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WHO IS AT RISK OF VITAMIN B12 DEFICIENCY?

Dietary vitamin B12 deficiency is usually determined by inadequate absorption, use of certain medications, or insufficient intake of the vitamin. 

Insufficient intake

Vitamin B12 deficiency usually develops in individuals who consume neither animal products (vegans) nor dietary supplements containing vitamin B12.

We can say that infants nursed by a vegan mother may be at risk for vitamin B12 deficiency. 

Inadequate absorption

Inadequate absorption of vitamin B12 can be caused by the following conditions: 

- Intestinal bacterial overproliferation: in this case, bacteria utilize ingested vitamin B12 and less of it is absorbed. 
- Inflammatory bowel disease (ulcerative colitis, Crohn's disease).
- Celiac disease.
- AIDS.
- Bariatric surgery.
- Liver disease (may interfere with vitamin B12 storage) and pancreatic diseases. 
- Decreased gastric acid which is more common in the elderly.

Use of medications
The use of certain drugs may change the absorption and metabolism of vitamin B12.

Metformin significantly decreases vitamin B12 levels, causing hyperhomocysteinemia. Therefore, patients with diabetes are more susceptible to vitamin B12 deficiency. 

Long-term proton pump inhibitor therapy increases the risk of vitamin B12 deficiency by reducing the digestive ability to release vitamin B12 from food. Eventually the amount of vitamin B12 absorbed by the body is reduced.

Antiacids block acid secretion from the stomach, which can lead to vitamin B12 malabsorption.

VIGNOZZI, C. (2022). Prevalenza della carenza di vitamina B12 nel paziente grande anziano. Pozzuoli, G. M., Laudato, M., Barone, M., Del Buono, A., Pozzuoli, B., Laudato, M. P., & Del Buono, M. (2018). La carenza di vitamina B12 e la terapia con metformi-na a lungo termine. Studio osservazionale cross-sectional in soggetti con diabete tipo, 2, 21-4. Ricci, G., Valtorta, P., & Ghiazza, B. La carenza di vitamina B12 e acido folico nell'anziano non anemico: studio di. Pancreas, 4(2), 6. Hunt, A., Harrington, D., & Robinson, S. (2014). Vitamin B12 deficiency. Bmj, 349. Den Elzen, W. P. J., Groeneveld, Y., De Ruijter, W., Souverijn, J. H. M., Le Cessie, S., Assendelft, W. J. J., & Gussekloo, J. (2008). Long‐term use of proton pump inhibitors and vitamin B12 status in elderly individuals. Alimentary pharmacology & therapeutics, 27(6), 491-497. Miller, J. W. (2018). Proton pump inhibitors, H2-receptor antagonists, metformin, and vitamin B-12 deficiency: clinical implications. Advances in Nutrition, 9(4), 511S-518S. Kibirige, D., & Mwebaze, R. (2013). Vitamin B12 deficiency among patients with diabetes mellitus: is routine screening and supplementation justified?. Journal of Diabetes & Metabolic Disorders, 12, 1-6.

WHY MAGNESIUM FOR DAYTIME AND EVENING? 

Magnesium tops the list of crucial nutrients. It is the fourth most abundant mineral in the human body and helps regulate heartbeat, sleep cycles, muscle contraction, energy production, immune function, hormone balance, and much more. If you dig into the research, the benefits of magnesium seem endless. It is safe to say that taking sufficient amounts of magnesium is non-negotiable.

Here is an overview of body functions for which magnesium plays a key role:
- Energy and metabolism
- Muscle contraction and relaxation
- Release of neurotransmitters
- Normal function of the parathyroid gland
- Vascular tone
- Synthesis and activation of enzymes
- Cardiac rhythm
- Activated platelet thrombosis
- Osteogenesis

Magnesium contributes to the energy metabolism of muscles and plays a key role in the health of the nervous system. 
Because it has such diverse properties, it is important to know which magnesium to prefer based on its function in the body, its absorption, and timing of intake.
Studies on the bioavailability of different magnesium salts consistently show that organic magnesium salts (e.g., magnesium citrate, taurate, bisglycinate) have higher bioavailability than inorganic salts (e.g., magnesium oxide).

MAGNESIUM FOR THE DAY
Magnesium malate is a dietary supplement that combines the essential mineral magnesium and malic acid, an organic compound found in fruits and vegetables. This combination is used to relieve chronic pain, improve physical performance, increase energy levels, and combat chronic fatigue.
Many studies confirm that magnesium citrate can prevent migraine and improve its symptoms, and it is also the best option to help muscle recovery and against pain in fibromyalgia. 
Magnesium taurate contains the amino acid taurine. This type of magnesium is essential for cardiovascular health, sopprattutto to maintain good blood pressure. 
MAGNESIUM FOR THE EVENING
Magnesium bisglycinate, sometimes referred to simply as glycinate, is probably the most popular type of magnesium on the market and the most studied with regard to sleep.  It works by increasing levels of gamma-aminobutyric acid (GABA), an important amino acid involved in sleep. When sleep begins in the evening, GABA signals to the brain that it is time to go to bed, and gradually brain communication begins to slow down, helping lower brain frequencies to deep sleep. Magnesium bisglycinate supports this pathway by maintaining healthy GABA levels.

Thus, it is essential to use magnesium in different types and at different times for our daily energy, muscle and heart health, and healthy sleep.

Henry, P. R., & Benz, S. A. (1995). Magnesium bioavailability. In Bioavailability of nutrients for animals (pp. 201-237). Academic Press. Newson, J. La guida completa al magnesio. Vignola, N. The Power of Sleep: your number 1 optimisation tool. Walker, A. F., Marakis, G., Christic, S., & Byng, M. (2003). Mg citrate found more bioavailable than other Mg preparations in a randomised, double-blind study. Magnesium research, 16(3), 183-191. Guerrera, M. P., Volpe, S. L., & Mao, J. J. (2009). Therapeutic uses of magnesium. American family physician, 80(2), 157-162. Köseoglu, E., Talaslioglu, A., Gönül, A. S., & Kula, M. (2008). The effects of magnesium prophylaxis in migraine without aura. Magnes Res, 21(2), 101-108. Chycki, J., Golas, A., Halz, M., Maszczyk, A., Toborek, M., & Zajac, A. (2018). Chronic ingestion of sodium and potassium bicarbonate, with potassium, magnesium and calcium citrate improves anaerobic performance in elite soccer players. Nutrients, 10(11), 1610. Boulis, M., Boulis, M., & Clauw, D. (2021). Magnesium and fibromyalgia: a literature review. Journal of primary care & community health, 12, 21501327211038433.

SPRING, IT IS TIME TO PURIFY !

Spring is like a new beginning after winter. It is the perfect time to shed old energies and embrace the freshness and vitality that this season brings.

With the arrival of spring, many of us feel the desire to rid ourselves of toxins and impurities (caused by alcohol consumption, fatty, sugary, fried and processed foods) accumulated in the body in order to feel lighter and more vital.

Although our bodies already have natural purification mechanisms through their organs, such as the liver, intestines and kidneys, at this time of year we can give them an extra hand to improve their efficiency. 
The liver is the organ that needs purification the most in our body due to the accumulation of toxins. The main roles of the liver are:

• produce bile, 
• promote the processing of absorbed food, 
• store sugar in the form of glycogen. 
  It also plays a key role on cholesterol and triglyceride synthesis, and lipid metabolism. 

How to purify the liver in spring with herbal medicine?

Milk thistle, known scientifically as Silybum Marianum, contains a potent active ingredient called silymarin, which is widely recognized for its benefits on liver health.

Silymarin is particularly effective in improving liver function in several ways. First, it aids in the elimination of toxins from the body, playing a key role in detoxification. It also promotes the regeneration of liver cells, thus helping to keep the liver healthy and functioning.

In addition to this, silymarin can help protect the liver from the damaging effects of drugs, smoking and other toxic substances, acting as a protective shield for this important organ.

Artichoke, known scientifically as Cynara Scolymus, is rich in micronutrients and active ingredients that make it extremely useful for liver health. The cynarin, chlorogenic acid and flavonoids found in artichoke leaves promote fat mobilization, bile excretion and cholesterol reduction, thus contributing to liver health.

Artichoke leaves are particularly renowned for their ability to stimulate diuresis and eliminate toxins from the body. Although they taste bitter, the benefits they offer are remarkable: they help reduce abdominal bloating, promote the elimination of excess fluids, and invigorate circulation.

Dandelion root, known scientifically as Taraxacum Officinale, is famous for its depurative and anti-inflammatory properties.  Its depurative and draining properties can promote proper liver function by stimulating bile production and facilitating the process of elimination from toxins accumulated in the body.

Extracts obtained from the aerial parts of the dandelion have been shown to possess several properties that promote skin beauty and health. These extracts are known for their anti-staining properties, which can help reduce the appearance of skin spots and discolorations, thus promoting a more even skin tone.

Dandelion may help stimulate kidney activity by promoting urine production and the removal of waste and toxins through the kidneys. This can be especially helpful in reducing water retention and promoting detoxification of the body.

Choline, is an essential substance for the human body that performs several important functions, including facilitating the flow of bile and promoting gallbladder emptying. Its action is to solubilize fats, thus helping to prevent their accumulation in the liver.

When it comes to protecting and supporting liver health, it is useful to consider taking hepatoprotective plants, which can be used in combination for synergistic benefits. We can incorporate these plants into our diet to protect the liver from damage and stress, improving its function and promoting detoxification of the body. Because of their properties, these plants can offer valuable support to keep our liver healthy and promote the overall well-being of our body.

Venneria, E. (2008). Valorizzazione dei prodotti ortofrutticoli tradizionali: effetti dell’efficacia antiossidante su modelli in vitro, ex vivo ed in vivo. Takkella, N., Konuri, A., Kishore, A., Rai, K. S., & Bhat, K. M. (2018). Role of Choline-Docosahexaenoic acid and Trigonella foenum graecum Seed Extract on Ovariectomy Induced Dyslipidemia and Oxidative Stress in Rat Model. Journal of Krishna Institute of Medical Sciences (JKIMSU), 7(1). DI SUPERSMART, I. C. Come ridurre la ritenzione idrica a livello dell’addome?. Omega, 2024, 01-11. Basnizki, Y., Zohary, D., & Mayer, A. M. (1992). Contenuto di cinarina e acido clorogenico nei semi germinanti di carciofo (Cynara scolymus L.). Journal of Genetics and Breeding, 46. GRASSO, C. S. N. F. LA SILIMARINA. De Fiore, R. Gli epatoprotettori proteggono il fegato?. Yang, Y., & Li, S. (2015). Dandelion extracts protect human skin fibroblasts from UVB damage and cellular senescence. Oxidative Medicine and Cellular Longevity, 2015. https://www.lombardinaturopata.it/2019/04/03/primavera-la-stagione-ideale-depurarefegato/#:~:text=Gli%20alimenti%20anticolesterolo%20per%20eccellenza,oilo%20extra%20vergine%20di%20oliva. Crocker, P. (2015). Succhi e centrifughe (Vol. 245). Newton Compton Editori.

PUREWAY-C™ FOR YOUR DEFENCES

Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin found naturally in some foods, added to others, and available as a dietary supplement. It is a nutrient the body needs to form blood vessels, cartilage, muscles and bone collagen. It is critical to the body's healing process and is an antioxidant that helps protect cells from the effects of free radicals.

Vitamin C has a high solubility in water. Because of this, absorption from the intestinal lumen and entry into cells is limited, and most of it is eliminated through the urine.

PureWay-C™ is an advanced form of vitamin C with greater capacity for absorption and uptake than all other forms. Due to the lipid metabolite technology of vitamin C, it becomes more fat-soluble. Thus its capacity and absorption rate at the intestinal level is increased.

It has a higher absorption and assimilation rate than all forms of vitamin C. Lipid metabolites of vitamin C are found to be 36% more bioavailable than Ester-C, 133% higher than standard vitamin C, and 91% higher than ascorbate.

PureWay-C™ also contains bioflavonoids from citrus in its formulation that protect vitamin C from oxidation, further support the immune system, and play a role in wound healing.

Hemilä, H. (2017). Vitamin C and infections. Nutrients, 9(4), 339. Schlueter, A. K., & Johnston, C. S. (2011). Vitamin C: overview and update. Journal of Evidence-Based Complementary & Alternative Medicine, 16(1), 49-57. Bellows, L., Moore, R., Anderson, J., & Young, L. (2012). Water-soluble vitamins: B-complex and vitamin C. Food and nutrition series. Health; no. 9.312. Pancorbo, D., Vazquez, C., & Fletcher, M. A. (2008). Vitamin C-lipid metabolites: uptake and retention and effect on plasma C-reactive protein and oxidized LDL levels in healthy volunteers. Medical Science Monitor, 14(11), CR547-CR551. Weeks, B. S., & Perez, P. P. (2007). Absorption rates and free radical scavenging values of vitamin C-lipid metabolites in human lymphoblastic cells. Medical science monitor, 13(10), BR205-BR210.

EXTRA ENERGY, EXTRA PERFORMANCE

Long-chain polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) are deeply researched for their effects on our bodies, and they are very important for cardiovascular health, brain health, visual capacity, and also for their anti-inflammatory action.

There is an increasing interest in finding nutrients and supplements that can improve athletic performance and recovery. Because an increased muscle oxidative stress and inflammatory responses among sportives have been reported consistently. In addition, it is well known that exhaustive or unaccustomed exercise can lead to muscle fatigue, delayed-onset muscle soreness, and a decrement in performance.

Omega-3 polyunsaturated fatty acids (EPA and DHA) have been shown to reduce the production of molecules that trigger inflammatory reactions (inflammatory eicosanoids, cytokines ), have immunomodulatory effects, and attenuate inflammatory diseases.

Omega-3s contribute to sports performance with several effects:

• Effects on muscles: EPA and DHA can potentially improve muscle mass or function through a beneficial effect on protein synthesis
• Enhanced recovery: the acute exercise recovery period is defined as the first 96 hours after exercise. It has been described that EPA and DHA increase the structural integrity of muscle cell membranes, which could explain the protective effect of EPA/DHA.
• Stronger heart: Several studies have shown that Omega-3s increase the level of oxygen uptake by the heart muscle.
• Effect on joints: Joint pain is extremely common in the athletic population due to local biomechanical factors, such as the degree of joint loading and abnormal loading, as well as the frequent occurrence of joint injuries. Omega-3s, through their anti-inflammatory effect can support the reduction of joint stiffness and pain.

Gammone, M. A., Riccioni, G., Parrinello, G., & D’orazio, N. (2019). Omega-3 polyunsaturated fatty acids: Benefits and endpoints in sport. Nutrients, 11(1), 46. Simopoulos, A. P. (2007). Omega-3 fatty acids and athletics. Current sports medicine reports, 6(4), 230-236. Bryhn, M. (2015). Prevention of sports injuries by marine omega-3 fatty acids. Journal of the American College of Nutrition, 34(sup1), 60-61. Walser, B., Giordano, R. M., & Stebbins, C. L. (2006). Supplementation with omega-3 polyunsaturated fatty acids augments brachial artery dilation and blood flow during forearm contraction. European journal of applied physiology, 97, 347-354. Thielecke F, Blannin A. Omega-3 Fatty Acids for Sport Performance—Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review. Nutrients. 2020; 12(12):3712. https://doi.org/10.3390/nu12123712

WHAT ARE THE THERAPEUTIC EFFECTS OF MILK THISTLE ?

Silybum marianum or milk thistle is the most studied plant in the treatment of liver disease. Its seeds contain active ingredients that are used against liver disease.

The active complex of milk thistle is a lipophilic extract of the seeds and is composed of three flavonolignan isomers (silybin, silyodianin, and silycristin) known collectively as silymarin.

Silybin is a component with the highest degree of biological activity and constitutes 50%-70% of silymarin. It has antioxidant, anti-inflammatory, antifibrotic, immunomodulatory, and hepatoprotective effects. 

Due to its antioxidant properties, it blocks or prevents lipid peroxidation, which is responsible for the destruction of cell membranes and plays a role in the removal of free radicals (reactive oxygen species that damage cellular structures). It also improves the outcomes of liver disease caused by oxidative damage.

The use of milk thistle seeds as a liver protector dates back to the first century. Antioxidant activity is one of the important factors for hepatoprotection. Antihepatotoxic potential: Silymarin protects liver cells from many hepatotoxins (chemicals capable of causing liver damage) in humans and animals.  

Do you want to know more?

The anti-inflammatory effects of silibin go beyond inhibition of reactive oxygen species-dependent mechanisms that act as pro-inflammatory agents. It hinders the inflammatory processio through inhibition of neutrophil migration and inhibition of Kuppfer cells.  

It also inhibits the formation of prostaglandin- and leukotriene-type inflammatory mediators and inhibits histamine release from basophils. Thus, milk thistle seeds may possess anti-allergic and anti-asthmatic activities. 

Long-term administration of silymarin improves immunity by increasing T lymphocytes, interleukins, and reducing all types of immunoglobulins. Silymarin may be useful in the development of therapeutic adjuvants where immunosuppression is required, including autoimmune and infectious diseases.

In addition, silymarin reduces phospholipid synthesis in the liver, neutralizing ethanol-induced inhibition of phospholipid synthesis. Finally, silymarin significantly inhibits hepatic lipid peroxidation and can reduce triglyceride synthesis in the liver.

Abenavoli, L., Capasso, R., Milic, N., & Capasso, F. (2010). Milk thistle in liver diseases: past, present, future. Phytotherapy Research, 24(10), 1423-1432. Hackett, E. S., Twedt, D. C., & Gustafson, D. L. (2013). Milk thistle and its derivative compounds: a review of opportunities for treatment of liver disease. Journal of veterinary internal medicine, 27(1), 10-16. Bhattacharya, S. (2011). Phytotherapeutic properties of milk thistle seeds: An overview. J Adv Pharm Educ Res, 1, 69-79. Jacobs, B. P., Dennehy, C., Ramirez, G., Sapp, J., & Lawrence, V. A. (2002). Milk thistle for the treatment of liver disease: a systematic review and meta-analysis. The American journal of medicine, 113(6), 506-515.

DISCOVER THE UBIQUINOL

Coenzyme Q10 (CoQ10) is an essential compound found naturally in virtually every cell in the human body, which is also known as ubiquinone.

CoQ10 is a lipid-soluble substance whose primary role is as an essential intermediate of the electron transport system in the mitochondria. Adequate amounts of CoQ10 are necessary for cellular respiration and ATP production. CoQ10 also functions as an intercellular antioxidant, and its presence was then demonstrated in all cell membranes and in blood, both in high- and in low-density lipoproteins, where it is endued with antioxidant properties

Numerous disease processes associated with CoQ10 deficiency can benefit from CoQ10 supplementation, including primary and secondary CoQ10 deficiencies, mitochondrial diseases, fibromyalgia (a syndrome characterized by pain and muscle stiffness), cardiovascular disease, neurodegenerative diseases, cancer, diabetes mellitus, atherosclerosis, migraine, male infertility, and periodontal disease.

It was reported patients who take cholesterol lowering drugs, which block the synthesis of CoQ10 inducing CoQ10 deficiency in the heart muscle, should make strong their heart with supplemental CoQ10.

Ubiquinol is the reduced, active form of ubiquinone and is found in almost every cell in our body. The human body uses CoQ10 by converting it into its active form (CoQH).

Being the active form, it is used directly by the body. Therefore, it acts faster than the standard form (CoQ10).

Ubiquinol plays an important role in preventing oxidative damage to membrane lipids and preventing the initiation and/or propagation of serum LDL (it is also called as bad cholesterol). Thus, it is a potent antioxidant.

From the age of 40, our body's ability to convert CoQ10 to CoQH decreases. Therefore, it becomes essential to take ubiquinol as a supplement.

Garrido-Maraver, J., Cordero, M. D., Oropesa-Ávila, M., Fernández Vega, A., De La Mata, M., Delgado Pavón, A., ... & Sánchez-Alcázar, J. A. (2014). Coenzyme q10 therapy. Molecular syndromology, 5(3-4), 187-197. Dallner, G., & Stocker, R. (2005). Coenzyme Q10. Encyclopedia of dietary supplements, 121-131. Langsjoen, P. H. (1994). Introduction to coenzyme Q10. Texas, University of Texas Medical Branch at Galveston http://faculty. washington. edu/ely/coenzq10. html (25.4. 2009). Garrido-Maraver, J., Cordero, M. D., Oropesa-Avila, M., Vega, A. F., de la Mata, M., Pavon, A. D., ... & Sanchez-Alcazar, J. A. (2014). Clinical applications of coenzyme Q10. Front Biosci (Landmark Ed), 19(4), 619-633. Ernster, L., & Forsmark-Andree, P. (1993). Ubiquinol: an endogenous antioxidant in aerobic organisms. The clinical investigator, 71, S60-S65. Frei, B., Kim, M. C., & Ames, B. N. (1990). Ubiquinol-10 is an effective lipid-soluble antioxidant at physiological concentrations. Proceedings of the National Academy of Sciences, 87(12), 4879-4883. Evans, M., Baisley, J., Barss, S., & Guthrie, N. (2009). A randomized, double-blind trial on the bioavailability of two CoQ10 formulations. Journal of Functional Foods, 1(1), 65-73. Alf, D., Schmidt, M. E., & Siebrecht, S. C. (2013). Ubiquinol supplementation enhances peak power production in trained athletes: a double-blind, placebo controlled study. Journal of the International Society of Sports Nutrition, 10(1), 24.

HAVE YOU EVER HEARD OF HOMOCYSTEINE ?

Homocysteine is an amino acid produced in the body and is produced from another amino acid called "methionine." A continuous cycle (methylation cycle) occurs in the body in which homocysteine and methionine are converted into each other.  High homocysteine levels are determined to be a risk factor for chronic diseases. It is desirable for the level of homocysteine in the body to be less than 10 mcmol/L. 

Studies have shown that there is a correlation between hyperhomocysteinemia (the finding an elevated concentration of homocysteine in the blood) and mental retardation, accelerated growth, osteoporosis (a disease characterized by deterioration of bone quantity and quality), venous and arterial thrombosis (characterized by obstruction of a vein or artery). In addition, an elevated plasma concentration of homocysteine could also cause atherosclerosis.

Among the main causes of hyperhomocysteinemia are:
1) Genetic predisposition to high homocysteine levels (MTHFR gene mutation);
2) Diet lacking or deficient in B vitamins, especially B12, folic acid, and B6; and
3) Smoking
4) Stress
5) Sedentary lifestyle

Diagnosis is verified by performing a simple blood test to measure how much is present in the blood. This can also detect if you have a vitamin deficiency or identify the cause of unexplained blood clots.

Once diagnosed, you may need to change your diet to lower homocysteine levels. If you have a vitamin deficiency, you can increase your simultaneous intake of vitamins B6, B12 and folic acid and/or by eating folate-rich foods such as vegetables, orange juice and beans.

Bendini, M. G., Lanza, G. A., Mazza, A., Giordano, A., Leggio, M., Menichini, G., ... & Giordano, G. (2007). Fattori di rischio delle malattie cardiovascolari: esiste ancora un ruolo per l'omocisteina. G Ital Cardiol, 8(3), 148-160. Van Dam, F., & Van Gool, W. A. (2009). Hyperhomocysteinemia and Alzheimer's disease: A systematic review. Archives of gerontology and geriatrics, 48(3), 425-430. Morris, M. S. (2003). Homocysteine and Alzheimer's disease. The Lancet Neurology, 2(7), 425-428. Gerhard, G. T., & Duell, P. B. (1999). Homocysteine and atherosclerosis. Current opinion in lipidology, 10(5), 417-428. Finkelstein, J. D., & Martin, J. J. (2000). Homocysteine. The international journal of biochemistry & cell biology, 32(4), 385-389.

DID YOU KNOW THE MAIN CAUSES OF FATTY LIVER ?

There are three main types of hepatic steatosis
- Alcoholic hepatic steatosis.
- The nonalcoholic hepatic steatosis.
- The acute hepatic steatosis of pregnancy. 

Nonalcoholic hepatic steatosis is an emerging disease that encompasses a broad spectrum of liver conditions, from simple steatosis to advanced pictures with fibrosis and necroinflammation, to the development of cirrhosis and hepatocellular carcinoma. 

The onset of hepatic steatosis includes the accumulation of triglycerides in liver tissue cells.The main factors for this event are excessive consumption of fatty foods (obesity, insulin resistance and malnutrition), increased triglyceride synthesis (hyperinsulinemia, excessive consumption of carbohydrates) and some changes on lipid metabolism (medication intake, an increase in VLDL synthesis, insulin resistance). 

Nonalcoholic hepatic steatosis is frequently encountered (50%) among patients with type 2 diabetes. Insulin plays a key role in the uptake of fatty acids from cells, as well as glucose. As resistance to insulin function develops, levels of circulating fatty acids increase because they cannot be absorbed by cells.

The other cause of hepatic steatosis is obesity. Obesity is assessed according to body mass index (BMI), which is calculated by dividing body weight (kg) by height (meters) squared. Increasing the BMI value also increases the risk of incidence to hepatic steatosis. 

Metabolic syndrome being characterized by the occurrence of conditions such as obesity, hyperlipidemia, hypertension and reduced insulin sensitivity, there is at least a threefold increased risk of diabetes and especially of fat accumulation in the visceral and arterial compartments, hence atherosclerosis and liver, hence NAFLD (non alcoholic fatty liver disease) or simple hepatic steatosis NASH (non alcoholic steatohepetatitis.)

Virus infections: Chronic Hepatitis C causes a more or less substantial increase in fat in liver cells. During HIV infection, fat accumulation in the liver is common, either spontaneously or following antiretroviral therapy.

Alcoholic liver steatosis is caused by the accumulation of triglycerides at the level of liver cells, caused by excessive alcohol consumption. Additional factors, such as, obesity and a high-calorie, hyperlipidic diet, may be added to promote triglyceride accumulation in the liver. 

Acute hepatic steatosis of pregnancy is a rare, little-known condition that occurs near term. Patients may have an inherited defect in mitochondrial beta oxidation of fatty acids (which provides energy for skeletal and cardiac muscle).

Tinghino, B. (2003). La fitoterapia nella disassuefazione da tabagismo. Tabaccologia, 2, 33-38. Romeo, E., Amante, A., De Luca, G., & Caserta, C. (2018). STEATOSI EPATICA NON ALCOLICA, RISCHIO CARDIOVASCOLARE E ATEROSCLEROSI. Lampi di stampa. Andreoni, M. Gestione della steatosi epatica non alcolica: dallo stile di vita, all'alimentazione, alla terapia di oggi e del futuro. GRASSO, C. S. N. F. LA SILIMARINA. Scoglio, R., & Grattagliano, I. Nuove linee guida americane per la gestione dei pazienti con steatosi epatica non alcolica in soggetti adulti nelle Cure Primarie. Fatti non foste a viver come bruti Ma per seguir virtute e canoscenza…, 10. Peritore, A., Di Lisi, D., Meschisi, M., Macaione, F., Cuttitta, F., Panno, D., ... & Novo, S. (2011). Sindrome metabolica e steatosi epatica: valutazione degli indici di insulino-resistenza e dei marker di flogosi. Cardiologia Ambulatoriale, 2, 90-96. Bugianesi, E., & Marietti, M. (2016). Non-alcoholic fatty liver disease (NAFLD). Recenti Progressi in Medicina, 107(7), 360-368.