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1-fatty-liver-diseaseWhere there’s a buck to be made…

Dr Carrie Decker ND explores trends in R&D by pharmaceutical companies and the evolving problem of liver conditions. With increasing rates of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) have become increasingly common, such that they are now the most common cause of liver disease in Western countries.[i] This has not gone unnoticed by those in the market of drug development. Where there is a disease to “treat” there is a buck to be made.

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April of 2013 FOCUS introduced the latest research on mixed tocotrienols from organic virgin red palm oil, and in November 2013 we further explored these novel molecules. We feel the quote from Bharat B. Agarwahl, PhD, of the University of Texas M.D. Anderson Cancer Center in Houston, sums it up well: “Tocotrienols exhibit health benefits quite different from that of tocopherols, and in most cases, these activities are superior for human use. Promising oral agents like tocotrienols are bioavailable, work on multiple pathways, and are already recognised as safe.”

Marilyn Arguillas is a gastroenterologist with a special interest in liver diseases particularly non-al­coholic fatty liver disease, chronic hepatitis, cirrho­sis and liver cancer. She is chair of Internal Med­icine-Gastroenterology at Davao Doctors Hospital in Davao City, Philippines. She was a member of the Executive Council of the Asian Pacific Associa­tion for the Study of the Liver (APASL) from 2006- 2010 and the President of the Hepatology Society of the Philippines from 2010-2012. In June of 2013 her findings on tocotrienols and fatty liver disease were presented as a Poster of Distinction by the Asian Pa­cific Association for the Study of the Liver (APASL) conference in Singapore.

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Hidden in the stately steppes of gentle rice paddies, lurking in shiny clusters of red and purple palm fruit, nestled in tiny annatto seeds from the achiote tree…lies a quartet of potent anti-inflammatory, highly protective molecules called tocotrienols. They are cousins to the four tocopherols. Together, all eight comprise the Vitamin E family, a lipid-loving arsenal of molecules essential to health. Each has its own healing profile. According to molecular biochemist Chandan Sen, of Ohio State University, “Current studies of the biological functions of vitamin E continue to indicate that each member of the vitamin E family possesses unique biological functions often not shared by other family members.”[1] 

Dr Todd Born ND explores the increasingly common problem of NAFLD.

Nonalcoholic fatty liver disease (NAFLD) refers to the presence of hepatic steatosis when no other causes for secondary hepatic fat accumulation (eg, heavy alcohol consumption) are present.  NAFLD may progress to cirrhosis and is likely an important cause of cryptogenic cirrhosis.[1],[2]  NALFD is now the most common cause of abnormal liver biochemistry in North America and likely in the UK and is also known to be associated with some drugs, genetic defects, obesity, insulin resistance and type 2 diabetes.[3]

The condition – Nonalcoholic steatohepatitis (NASH) is increasing in prevalence, in tandem with the obesity epidemic, in both children and adults. Identifying specific dietary components that drive NASH is important for successful management of this disease.

Nonalcoholic fatty liver disease (NAFLD) encompasses a range of liver diseases. Simple steatosis, or fatty liver, is now found in up to 31% of adults[1] and 16% of children.[2] Of those with steatosis, approximately 5% will develop nonalcoholic steatohepatitis (NASH), in which steatosis is accompanied by inflammation and fibrosis.[3] Up to 25% of NASH patients will progress to cirrhosis. NASH is the third leading indication for liver transplantation in the United States and will become the most common if current trends continue.[4] Therefore, understanding its pathogenesis and treatment is of utmost importance.

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coverimageCompared with our ancestors, Western societies today lead a lifestyle that is much more sedentary, probably as a result of cultural changes stemming from modern socio-economic morays. Taking into account differences in body size, our energy expenditure per kilogram of body weight has been estimated to be <40% of that of our prehistoric ancestors.[1] Current estimates suggest that 7 out of 10 adults are inactive or lack adequate conditioning,[2] and this lack of adequate exercise, combined with dietary indiscretion, has contributed to the worldwide epidemic of obesity and non-alcoholic fatty liver disease (NAFLD). NAFLD, is now considered to be around 20–30% prevalence in Western countries.

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