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Have you heard of fatty liver disease? Well, fatty liver disease is just what it sounds like—it's when fat builds up in the liver and starts causing issues. The official name for it is “nonalcoholic fatty liver disease,” or NAFLD for short. Now, if that fat buildup leads to inflammation, it’s called “nonalcoholic steatohepatitis,” or NASH. The “nonalcoholic” part just means it’s not caused by alcohol, which can also lead to similar liver problems. NASH is a more severe liver disease compared to NAFLD. This is because inflammation in the liver can lead to cirrhosis (scarring or fibrosis of the liver) and liver failure. Fatty liver disease happens when there's too much fat in the liver, but we’re still figuring out what actually causes that buildup. We do know that carrying extra body fat can raise the risk, and how our bodies handle sugars and fats might play a role, too. It’s also more common in Hispanic people than in other racial groups. Additional risk factors include a larger waist size, type 2 diabetes, and metabolic syndrome. Most people with fatty liver disease don’t have any symptoms. These happen much later in people who have more severe liver disease. If and when symptoms do happen, some people experience jaundice (yellowing of the skin or eyes), fatigue, and abdominal swelling from fluid build-up (ascites). Weakness, weight loss, and nausea or vomiting can also occur. People usually find out they have fatty liver disease by chance, often during tests for something else. For instance, routine blood tests might reveal higher levels of liver enzymes like AST and ALT. The increasing prevalence of obesity and metabolic syndrome has made NASH a significant public health concern. However, recent research has highlighted glucagon-like peptide-1 (GLP-1) agonists as a promising therapeutic option for improving NASH. In this podcast, we’ll discuss how GLP-1 agonists work and the clinical evidence supporting their effectiveness in treating NASH. Understanding GLP-1 Agonists GLP-1 is an incretin hormone produced in the intestines that plays an important role in glucose metabolism. GLP-1 agonists, such as liraglutide and semaglutide, mimic the action of this hormone, leading to increased insulin secretion, decreased glucagon release, and reduced appetite. Originally developed for the treatment of type 2 diabetes, GLP-1 agonists have gained attention for their potential effects on liver health, particularly in NASH patients. How Do GLP-1 Agonists Work in NASH? Weight Loss and Appetite Regulation: One of the primary benefits of GLP-1 agonists is their ability to promote weight loss. Excess weight is a significant risk factor for NASH, and weight reduction can lead to improvements in liver histology and function. By decreasing appetite and increasing satiety, these medications can help patients achieve significant weight loss, which may directly improve liver health. Improved Insulin Sensitivity: GLP-1 agonists enhance insulin sensitivity and glucose metabolism. Improved insulin action can reduce hepatic fat accumulation, a key feature of NASH. These agents may help manage the underlying metabolic dysregulation associated with NASH by improving insulin resistance. Direct Liver Effects: Emerging evidence suggests that GLP-1 receptors exist in liver cells. Activation of these receptors may directly influence liver inflammation and fibrosis. GLP-1 agonists have been shown to reduce markers of liver inflammation and fibrosis in preclinical models, indicating a potential role in mitigating liver damage. Antioxidant Properties: GLP-1 has antioxidant effects, which can help reduce oxidative stress—a significant contributor to liver injury in NASH. By decreasing oxidative stress, GLP-1 agonists may protect liver cells from damage and promote better liver health. Clinical Study Findings Several clinical studies have explored the efficacy of GLP-1 agonists in treating NASH, with promising results: Liraglutide Study: In a randomized controlled trial, patients with NASH treated with liraglutide showed significant reductions in liver fat content and improved liver histology after 48 weeks. The study reported a reduction in necroinflammation and fibrosis scores, highlighting the potential of liraglutide as a therapeutic agent for NASH. Semaglutide Research: A recent trial involving semaglutide demonstrated notable improvements in liver fat content and metabolic parameters among participants with NASH. The study indicated that patients experienced a significant reduction in body weight, which correlated with improved liver function tests and reduced hepatic inflammation. Long-Term Benefits: Ongoing research examines the long-term effects of GLP-1 agonists on NASH progression and resolution. Early data suggest that sustained treatment can lead to lasting improvements in liver health, reinforcing the need for long-term...

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The ketogenic diet, or keto diet, has gained immense popularity in recent years for its effectiveness in aiding weight loss and improving overall health. This high-fat, low-carb diet has been shown to help people shed unwanted pounds and improve various health markers, such as blood sugar levels and cholesterol. One key component of the keto diet is apple cider vinegar (ACV), which has been touted for its numerous health benefits, including aiding in weight loss. When combined, keto and ACV form a dynamic duo that can supercharge your weight loss efforts and help you achieve your health goals.

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When following a ketogenic diet, your body enters a state of ketosis, where it burns fat for fuel instead of carbohydrates. This metabolic state can help you lose weight and improve your overall health. Apple cider vinegar, on the other hand, has been shown to have various health benefits, such as improving digestion, balancing blood sugar levels, and aiding in weight loss. When combined with the keto diet, ACV can further enhance the weight loss and health benefits of the diet.

Apple cider vinegar is known to help regulate blood sugar levels by improving insulin sensitivity and reducing blood sugar spikes after meals. This can be especially beneficial for those following a keto diet, as it can help maintain stable blood sugar levels and prevent cravings for sugary foods.

In addition to its effects on blood sugar levels, apple cider vinegar has also been shown to improve digestion and gut health. The acetic acid in ACV can help promote the growth of beneficial bacteria in the gut, which can improve digestion and nutrient absorption. This can be particularly important for those following a high-fat diet like keto, as it can help prevent digestive issues such as bloating and constipation.

How to Incorporate Keto ACV Into Your Routine

One easy way to incorporate apple cider vinegar into your keto diet is to use it as a salad dressing or marinade. Simply mix ACV with olive oil, herbs, and spices to create a flavorful dressing that can be drizzled over salads or used to marinate meats and vegetables. This can help enhance the flavor of your meals while providing the health benefits of apple cider vinegar.

Another way to include apple cider vinegar in your keto diet is to drink it diluted in water before meals. Simply mix one to two tablespoons of ACV with water and drink it 15-20 minutes before eating. This can help improve digestion, regulate blood sugar levels, and aid in weight loss by reducing cravings and increasing feelings of fullness.

You can also incorporate apple cider vinegar into your keto baking recipes by using it as a leavening agent. The acidity of ACV can help activate baking soda, which can help your baked goods rise and become light and fluffy. This can be a great way to enjoy your favorite keto treats while reaping the health benefits of apple cider vinegar.

Frequently Asked Questions About Keto ACV

Q: Can apple cider vinegar help with weight loss on its own?

A: While apple cider vinegar has been shown to aid in weight loss, it is most effective when combined with a healthy diet and regular exercise. When combined with the keto diet, ACV can help enhance the weight loss benefits of the diet.

Q: Is it safe to consume apple cider vinegar every day?

A: Apple cider vinegar is generally safe to consume in moderation. It is recommended to dilute ACV in water before consuming it, as the acidity of undiluted vinegar can be harsh on the stomach lining. It is also important to consult with a healthcare provider before making any significant changes to your diet.

Q: Can I take apple cider vinegar supplements instead of liquid ACV?

A: While apple cider vinegar supplements are available, it is generally recommended to consume liquid ACV, as the supplements may not provide the same health benefits. The acetic acid in liquid ACV is thought to be responsible for its health benefits, so it is best to consume the liquid form for optimal results.

Q: How long does it take to see results from combining keto with apple cider vinegar?

A: The results of combining keto with apple cider vinegar can vary from person to person. Some may see results within a few weeks, while others may take longer. It is important to be patient and consistent with your diet and lifestyle changes to achieve the best results.

Q: Are there any side effects of consuming apple cider vinegar?

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A: While apple cider vinegar is generally safe for most people, some may experience side effects such as digestive issues, tooth enamel erosion, or drug interactions. It is important to start with small doses of ACV and monitor your body’s response. If you experience any adverse effects, it is best to discontinue use and consult with a healthcare provider.

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What is insulin resistance? Discover the causes of insulin resistance, commonly associated conditions such as fatty liver and type 2 diabetes, and how insulin resistance impacts your weight and where it is stored. Deborah J. Wexler, M.D., M.Sc., Associate Professor of Medicine at Harvard Medical School, Associate Clinical Chief of the Massachusetts General Hospital Diabetes Unit, and Clinical Director of the Massachusetts General Hospital Diabetes Center, discusses the importance of proper diet and exercise when trying to stay healthy with insulin resistance. For more information on insulin resistance, click here: https://www.massgeneralbrigham.org/en/about/newsroom/articles/what-is-insulin-resistance Subscribe Link: https://www.youtube.com/channel/UCYrLjATd88gPwIKntCoR0WQ?sub_confirmation=1 0:00 - Intro 0:44 - The Causes Of Insulin Resistance 1:07 - Common Conditions That Occur With Insulin Resistance 2:08 - Does Insulin Resistance Cause Type 2 Diabetes? 2:49 - Storing Extra Weight 3:20 - Insulin Resistance Treatments About Mass General Brigham: Mass General Brigham combines the strength of two world-class academic medical centers, five nationally ranked specialty hospitals, 11 community hospitals, and dozens of health centers. Our doctors and researchers accelerate medical breakthroughs and drive innovations in patient care. They are leaders in medical education, serving as Harvard Medical School faculty and training the next generation of physicians. Mass General Brigham’s mission is to deliver the best, affordable health care to patients everywhere. Together, we transform the health of our communities and beyond. #InsulinResistance #InsulinResistanceDiet #MassGeneralBrigham Visit Mass General Brigham: https://www.massgeneralbrigham.org/ Find us on social: Twitter: https://twitter.com/MassGenBrigham Instagram: https://www.instagram.com/massgeneralbrigham/ Facebook: https://www.facebook.com/MassGeneralBrigham/ LinkedIn: https://www.linkedin.com/company/mass-general-brigham/ Mass General Brigham: https://www.youtube.com/massgeneralbrigham Insulin Resistance: Treatment & How it Affects Weight Loss | Mass General Brigham https://youtu.be/pICzegjGnOY

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