Article content continued

The data in this article are supported by a recent study in the U.S. which showed that NAFLD is the most rapidly increasing indication for liver transplantation in 18- to 40-year-old adults, having increased tenfold in the last decade. Yet the majority of my patients don’t recognize the harms of daily soda, fruit juice, flavoured yogurt, cereals, highly refined breads and other processed foods. According to the Heart & Stroke Foundation of Canada, Canadian adults now consume 48 per cent of their daily calories as ultra-processed foods, and our children consume 57 per cent. These foods raise blood sugars and insulin levels, which can eventually lead to the development of not only fatty liver, but also Type 2 Diabetes. Public and health care authorities do not grasp the magnitude of the situation, and the metabolic effects of these refined foods have largely gone unrecognized.

It is always amazing to see a patient’s NAFLD and Type 2 Diabetes improve with simple dietary counselling. Cirrhosis from NAFLD is preventable. We need to develop and institute nationwide nutritional educational and counselling programs aimed at reducing the overconsumption of sugars, refined grains and ultra-processed foods. This includes teaching people about the harmful effects of these foods, but more importantly radical change of the consumer food environment so these foods are not as readily available. We also need to educate Canadian physicians and health providers, and make it easy for them to offer therapeutic nutrition to address this massive problem. I am a member of a not-for-profit organization called the Canadian Clinicians for Therapeutic Nutrition, which promotes a food-first approach to preventing chronic disease.

Our policymakers need to take notice. We are facing a crisis of metabolic disease, and our publicly funded health care system is unlikely to survive if we do not change our food environment.

Supriya Joshi, MD, FRCPC, works at Credit Valley Hospital in Mississauga as a gastroenterologist with specialty training in managing liver disease.