Tag Archives: obesity
31 Days of Wellness: Sipping Ourselves to Death

31 Days of Wellness: Sipping Ourselves to Death

We are surrounded by an ocean of sugary drinks, coming in every possible flavor, color, bottle, can, container, and size known to man. They are all missing one component-nutritional value.

We are sipping ourselves to death. We are told by advertisers that these fluids will make us better athletes, more hip as a person, or simply enjoy life better. What they don’t say is the needless calories they make you pack on with each gulp.

While none of these beverages on their own are lethal, it is the sum of all we consume that causes damage. An occasional soda will not kill you. Having several every day, as you wash down your favorite junk food, will. An occasional “anything” is not what hurts us. Daily dosing of man-made junk does.

For this year, among all of the other rules I’d like you to think about, is to work on eliminating all of these sugary, no-nutrition drinks. Drink water, coffee, and tea. Give it a try.

Have a great day.

Dr. Joe Galati

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Top Five Symptoms of Hepatic Encephalopathy

Top Five Symptoms of Hepatic Encephalopathy

Hepatic Encephalopathy

Hepatic Encephalopathy

Hepatic encephalopathy, seen in advanced liver disease and cirrhosis, results in a number of neuro-psychiatric symptoms, that cover a wide spectrum of manifestations. Being aware of the clinical presentations are important for both the patient and their caretaker, as well as healthcare professionals involved in their care. These include:

 

 

  1. Personality changes.
  2. Changes in sleep-wake cycles, associated with excessive daytime somnolence and nighttime insomnia.
  3. Disorientation to person, place and time.
  4. Development of inappropriate behavior, associated with confusion.
  5. Coma.

Individuals with hepatic encephalopathy have serious live problems, and should be considered for liver transplant evaluation.  All of us at Liver Specialists of Texas are experienced to care for these complex patient needs.

 

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Top Five Reasons to Evaluate Nonalcoholic Fatty Liver Disease (NAFLD)

Dr. Rashid Khan adds this blog entry further reviewing important issues related to nonalcoholic fatty liver disease (NAFLD)

I few weeks ago I wrote on this topic as guest editor on Dr Joe Galati’s blog. We talked about some basic concepts surrounding Nonalcoholic Fatty Liver Disease (NAFLD). To recap, this condition involves fat accumulation in the liver of non drinkers. I mentioned the importance of prompt evaluation, necessary investigations and potential therapies. Here I once again write about this common condition, afflicting close to 100 million Americans, highlighting five reasons why NAFLD needs to be taken seriously.

  1. The most relevant reason from a liver doctor’s perspective is the potential transformation of fatty liver disease to liver cirrhosis. Fatty liver is generally benign, but the development of cirrhosis becomes a game changer.
  2. Along with the potential risk of cirrhosis, comes the added risk of developing liver cancer. Studies have shown that this risk is even present in the absence of cirrhosis, though small.
  3. Cardiovascular disease( CVD) is one of the most common medical conditions in the US and globally. NAFLD and CVD go hand in hand. Usually both exist in many patients. Fatty liver is known to be an independent predictor of CVD.
  4. Type II diabetes is another very common medical condition . Numerous studies have shown the propensity of diabetic patients to develop fatty liver . This association is bi directional, meaning some patients with fatty liver will go on to develope diabetes.
  5. Finally, I will mention chronic kidney disease( CKD), another disease afflicting millions of Americans in this day and age. While the association of NAFLD and CKD may not be as robust as with CVD and diabetes, nevertheless it all comes back to the metabolic syndrome entity, which involves dangerous plaque build up in the blood vessels throughout the body.

 

Here at Liver Specialists of Texas, it is our sincere hope that fatty liver disease is recognized and evaluated in its earliest stages. Our practice is specifically geared towards the management of these patients, as well as other liver diseases, and we will be more than happy to see you in our offices.

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AASLD Liver Meeting 2015

AASLD Liver Meeting 2015

LiverMtg-logo

 

 

For the next several days, liver disease experts from around the world will be in San Francisco learning and sharing the latest developments in liver disease at the annual Liver Meeting.

Today, the one-day postgraduate course covered common clinical conditions, including non-alcoholic fatty liver disease, hepatitis C, liver cancer/hepatocellular carcinoma, and complications of cirrhosis, including volume overload/ascites, malnutrition, and hepatic encephalopathy.

More updates will be posted through the meeting.

Dr. Joe Galati

Liver Meeting 2015

 

 

 

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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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