stated repeatedly this this generation-our children-will not live as long as their parents.

So what to do? An action plan? Start with the following:
A. Look at your kids weight: take action if your child is overweight
B. Thin out you food closets of processes foods.
C. Learn to cook and feed your family real good
D. Teach your kids

This weekend I am attending a girls high school golf tournament. The girls participating are generally 15 to 17 years old. With the players dressed in skirts, shorts, and golf shirts, you can get a sense of their underlying physique.

the merits of regular, vigorous exercise.

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New York Times: Fatty Liver Threat Tied to Obesity

New York Times: Fatty Liver Threat Tied to Obesity

6a00e54eea9caa8834011168d37593970c-500wiThe New York Times posted a great article by Anahad O’Connor, titled Threat Grows From Liver Illness Tied to Obesity. Click the link to read the full article. As a liver specialist, I see the effects of obesity daily, and the liver disease that results.

These are my thoughts on this:

Obesity is public enemy #1. Yes, cancer, heart disease, mental health concerns, and diabetes we are all familiar with. For the past decade, obesity has been tied to most of these conditions. I have patients that would rather continue the path of consuming processed foods, rather than make the decision to modify their diet. I have found that most adults, and especially those under 30 years old, have a limited range of cooking abilities-thus prepared foods are far more attractive to them, avoiding the need to cook a meal from scratch. The alternative to this non-change in behavior is a potentially slow and progressive slide towards more advanced liver disease, cirrhosis, liver cancer, and the need for transplant. What a choice: eat better and exercise, or get liver cancer? A 10% drop in body weight has been shown to slow the progression fat causes in the liver. Transplant is not the answer. Besides the massive healthcare cost, without a change in behavior, fatty liver will return in the transplanted liver within a year, and by 3 years, it may be as high as 50%. As a nation, we simply do not have the money to pay for all of this. The cancerous spread of fast food chains into every corner of your neighborhood needs to stop. In 10-15 years, we will have a generation of disabled citizens, riddled with diabetes, heart disease, and on dialysis. We will become a second-rate nation.

Look at this video we produced recently, which outlines some of the simple steps needed for better nutrition and health.

Added Bonus: Listen to my comments on Olive Garden

Your thoughts on this? I want to hear back from you.

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Childhood Obesity: New Research Released in New England Journal of Medicine

A new article in the NEJM sheds light on the origins of obesity. It seems obesity starts earlier than expected, and obese 5 year olds are at risk for life-long obesity.

Listen to Dr. Galati’s podcast here.


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New Research Study: Fatty Liver Disease (NASH)

We have started screening for a new research study for those patients with fatty liver disease, also known as NAFLD and NASH. The study is a randomized, double-blind, controlled, multi-center phase 2 study evaluating the role of two medications called Roflumilast and pioglitazone.

Study candidates will receive one or both medicines, and will be evaluated to determine the degree of fat in the liver, as well as improvements in their liver enzymes (ALT and AST).

Participants will need to first meet all eligibility criteria of the study. Once enrolled in the study, all treatment related medicines, testing, and care will be paid for by the sponsor of the study. The study will last approximately 5 months.

If interest, contact our office at 713-794-0700 and ask for Paula.

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Salad for Breakfast: Really? Another Twist to Try

Salad for Breakfast: Really? Another Twist to Try

Over the years, I have written about the benefits of eating salad for breakfast. Usually, this is received with an assortment of facial expressions, and the obligatory polite statement that they would “give it a try”. To date, numerous colleagues and patients have admitted that they’ve made salad for breakfast. Others frown. Despite this, I continued to eat it myself, as well as preach the benefits of eating a fresh salad for breakfast.

Mark Bittman, an author and columnist for the New York Times, is quite serious about preparing salad for breakfast. In his new book, VB6, he outlines the benefits of eating salad for breakfast, and supplying a number of wonderful recipes to readers.

This morning, I prepared an off the top of my head salad for breakfast. This included a bed of fresh romaine lettuce. Side note: I am rethinking bagged salad, which is proliferating at grocery stores around the country. I’m a bit concerned about foodborne illnesses that are becoming routine stories on the nightly news related to a wide assortment of prepackaged salads.

More on this morning’s salad.

After cleaning the romaine lettuce, I used half a can of white navy beans, rinsed them thoroughly, and mashed them with a fork in a bowl. I added copious amounts of extra-virgin olive oil, along with salt and garlic powder to taste. With a little more time, I would’ve used a clove of freshly crushed garlic. Placing this in the center of the romaine bed, I added to it the following items:

Half of a banana sliced
One whole fresh tomato sliced
One green pepper chopped into small pieces (normally I would’ve tried for a red pepper but the green one is all I had handy)
One fresh orange divided and sliced

I drizzled a small amount of a prepared raspberry vinaigrette salad dressing low in sodium, sugar, and overall calories.

I won’t bother with analyzing the nutritional content with regard to fruit and vegetable servings, dietary fiber, phytonutrient content, calories, and fat. It’s clear from any observer that this is a nutrient rich breakfast, that is inherently high in nutritional value and simply good for you. There’s no chemicals, artificial flavors, or ingredients that are not natural.

This breakfast took me less than 10 minutes to prepare. The contents should be readily available in a house that takes nutrition serious. I feel good about myself this morning, and I’m confident that I am off to a good start.

Seriously think about having salad for breakfast at least once a week. I believe you’ll find it’s not as bad as it sounds.

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Lentils: A Super Food to Love

Lentils: A Super Food to Love

LentilsDay 20.

Hard to believe we are almost finished with the 31 Days of Wellness. Don’t fear, there are 334 days in the year left afterwards.

There is a very nice entry from the New York Times Recipe for Health section, that features an assortment of healthful recipes you should all bookmark and check in with from time to time. Today I chose the entry on Lentils.

If you have lentils, you have dinner. This high-fiber, protein-rich legume cooks in 20 to 40 minutes, depending on the dish, and requires no soaking. Lentils are the basis for many starters and salads, soups and stews, side dishes and Middle Eastern pastas. The distinctive flavor has been adapted to a variety of classic cuisines, from France to the Mediterranean, from India to Mexico and North America.

The usual supermarket offerings are brown lentils, but there are other varieties and they’re all worth looking out for. Chefs prefer the pricier small black “beluga” lentils (in their raw state they glisten like caviar, but the resemblance stops there) and the firm green Le Puy lentils from France, because when cooked both types stay intact and maintain a firmer texture. But the flavors of all three are similar enough to make them interchangeable in this week’s recipes.

Red lentils, available in Indian and Mediterranean markets, have a different taste, more akin to dried favas or split peas, and a very different texture when cooked, so do not attempt to substitute these for the brown, black or green varieties.

One fact worth noting: unlike other beans, lentils do not contain sulfur, the gas-producing element in legumes. And in addition to being an excellent source of soluble fiber and a good source of protein, manganese, iron, phosphorous, copper, vitamin B1 and potassium, lentils are an excellent source of molybdenum, a mineral important in the metabolism of fats, carbohydrates and iron. — Martha Rose Shulman

Like so many foods, the key message all of us are stressing is the need to experiment, and leave your comfort zone of what you are used to. Discuss it over with your family, and each week select one new vegetable to try. If you don’t like it, try another.

Send me your feedback, and share your experience. Keep trying.

Dr. Joe Galati

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Is there a Special Diet for Hepatitis C?

In this video, Dr. Galati explains the commonly asked question about “special diets for hepatitis C”, or for that matter, any form of liver disease.


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