”Why do more and more people get fatty liver nowadays? It is related to the excess nutrition caused by high-fat and high-protein diet, low activity, stimulation by alcohol and carbonated drinks, and abnormal liver lipid metabolism caused by long-term medication. Although mild fatty liver can be asymptomatic, it will slowly develop into cirrhosis and liver cancer if we do not intervene early and regularly. In this article, we will explain what is fatty liver and what should we do about it? Fatty liver The accumulation of lipid in the liver cells is more than 5% of the wet weight of the liver due to disease or medication, which is called fatty liver. Depending on the cause, the lipids accumulated in the liver can be triacylglycerols, fatty acids, phospholipids or cholesterol esters, among which triacylglycerols are the most common. Depending on the fat content, fatty liver can be classified into three types: light, medium and heavy. Fatty liver is a common clinical phenomenon rather than a separate disease and includes pathological changes such as steatosis, steatohepatitis and cirrhosis. The clinical manifestations of fatty liver are asymptomatic in mild cases and aggressive in severe cases. Mild cases of fatty liver may have no clinical symptoms, especially in the elderly due to overeating or high-fat diets, and are clinically referred to as “hidden fatty liver”. In moderate or severe cases, especially those with longer duration of disease, the symptoms are more obvious. Clinical symptoms Common symptoms are fatigue, loss of appetite, right quarter pain, nausea, abdominal distension and other symptoms of liver dysfunction. It may be accompanied by abdominal pain, mainly right upper abdominal pain, occasionally upper middle abdominal pain, with pressure pain, rebound pain, fever and increased white blood cell count in severe cases, similar to the manifestation of acute abdomen, such manifestation is rare. Severe fatty liver disease may be combined with portal hypertension and gastrointestinal bleeding. It may also be accompanied by anemia, linguitis, peripheral neuritis and neurological symptoms due to vitamin deficiency, ascites and lower limb edema, spider nevus, gynecomastia, testicular atrophy, impotence and amenorrhea and infertility in women. Definitive diagnosis depends on liver aspiration biopsy. Generally speaking, fatty liver is a reversible disease, early diagnosis and timely treatment can often be restored to normal. Fatty liver is not only a reversible disease, but also a pathological manifestation of systemic diseases in the liver. If it can be detected early and treated timely and comprehensively for the causes, the lesions in the liver can still be reversed before further evolving into cirrhosis. The principles of fatty liver treatment can be summarized as follows: (1) Remove the causes and triggering factors, and actively control the original disease. Patients with alcoholic fatty liver caused by long-term alcohol abuse and alcoholism should abstain from drinking. The key to the treatment of obesity and diabetic fatty liver is to effectively control weight and blood glucose; and most drug-related fatty liver can be completely restored to normal within 2 to 3 months after timely discontinuation of drugs. (2) Adjust the diet plan and correct nutritional imbalance. Some people think that more fat, less meat, simply eat a vegetarian diet will solve the problem. This is actually not true. A sharp reduction in fat intake in a short period of time is not only ineffective, but also causes symptoms such as hypoglycemia. In fact, in the case of a certain total caloric energy, high protein, moderate carbohydrates and fat can not be less, but to a reasonable distribution of the principle. Ensure high protein intake is conducive to the smooth discharge of lipids from the liver, reducing the chances of fatty liver and facilitating the recovery and regeneration of liver cell function. Reduce sugar and sweet food. Carbohydrates are mainly supplied by cereals and grains. In addition to the natural carbohydrates contained in vegetables and fruits, try not to use refined sugars, honey, fruit juices, jams, preserves and other sweet foods and sweet snacks. Fat should be in moderation. Plant-based fats should be the main source, try to consume more unsaturated fatty acids (such as olive oil, tea oil, etc.) and limit the intake of saturated fatty acids (such as lard, butter, butter, etc.). Patients with fatty liver and other liver diseases should also absolutely avoid alcohol. Patients with fatty liver disease should not eat an excessively fine diet, and the staple food should be a combination of coarse and fine grains, with more vegetables, fruits and mushrooms and algae to ensure adequate intake of dietary fiber. Foods rich in dietary fiber include coarse wheat flour, brown rice, hard fruits, beans, mushrooms, kelp, fungus and duck pears. Multivitamins can protect liver cells and prevent damage to liver cells from toxins. Therefore, fatty liver patients should eat more foods rich in various vitamins, such as fresh yellow and green vegetables and fruits. (3) Adhere to the necessary exercise to maintain the ideal weight. For patients with fatty liver caused by obesity, diabetes mellitus and hyperlipidemia, adhere to moderate amount of exercise, lasting 10-30 min each time, more than 3 times a week. For obese people exercise therapy is more important than dieting alone to lose weight, the reason is that exercise to lose weight is mainly to get rid of abdominal visceral fat, which can often cause triacylglycerol, low-density lipoprotein (LDL) decline and high-density lipoprotein (HDL) rise, glucose tolerance improvement and blood pressure decline. Daily exercise caloric expenditure of 1260kJ can lead to weight loss of 4.5kg in 4 months. (4) Maintain relatively normal blood lipid and blood glucose levels. (5) Appropriate supplementation with hepatoprotective, lipid-lowering and anti-liver fibrosis drugs if necessary to promote intrahepatic lipid excretion and prevent hepatocyte necrosis, inflammation and fibrosis.