hello and welcome to in good shape one of the many myths at the beginning of the corona crisis was that alcohol could kill the virus. could that be the reason that the consumption of alcohol has increased in many regions of the world since a coronal break if that is so this could be a very dangerous development especially for liver. our liver is our main metabolic organ that gets rid of many toxins one of the most frequent disease is the liver and it's not only due to alcohol consumption. or specialist philip heading to his next appointment with a customer the 37 year old often drives long distances for his work he usually doesn't have much time to eat and must settle for something quick typically he'll stop at

a roadside restaurant for some fast food. and obviously i try to eat a healthy diet freshly cooked things like chicken or other meat or a salad. but unfortunately it often doesn't work out i just have to stop off at a fast food place for a burger and fries. for the pepper is one meter 81 tall and weighs $93.00 kilos that's a little above the ideal weight like many people every 2 years he goes to his g.p. for a general checkup including a blood test but his last visit to the doctor showed his liver values were 5 times what they should be he was surprised because he feels absolutely fine. i have no pain no dizziness nothing all completely normal. still the test results bothered him so we got an appointment with hepatologist

zealots and. he says it's no small matter if blood tests showed liver enzymes are seriously elevated as in for the peckers case they now need to investigate what's causing it. to leave my lighted life we have intelligence always say that the liver suffers quietly to begin with you know it is little if anything you might feel a bit of a twinge in your liver and that's it if it goes unchecked for you. years or even decades. with a liver cirrhosis. and then it can be too late. he 1st conducts an ultrasound and immediately it becomes clear that philip peckers liver is in great condition has been shown you can see that the liver tissue is slightly lighter in color than the kidney tissue and that indicates the beginning of fatty liver disease. a so-called fibro scan is used to measure how much fat has been deposited

in the liver in the past patients had to undergo a painful biopsy but these days it's a lot easier for cases like this one the test shows that our patient needs to be treated this damage to the liver is only one aspect fatty liver disease also means your greater risk of cardiovascular disease where you may get a hardening of the arteries or even a heart attack so it's twice as important to do something about it. more and more patients are developing problems like for the ppaca the liver serves many vital functions such as filtering the blood coming from the digestive tract but when we. the wrong kinds of foods it starts to store fat and can no longer work properly it begins to swell and can reach twice its size. liver cirrhosis and eventually organ failure. is nowhere near that stage the good news for him is that his liver can

still make a complete recovery but only if he makes some changes to his lifestyle and diet to fit avoid eating too much fat sugar sugar is contained in many foods fruit juices or one example of the things that have been sweetened and often it's fructose that's been used which is especially bad it's like pure alcohol for the little. cool. it's been a healthy shock for the patient since the diagnosis he started exercising regularly . he goes jogging 3 times a week for 30 minutes and he's also changed his diet introducing a lot more salads and healthy snacks and his efforts have paid off just one month later the liver enzyme levels in his blood have dropped significantly and his test results are now almost normal. stuff explicit travel ism is always active so you can reverse things very quickly but only if you're disciplined

and i think mr head is certainly being disciplined he was highly motivated. plans to keep up the good work it may not always be easy but the benefits are great . as a g.p. i certainly know a lot about the liver but now i'm sitting next to a man who knows everything about it. from the german red cross western clinic in berlin thanks for having me today you just saw a patient who was in his prime healthy he was not an alcoholic but he hadn't had a liver how could this be fed to store in the liver in most cases there's a dispute between too much fat or too much sugar and in decreased use of it so when this is in balance the liver is there to store fat for bad times which usually do not come in the western world but could that mean that a lot of people have said liver without even knowing it yes indeed it's a prevalence of fat liver is more than 30 percent in the western world and even though kids have

a high incidence of fatty liver with up to 20 to 30 percent of kids who do have an increase in pathologic storage of fat in their liver not long ago affect the liver was considered as something quite trivial but it's not is it the opposite is the case so when the liver does not function anymore we haven't decreased production of proteins which means decreased muscle production it is good for cutting off it's important for a lot of functions without a liver we cannot live so when there is new. priests' storage of fat then the liver in flames and it comes to scarring of the liver surfaces so when this is cirrhosis the functions of the or decreases in patients do die from liver cirrhosis also the prevalence of liver cancer is enhanced by a fat storage the most common reason for liver cancer in the western world is liver so it is not a trivial disease it's an important and life threatening disease. one of the

causes for a thetan liver is alcohol consumption just under lead to a beer or approximately $300.00 milliliters of wine can be dangerous for men or women it's even less but any how many people drink alcohol on a regular basis. when diagnosing alcohol addiction doctors often start with the so-called cage test it's a series of questions that require a yes or no answer anyone who answers 2 or more of the questions with a yes is in danger of becoming dependent on alcohol we conducted the test on a few people without telling them what it was about to start with the letter c. as in cut down drinking have they ever considered drinking laughs. here every day but no i'm not into alcohol. i don't really drink that much sometimes i think it is better to drink less. yes i

think about how to fix my health because in the next letter is as an annoyed if you ever been annoyed by people criticizing your drinking habits the right is not you know it's never been that bad but i do criticize myself in trying to observe my own drinking habits. i actually know people who have to decide for themselves but i have many criticized yes. no my friends never say anything because we're all drinking together. then there's g. as in guilty if you're drinking habits ever made you feel guilty. and i know that well actually yes i do feel bad for my body because i know that it's not the healthiest activity so then i feel a bit guilty. no i don't. know not really. not at all i know my limits. of one yes occasionally if i've overdone it then i do feel guilty about drinking. and finally there's an easy as an eye opener if you ever

needed alcohol 1st thing in the morning to stabilize your nerves or make the start of the day easier. no definitely not no never mornings almost never need. almost maybe around christmas but other than that no night no way more you in the mornings on the morning. i just have a regular breakfast to my guns on. the 30 people we ask 5 of them answered at least 2 questions with a yes according to the cage test those subjects have a heightened risk of alcohol addiction dismissal well i'm aware that drinking is very much part of my day and that i drink too much if it doesn't i call it will be with you it's going like this well no i don't think i have an alcohol problem. but i think it's a good idea to monitor how much you drink. some of those who took our

test were surprised that these innocent questions can indicate a possible dependence on alcohol all of them seem to have their own definition of a whole i think if you lose your ability to see what's happening to you. you might get to the point that you think it's normal to drink in the morning. and i want to just drink i think if you drink every day you have a problem but it depends on the reason this is a glass of wine you're drinking for pleasure. if you really needed to unwind. but clearly it's not always apparent from the outside whether someone has a problem with alcohol. a lot of people drink some over the day like a glass of wine over lunch or some beer or dinner is this the risk for developing a fatty liver unfortunately the individual risk to develop fatty liver is very different in humans you can say that you're on the safe side if you do not consume

more than one on maximum of 2 units per day so one unit would be a glass of wine or a bottle of beer containing what 5 front of them else so how could i as a patient knew that i have a little problem unfortunately symptoms of fed livers develop very very late in some cases even at that time when it's too late already so when you think you might have affected liver when you consume too much i'll call or eat or drink too much go to your doctor you can use the ultrasound and check if you have had a liver and then it's up to you. everything with the names it sounds healthy at 1st for example it gets its name from is that chilled sauce foods. for a long time was even recommended from doctors to diabetics today the industry uses it on the message in processed foods sweets and soft drinks that leads to obesity heart and intestinal diseases and fatty liver. we can't get enough of the

stuff although we know how unhealthy sugar is we can stop eating it but one particular sugar is thought to be especially unhealthy and in higher doses over long periods it can be very harmful fruit shows. is funny missional problems related to fructose have come to light in recent years it is a sugar that has a significant impact on the liver if you eat fructose in large amounts it can lead to fatty liver disease. and our fruit toast consumption is on the rise many processed foods contain it as do all sorts of sweet treats highly concentrated fruit towse is being produced on an industrial scale and there is one reason for that it's the most powerful sweetener of all the sugars and ferry cheap to produce . for a long time fruit was even considered healthy it used to be recommended for diabetics

because it doesn't raise blood sugar levels through toast behaves differently in the body than glucose for example. glucose reaches the bloodstream directly via the small intestine and in doing so raises the sugar levels in the blood with the help of the hormone insulin glucose is transported to the cells and provides them with energy. fruit joe's takes longer than glucose to enter the blood stream from the small intestine the cells can process it so it's sent to the liver to be broken down and turned into fat. nutritional scientist on to be a scripture has studied the effect of fruit towse he conducted an experiment to find out how the. human body breaks it down. to a number of test subjects with varying amounts of fruit those under this plastic could he was able to gauge how much energy the test subjects used during the experiment. blood samples were taken every 5 minutes to test the sugar levels

i missed and you measure how much sugar live and used how much fast it produced and how much of the sugar was stored despite. the results of the tests show that too much fruit toast leads to weight gain but what's even worse is the damage that fruit does to the liver it basically s. the same effect as consuming too much alcohol. then i feel able to fuse. the has too much to do i don't break down the front toes then it continent telling lies it properly and stores it as fast. the liver turns the fruit juice into fact part of which is transported throughout the body and stored as fat deposits but the liver itself begins to store the fat too that leads to a fatty liver just like consuming too much alcohol does. what's

more influences the hormones that regulate appetite. since finding that's what makes us feel full stay hungry is a fascinating subject and fructose clearly plays a role in that function. when we consume too much fruit toast the hormone grayling is produced in the stomachs mucous membrane this hunger hormone signals to the brain that we haven't had enough to eat yet. we eat more. often the main problem isn't even solid food we get especially large amounts of fruit those in our beverages whether in soft drinks or. or fruit juice. women so in a flash if you take a bottle like this it contains a leisure about 2 g.'s it's just the same sugar content as the apples themselves but if i did the whole leisure it's like eating 8 apples when try to eat 8 apples i

get sick of them quickly but i can drink the whole bottle easily in the flesh and it's nice things consumers who want to reduce their fruit chosen take should check the labels of soft drinks and processed foods but what about fruit itself don't worry fruit is still healthy it contains less fruit toast and provides fiber and vitamins i have to admit i do love sweets you have to keep them no you don't but it depends how much sure your body is tolerating usually you should not eat more than 25 grams of sugar which is about 6 troops of sugar but what if they eat sweets and then start for a jog or run if you burn the sugars which are eating this is not a problem but usually people who are not doing sports enough or not exercising eating too much sugar and then they're storing it in the liver which then produces or causes for a clever letter we find in daily life sure traps are called traps because you don't

think about that a cup of cappuccino usually is about 400 kilo careens apple juice or orange juice contains ass many calories as coca-cola so smoothies for example they contain a lot of calories 4 to 500 kilo calories so if you eat or drink 3 of them you have enough calories for the full day children ready to go food pizza soft drinks sweets can they develop if had liver yes they can and about 30 percent of the kids do have fed liver we all love ready to go food because it is easy to eat and tastes well however the contain a lot of sugar which is actually then not used and stored in the liver which produce. this is fed liver so you need a balanced diet containing sugars but more importantly proteins and i mean an asset to grow well let's be honest what would be the easiest thing you could give up money the internet your partner we humans find it difficult to eliminate the

familiar things from our lives for me personally i could not do without the show and without sugar the people in our next report tried to give up sugar and took part in an exciting experiment. so yes ultimately step on the scale let's see how happy you are it's. ok to all the good eating less sugar make us healthier so. the group of $65.00 people are about to find out they're going to exclude all sweets and added sugar from their diet for the next 3 months sun group laughing dog who's a doctor specialized in nutrition will monitor them through ios. and cannot fail it's 57 i'm suffering from joint pain considered and i have a lot of inflammation in my body which could be down to my sugar intake and the doctors aren't so sure that i'm one of these 3 months per readjustment the idea is

to get through it and then continue on a lower sugar intake and that's what i'm aiming for it's now or never and martin kim edwards has already had a heart bypass. his blood pressure and cholesterol levels are too high so he's on medication for the us. to get some states to come off of these cholesterol tablets because of the side effect. if you lose weight by changing your diet it's possible we might be able to stop all the medication. blood samples are 1st taken from all the participants the doctors want to monitor how the reduced sugar intake affects their patients' metabolism. so on who graph and off will check their blood values again at the end of the program. so from now on our test participants will need to be disciplined. it's week one then down he is

off a letter husband are noticing some changes on the table. we used to have a plate of cookies now we have flowers for. the participants our light isa maximum of 25 grams of added sugar a day that 8 q 6. that's the limit recommended by the world health organization. and half a list starting to notice the difference after 5 days on this new diet my heart burn is gone it has an effect on your partner. the doctor has summoned martin gets to the surgery to discuss the results of his blood test despite the medication he's on his blood pressure is too high. and he's overweight he's one meter 80 tall and weighs just under 105 kilos. this ultrasound image shows very clearly that you have a fatty liver but that's reversible we can work on that. 7

weeks now. the group are having a party to celebrate reaching the halfway point 2 thirds of the participants have managed to stay in the program. but fail is really missing the sugar the 1st. patient i feel like i'm constantly on the edge. she's come to discuss her progress with the doctor although she's lost 4 kilos in weight she's still not satisfied because instead of eating chocolate she's now started snacking on potato chips instead. the t.v. commercials don't help i've noticed that when you're watching t.v. in the evening you're constantly getting ads for something sweet or food in general . but i think losing 4 kilos in just under 8 weeks is a lot after all the only thing we've changed is reducing the amount of free sugars

i think that's a huge achievement martin kim it's on the other hand just surprised how easy it's been to reduce his sugar intake. he's also been exercising a lost and has lost 7 kilos this is what you've done brilliantly with changing your diet your top fit and your losing weight and what about the other participants the 3 months when i passed on the final blood test is about to reveal all. more than 40 participants have held out to the end. half as joint pain is much better and she no longer needs to take a course on. it's been a huge success especially if it carries on like this i saw my orthopedist yesterday and he was very impressed he says i have to keep it up to. her lab results also look promising her cholesterol levels liver and fibroid values have all improved that means she's now less at risk of developing diabetes. you've managed to make

the change it would be great if you could now keep that up. mass incriminates has lost nearly 9 kilos and the blood tests shows that his cholesterol levels have sunk to. your blood results of improved across the board i'm very pleased. if he continues to lose weight he might soon be able to come off the cholesterol tartlets. 3 months with a radically reduced sugar intake have paid off nearly all the participants have lost weight and feel better for us and most of them want to continue on a low sugar diet. so if i would keep away from sugar completely my liver would heal so what's your job as a specialist unfortunately the dracs against liver so often. patients . also. potentially efficiently. treat your sugar

efficiently both are risk factors for developing fatty liver so why. what should the patient do the human being is weak so what you have to do you have to change your diet you have to eat more protein more amino acid less sugar you have to start exercising usually you cannot start with a 2 or 5 kilometers walk but you should start slowly you know to burn more calories than you eat as a g.p. and know that it's very difficult for my patients to go for a complete lifestyle change so how could it work yes indeed it's takes a lot of times and effort to convince a patient to change your life it's convenient to go on as you already did for 20 or 30 years to enjoy a red wine or to enjoy a good food however sometimes the patients has to experience a trauma or or problem you to think about his own health to change his life thanks so much for this very interesting talk was

a pleasure thank you very much so exercise is good against a fatty liver and when i exercise i get my best ideas what about you and if you're a bit like me send me your best ideas. good shape for your weekly health show one g.w. covers many aspects of health care look at what's new in medical treatments nutrition fitness and beauty. we discuss these topics in depth with specialist and give you the chance to pose your own questions so do get in touch. you may ask yourself is today so over yet no it's not it's over in 321.

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