- 5 weeks ago
In this month’s Stay Well Health Chat, Andrew Salciunas from 97.5 The Fanatic speaks with Virtua Health’s Dr. Ashraf Malek about fatty liver disease, why it is becoming more common, and how people can take a proactive approach to liver health.
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00:01Hello, everybody, and welcome into another Virtua Stay Well Health Chat.
00:07I'm Andrew Salchunas from 97.5 The Fanatic.
00:09You can catch me in the morning with Johnny Marks.
00:13Mornings with Marks and Salchunas every day on 97.5 The Fanatic from 6 to 10.
00:17But the Virtua Stay Well Health Chat is not just all about our takes on our sports teams.
00:21It's about our bodies. It's about taking care of ourselves.
00:25And I love doing these, as I tell you, every single time.
00:28My wife is in the health system.
00:29My mom is in the health system, so it's very close to home.
00:33And I'm also the typical guy that doesn't really, truly take care of himself enough,
00:36which is why I am so lucky that I get to talk to the wonderful team at Virtua Health,
00:42all the doctors, and give you the information that you also should listen to
00:47because you should take care of your bodies as well.
00:49And today, I'm lucky to be joined by Dr. Ashraf Malik,
00:53who is a board-certified, fellowship-trained transplant hepatologist
00:57providing advanced care for people with liver conditions,
01:01which that's been a big topic in society recently,
01:04and we're going to get into that as to why it is.
01:07But he serves as the director of the Virtua Advanced Transplant
01:11and Organ Health Fatty Liver Clinic
01:13and is an assistant professor of medicine
01:16at the Rowan Virtua School of Osteopathic Medicine.
01:20Go profs.
01:21I'm not too far from Rowan University,
01:23so I know all about that campus very well.
01:25Doc, thanks for joining me today.
01:26How are you?
01:28Hi.
01:28Good morning.
01:30I'm good.
01:30And thank you for the invite.
01:32I can't wait to talk about this
01:34because it's one that I think we just hear about every once in a while,
01:38but we don't dive deep into it.
01:40We all know about our heart health
01:42and talking about high blood pressure
01:45and what's the right things to eat
01:47and exercise and all these things.
01:49But the liver is a big part of our body,
01:52and I feel like it's sometimes missed
01:54when we talk about taking care of ourselves,
01:56which is why it's really important to have this conversation.
01:59So let's start with what fatty liver disease is.
02:03Can you start there, Doc?
02:04Fatty liver is defined as
02:06when there's excess buildup of fat in the liver,
02:09and usually a normal person can have a little bit of fat,
02:12which is less than 5% of the fat
02:14that's considered a normal amount of fat in the liver.
02:17When there is more than 5% of fat in the liver
02:20or excess fat buildup in the liver,
02:22that is when you call it fatty liver disease.
02:25So I mentioned that it's something
02:27that I'm hearing more and more about.
02:29I imagine that you have seen with your own research
02:32and doing everything that you do for the Virtua team
02:35that you're seeing an increase of it.
02:37Why is it becoming more common in society?
02:40Because we've been seeing high rates
02:43of all this metabolic condition in the society,
02:47we have more patients with diabetes,
02:50we have been seeing more obesity,
02:52excess body weight,
02:53high blood pressure, cholesterol,
02:55as I mentioned.
02:57All this, and because of the high rates of this condition,
03:00we've been seeing more and more patients
03:02with fatty liver disease.
03:04In addition to that,
03:07if somebody doesn't have good healthy lifestyle,
03:10for instance, not eating properly,
03:12not eating healthy food,
03:13not doing exercise or regular activity,
03:16all these things can lead to excess buildup of fat
03:20in the liver.
03:22There are recently,
03:24actually there is a recent change
03:27in the terminology of the fatty liver disease.
03:30We used to call it something called
03:32non-alcoholic fatty liver disease.
03:34The reason all the society have changed the name,
03:37and the reason for that is because
03:39there is a strong connection
03:41between the metabolic condition and liver health.
03:45And secondly,
03:47the new name actually can help
03:50both patients and provider
03:53understand the underlying cause of the disease.
03:56So instead of calling somebody
03:58has non-alcoholic fatty liver disease,
04:00because it is strongly linked to metabolic health,
04:02that's why the name has changed.
04:05Now there are two types of fatty liver disease.
04:08The most common one
04:10are the ones who has only fat
04:12but no or minimal inflammation.
04:15And the less common one,
04:16which is more aggressive type
04:19or more severe type,
04:20we call it MASH.
04:21And this is something also
04:23in a lot of people want to know what MASH is.
04:26MASH stands for
04:27metabolic dysfunction-associated
04:30stethyl hepatitis,
04:31which is more aggressive from
04:32or severe from
04:33fatty liver disease
04:34because a lot of the patients
04:37who have MASH
04:37actually can lead to liver damage over time,
04:40which is scarring or fibrosis of the liver
04:44eventually can lead to cirrhosis.
04:47So let's talk about risk factors.
04:50Who is most at risk
04:52for developing fatty liver disease?
04:54Is this something that's genetic?
04:56Is this something that is just caused
04:58by our own lifestyle?
05:00And can someone have it without knowing it?
05:04Like here I am sitting here today,
05:06I know I like to have a few beers
05:07every once in a while,
05:08but I have no idea
05:09if my liver is in good shape or not.
05:11So who is at risk?
05:12And is there any way
05:13that people have no idea
05:15that they're currently suffering from something?
05:19So those conditions
05:21I just had mentioned,
05:22somebody who has obesity,
05:26so about 50 to 70% of them
05:29can have fatty liver disease.
05:31So you can imagine
05:31most of the patients who are heavy,
05:35they can have fatty liver,
05:36diabetes or prediabetes,
05:38high blood pressure, cholesterol,
05:40somebody who don't have a good,
05:45healthy lifestyle in as far as eating goes,
05:48those, you know,
05:49eating a lot of carbs,
05:51sugary drinks, processed food.
05:54And then somebody who has,
05:56is not active in their life,
05:57you know,
05:58there are, you know,
05:59a lot of people who,
06:01you know,
06:02because of their,
06:03you know, job,
06:04because, you know,
06:05they don't get a chance
06:06to do a lot of activities.
06:08There is a genetic,
06:10you know,
06:11fatty liver disease,
06:12you know,
06:13because it can run in the family.
06:14We don't have a commercially,
06:17a commercial blood test available for that,
06:19but it could be genetic.
06:23The most worrisome thing
06:25with the fatty liver disease
06:26is it is silent.
06:29So it can occur any of this,
06:33if someone has any of this condition
06:35and can be silent
06:36and may not have any symptom.
06:38MASH or, you know,
06:39is actually becoming
06:41the most common cause
06:43of liver cirrhosis,
06:44liver failure,
06:46and liver cancer.
06:47So this is very,
06:48very concerning.
06:49You don't need to drink alcohol
06:52to get serious liver disease
06:55or cirrhosis.
06:56Fatty liver in itself
06:57actually can lead to liver disease,
07:00liver cirrhosis in the long term.
07:02So doc,
07:03you've given us
07:03a lot of information
07:05about trying to find ways
07:06to keep our liver healthy
07:07or to even find out
07:09if our liver needs
07:10some extra work right now.
07:12So how important is it
07:14that we have routine visits
07:16when it comes to our liver?
07:17So it is clearly important
07:18that annual routine visit
07:21is very, very important.
07:22Anybody with any of this condition,
07:24they should get routine blood tests
07:27along with their special,
07:29there are some special liver tests
07:31for fatty liver
07:32and their special liver scan
07:33for fatty liver
07:34they should do
07:36on their annual visit
07:38so that they,
07:40to make sure their liver is healthy,
07:43to make sure there is no liver damage
07:44or liver fibrosis or scarring.
07:47And this is something
07:48should be done
07:48on a routine basis.
07:51It's not a one-time test.
07:54So from time to time,
07:55they should get this blood,
07:57those tests done.
07:59And so early identification
08:00is the key.
08:02And the reason for this routine
08:05annual visit and test
08:06is to identify patients
08:08who have fatty liver
08:10and something can be done.
08:12They can change their lifestyle
08:13and protect their health
08:15to make sure they don't progress
08:16to severe liver disease.
08:18All right.
08:19So how do I keep my liver healthy?
08:21Not that I've gotten that test done
08:23just yet,
08:24but let's say I got a clear,
08:26like clean bill of health
08:27with my liver right now.
08:28What are the practical steps
08:29that I and all of our viewers
08:31and listeners
08:32can take every single day
08:33to really support
08:34that healthy liver?
08:36The first and most important step
08:38for the,
08:40for to keep the liver healthy
08:42or, you know,
08:43for good liver health
08:45is lifestyle changes.
08:47The good news is that
08:48the same habit
08:50which protects the heart
08:51actually also protects the liver.
08:53So healthy lifestyle changes,
08:56eating vegetables,
08:58fruits, whole grain,
09:01you know,
09:01limiting processed food,
09:03you know,
09:04added sugar,
09:04sugary drinks
09:05in conjunction
09:07with regular activities,
09:09you know,
09:09regular exercise.
09:10All these things actually,
09:12you know,
09:12can help protect
09:13the liver health over time.
09:17another good news
09:18is that
09:18now we have,
09:19you know,
09:20to approve
09:22the approved medication
09:23for the,
09:25for the fatty liver.
09:26So in addition
09:27to the lifestyle changes,
09:29if they're eligible,
09:31they can,
09:32you know,
09:32get this to,
09:33one of those
09:33to approve medication
09:34for fatty liver.
09:35Now,
09:36I want to go back
09:37before we end
09:38this conversation today
09:39to sort of something
09:40that we talked about
09:40at the very beginning.
09:41When I,
09:41when I first introduced you,
09:43I talked about
09:43how it seems like
09:44sometimes the liver
09:45is the afterthought,
09:46right?
09:46We think about the heart.
09:48We think about our mental health.
09:49We think about our blood work.
09:50We think about everything.
09:51The liver kind of,
09:52I don't know when that
09:53falls in line for people
09:54when they think about
09:55ailments of their own body
09:57and what to take care of.
09:58So I would like you
09:59in closing
10:00to sort of send a message
10:01to everybody
10:01that's watching this.
10:03Ways to remember
10:04about our liver
10:06and fatty liver disease
10:07and taking care of our body
10:08because taking care
10:09of our body
10:09is not,
10:10hey,
10:11can I get up this morning
10:12and go for a run?
10:13Taking care of our body
10:14is also everything else
10:15so that we all live
10:16long, healthy lives.
10:17So what would your message
10:18be to somebody
10:19that hasn't really
10:20started thinking
10:21about the health
10:22of their liver
10:23at whatever stage of life
10:24they are in
10:25watching this right now?
10:27So most important message
10:30I have for the audience
10:32is fatty liver disease
10:34is very common
10:35it's very common
10:36it's estimated
10:37about 80 to 100 million
10:39people in USA
10:40it's a large number
10:41of people
10:42who has fatty liver
10:43fatty liver disease
10:44so it's common
10:45and silent
10:46so meaning that
10:48you may not have symptoms
10:50you know
10:51but you can still
10:52have fatty liver
10:53that's number one
10:54so since it can lead
10:56to serious liver damage
10:58early identification
11:00is the key
11:01so don't wait
11:03for symptom
11:05you know
11:06it may be too late
11:08so be proactive
11:09rather than reactive
11:10so if you have
11:11any of this condition
11:12if you think
11:13your lifestyle
11:14you know
11:16diet habit
11:16is not so great
11:17please go ahead
11:18and check it out
11:19for fatty liver disease
11:20and second
11:21is
11:22you know
11:23healthy lifestyle
11:25make sure
11:25you eat healthy
11:26you know
11:27balanced
11:28healthy diet
11:28you know
11:29more fruits
11:29and vegetables
11:30whole grains
11:31you know
11:32less processed food
11:33sugary drinks
11:34and
11:35and just
11:36be active
11:37you know
11:37exercise
11:38and do regular
11:39physical activity
11:40I love the message
11:42be proactive
11:43not reactive
11:43that's
11:44that's a really good message
11:45when we're taking care
11:46of our liver
11:47and look
11:48it sounds scary
11:48right
11:49we talk about
11:49silent diseases
11:50and silent killers
11:51but this is why
11:53you rely on doctors
11:54this is why
11:55you rely on the team
11:56at Virtua
11:56and this is why
11:57I rely on Dr. Malik
11:58to give you this
11:59information today
12:00if you want to learn
12:01more about
12:01advanced transplant
12:02and organ health
12:03at Virtua Health
12:04please visit
12:05go.virtua.org
12:07slash
12:08V-A-T-O-H
12:10that's
12:10go.virtua.org
12:12slash
12:13V-A-T-O-H
12:14and I do want to ask
12:15one more question
12:16before we go
12:17because
12:17I just sent the message
12:18up to learn more
12:19about transplant
12:20and organ health
12:21the liver
12:23when it comes to
12:24transplants
12:24what is that
12:26system like
12:26I feel like
12:27every time
12:27I have a conversation
12:28there is some
12:29sort of
12:29transplant list
12:30that we can
12:31talk about
12:31I know that's
12:33like way down
12:34the line
12:34right now
12:35let's take care
12:35of ourselves
12:36but if somebody
12:36does get to
12:37that point
12:38can you just
12:39sort of walk us
12:40through that
12:40process
12:41doc
12:42sure
12:43so if somebody
12:44thinks
12:44they need a
12:45transplant
12:46or told by
12:47a physician
12:48they can
12:49always call
12:51our
12:52you know
12:53transplant
12:53office
12:55they need to
12:56see usually
12:57usual processes
12:58they need to
12:59see a
12:59hepatologist
13:00like me
13:00get evaluated
13:02to check
13:03if there is
13:04a need for
13:05transplant
13:05and once
13:07we kind
13:07of
13:07evaluate
13:08them
13:08if you
13:09feel like
13:09the person
13:10needs to
13:10get on
13:10the list
13:11you know
13:12getting all
13:12the history
13:13and everything
13:13then the
13:14person will
13:15usually meet
13:15the team
13:16we have a
13:16transplant team
13:17which consists
13:18of the
13:19transplant surgeon
13:20the psychiatrist
13:21the transplant
13:22coordinator
13:24pharmacist
13:24social worker
13:26nutritionist
13:27so they'll meet
13:28the whole team
13:28and they will
13:29go over the
13:29process
13:30because it's
13:31you know
13:31liver transplant
13:32it's a huge
13:32surgery
13:33we make sure
13:33the person
13:35is medical
13:35stable
13:36you know
13:37make sure
13:37that they don't
13:38have any other
13:38issues going on
13:39so that's why
13:40meeting the
13:40whole team
13:41and they'll
13:41go through
13:42the you know
13:43series of
13:43testing
13:44make sure
13:44their heart
13:45is good
13:46there's no
13:46heart issue
13:47there's no
13:47long issue
13:47everything is
13:48so good
13:48once they
13:50kind of
13:50finish all
13:50the testing
13:52and that's
13:52when we
13:53discussed
13:53again
13:54in our
13:55meeting
13:55you know
13:56we have
13:56like a
13:56weekly
13:57meeting
13:57we make
13:57sure
13:58we kind
13:58of go
13:58over all
13:59the testing
13:59and everything
14:00once they
14:00complete all
14:01the testing
14:01and we
14:02feel like
14:02they're ready
14:02for listing
14:03then they
14:04get actually
14:05on the
14:05actual
14:06transplant
14:06waiting list
14:07be proactive
14:09not reactive
14:11but if it
14:11does reach
14:12that point
14:13go.virtua.org
14:15slash v-a-t-o-h
14:17to learn more
14:18about advanced
14:19transplant
14:19and organ
14:20health
14:20at virtual
14:21health
14:21dr malik
14:22that was a
14:22lot of
14:23fantastic
14:23information
14:24i really
14:25appreciate
14:25everything
14:25that you
14:26do
14:26for this
14:27world
14:27right
14:27i appreciate
14:28it
14:28and thanks
14:29for coming
14:29all of
14:30me
14:30today
14:30for this
14:30month's
14:31virtual
14:31stay
14:31well
14:31health
14:32chat
14:32thanks doc
14:33thank you
14:33very much
14:34thanks for
14:34the
14:34invite
14:35again
14:35you