??'|'Past Presentations'| Food on Prescription |'Liver and Heart Health

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• Event: IPM Congress 2024

• Date: 6th June 2024

• By:'Dr David Unwin

• Estimated Read Time: 8'9'minutes

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Introduction: The Underestimated Battle for Liver Health

At the IPM Congress 2024, Dr David Unwin captivated audiences with his session titled "Liver and Heart Health: A David and Goliath Story." With over 38 years of experience as a GP, Dr Unwin highlighted the often-overlooked importance of liver health. Drawing a parallel between the biblical story of David and Goliath, he called for a shift in focus from heart health to liver health, a critical yet neglected area in medical training and practice.

Dr Unwin likened liver health to David, the underestimated hero, urging the audience to embrace this crucial aspect of healthcare. His session was a compelling call to action for medical professionals to take Non-Alcoholic Fatty Liver Disease (NAFLD) seriously and explore dietary interventions as transformative solutions.

The David and Goliath Paradigm: Understanding the Liver's Role

Dr Unwin began by highlighting a stark discrepancy: while heart disease dominates medical discussions, liver disease receives significantly less attention. This is evident in the number of journals dedicated to each'381 for cardiology compared to just 80 for hepatology. Despite this disparity, liver health has profound implications for overall well-being, particularly in relation to NAFLD, which affects 38% of the population and is a major risk factor for cardiovascular disease.

While cardiologists often command the spotlight, liver specialists remain unsung heroes. Dr Unwin urged the audience to rethink this imbalance, noting that addressing liver health could have far-reaching impacts on cardiometabolic conditions.

The Rising Tide of Non-Alcoholic Fatty Liver Disease

Dr Unwin explained that NAFLD is a silent yet widespread pandemic, affecting more than one-third of the population. Alarmingly, many NAFLD patients are unaware of their condition due to the lack of symptoms, even when liver function tests are normal. He emphasized that cardiovascular disease, rather than liver-related illnesses, is the leading cause of death among NAFLD patients.

The Framingham Heart Study, a landmark in cardiovascular research, revealed a clear link between elevated liver enzyme levels and increased risk of heart disease and mortality. This underscores the urgent need for greater awareness and intervention in managing NAFLD.

A Patient-Centric Approach: Case Studies and Diet

Through powerful case studies, Dr Unwin illustrated the impact of dietary changes on liver health. He shared the story of Dan, a 39-year-old patient who reversed his NAFLD and type 2 diabetes through a low-carbohydrate diet. By reducing liver fat, Dan achieved improvements in triglyceride levels, blood pressure, and overall cardiovascular health.

Dr Unwin emphasized the simplicity and efficacy of low-carbohydrate diets. By reducing circulating insulin levels, these diets not only address NAFLD but also improve metabolic health. The results, he noted, are often rapid and transformative, offering hope to patients who might otherwise face lifelong medication or worsening health.

Connecting the Dots: Liver Health and Cardiometabolic Diseases

Dr Unwin underscored the interconnectedness of liver health, type 2 diabetes, and cardiovascular disease. Insulin resistance, a consequence of fatty liver, plays a pivotal role in the development of type 2 diabetes and related complications. He explained how excess glucose is converted into fat (triglycerides) in the liver, contributing to metabolic dysfunction.

Referring to the work of Dr Roy Taylor, Dr Unwin highlighted how fat accumulation in the liver leads to insulin resistance, reinforcing the need for preventive dietary interventions. He also stressed that addressing liver health early could mitigate the progression to diabetes and cardiovascular disease, significantly improving patient outcomes.

From Concept to Practice: Implementing Dietary Changes

Dr Unwin advocated for a proactive, preventive approach to healthcare. By addressing high-risk metabolic states during pre-diabetes rather than after the onset of type 2 diabetes, healthcare professionals can dramatically increase the chances of reversal. He recommended practical dietary strategies, such as the "turn the white stuff green" guideline, which encourages replacing starchy foods with green vegetables.

Dr Unwin also addressed concerns about the safety of low-carbohydrate diets, reassuring the audience with findings from recent studies. These diets have been shown to improve cardiovascular risk profiles, lower blood pressure, and reduce the need for medications.

Conclusion: A Call to Action for Liver Health Awareness

Dr Unwin concluded his session with a passionate appeal for healthcare professionals to prioritize liver health. He urged the medical community to shift the narrative towards a holistic approach, integrating dietary measures into mainstream care.

By focusing on liver health, he argued, we can not only mitigate the risk of cardiovascular disease and diabetes but also transform the lives of patients, allowing them to lead healthier, more independent lives. As Dr Unwin eloquently put it, understanding the 'long silent scream' of the liver is essential to preventing the challenges of type 2 diabetes and beyond.

Dr Unwin's engaging dialogue and insightful commentary inspired the audience to take action, making liver health a central focus in their practice. His message resonated as a beacon of hope and a call to reevaluate the priorities in modern medicine.

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Further Reading

For those interested in exploring more of Dr. David Unwin's work on low-carbohydrate diets and their impact on health, here are some recommended articles and resources:

• Diet Doctor Podcast #33 ' David Unwin, MD'- In this podcast episode, Dr. Unwin shares his journey from traditional general practice to advocating low-carb nutrition, discussing patient successes and insights into diabetes management.
• Reverse Diabetes with Dr. David Unwin | The Doctor's Kitchen Podcast'- Dr. Unwin discusses his approach to achieving drug-free remission of type 2 diabetes in patients through lifestyle changes and a low-carb diet.
• Low Carb for Doctors: Explaining Low Carb in a Simple Way'- Dr. Unwin explains how doctors can convey the concept of low-carb diets to patients, emphasizing the impact of carbohydrates on blood sugar levels.

For more resources and transcribed sessions from the Food on Prescription Conference, visit our Food on Prescription Conference page.

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