A big belly with normal weight — is it a reason to check the liver?

      According to Dmitry Karpenko, a candidate of medical sciences and associate professor at the Department of Polyclinic Therapy of Pirogov University, normal weight alone does not guarantee liver health.

      — Fatty liver disease occurs not only in people with excess body weight but also in seemingly thin patients, — explains the doctor.

      This refers to a phenomenon that specialists call skinny fat or "thin obesity."

      What does this mean?

      A person may appear slim and even have a normal body mass index (BMI), but still have an excess of internal — visceral — fat. This type of fat is considered the most dangerous.

      It accumulates around internal organs and is associated with a high risk of metabolic disorders, including fatty liver disease.

      What harms the liver the most?

      Many consider fatty food to be the main enemy of the liver. However, as the specialist notes, the problem is often not with fats per se. Much greater harm is done by products that contribute to weight gain and metabolic disruption.

      First and foremost, these include:

      excess sugar;

      sweet drinks;

      baked goods;

      fast food;

      products high in simple carbohydrates.

      Such eating habits often lead to the development of metabolically associated fatty liver disease. In this condition, fat begins to accumulate in liver cells.

      Initially, steatosis develops, and then in some patients, the process may progress to fibrosis — the formation of scar tissue.

      Who should check their liver?

      People at risk include those with:

      abdominal obesity;

      high cholesterol;

      diabetes or prediabetes;

      high blood pressure;

      excess weight;

      a large waist circumference even with normal weight.

      For a primary assessment of liver condition, basic diagnostics are usually sufficient.

      — The first stage of screening is an ultrasound of the abdominal organs and laboratory indicators of liver function, — says the doctor.

      Such tests include:

      ALT;

      AST;

      bilirubin;

      GGT;

      alkaline phosphatase.

      Is it true that coffee is good for the liver?

      It sounds surprising, but yes. According to the doctor, among food products, coffee has the most convincing evidence base regarding liver protection.

      — Coffee has proven hepatoprotective effects and can prevent the development of liver fibrosis, — notes the specialist.

      A safe norm for most people is considered to be about 4–6 cups a day, calculated as espresso.

      The main conclusion is simple: protecting the liver should not be through "detoxes" and dietary supplements, but through lifestyle. Weight control, rational nutrition, moderate physical activity, and limiting alcohol work much more effectively than any trendy schemes.