Life style
Non-alcoholic fatty liver: the twin of diabetes
In an interview with Sunday Island, Prof. Anuradha Dassanayake, Consultant Physician and Professor in Pharmacology with special interest in liver disease from the Faculty of Medicine, University of Kelaniya throws light on non-alcoholic fatty liver disease (NAFLD) which is affecting almost 60% of middle aged and the elderly population and around 10% of adolescents in Sri Lanka. It is also known to be the ‘twin of diabetes’. The ‘grim and grave’ situation of NAFLD calls for recognition of it as a ‘health emergency’ today says Prof. Dassanayake
by Randima Attygalle
A precursor to cirrhosis and liver cancer, NAFLD is caused by accumulation of extra fat in liver cells that is NOT caused by alcohol. Largely triggered by fast food and lack of exercise, NAFLD is more prevalent among South Asians.
“The research confirms that even in countries such as the UK, NAFLD and cirrhosis are more common in those of South Asian origin,” explains Prof. Anuradha Dassanayake. He also says that genetic involvement of NAFLD is also notable. “Those with a family history of liver disease or liver cancer are more susceptible to develop NAFLD at a young age and they have a higher risk of developing cirrhosis by the age of 50 to 60.” Metabolic risk factors for NAFLD include cholesterol, heart disease and diabetes. Smoking and alcohol progress liver disease very rapidly.
Excess calorie intake which is accumulated as fat all over the body, leads to obesity which is a risk factor for NAFLD. This excess fat is harmful to multiple organs in the body including the brain, liver, kidney and the heart. The excessive fat however is not derived only by eating ‘fatty meals’ such as processed meat and fried food but also by excessive carbohydrates and sugar, all of which is converted to fat in the end, points out Prof. Dassanayake.
“Wherever there is fast food, NAFLD is inevitable along with diabetes and heart disease,” says the senior consultant. “While it takes about two hours for a square meal to be prepared at home, it takes just two minutes to get a fast food meal which has no fibres but fortified in calories and carbs which is a very dangerous combination.” Saturated fats and calories of fast food make permanent changes in gut microbiota by altering the ‘friendly microorganism’ (which is required for gut health) into dangerous organism. “Once such permanent change is made, it is hard to shed body fat, even if you eat very little,” Prof. Dassanayake explains. Fructose syrup which is made out of corn is also ‘deadly for the liver’ he says. “Fructose is sweeter and cheaper compared to table sugar and is often found in commercially prepared sweets and beverages.”
The sedentary lifestyle which compounded by the COVID-pandemic is likely to see a rise of increased number of NAFLD cases including children, observes the Consultant. “Lack of physical exercise, increased screen-time before computers, phones and TVs are making most children overweight or obese which is a precursor to NAFLD.” A recent study from the Central Province reveals that about 20% of the estate workers have NAFLD. This is largely attributed to their diet of all-carbs with no fibre, points out Prof. Dassanayake.
The condition which is also considered the ‘twin’ of diabetes, will lead to an epidemic of cirrhosis (the progressive phase of NAFLD where the liver is hardened) in the next 20 years, unless a global campaign declaring it a ‘healthy emergency’ is realized, warns the physician. “NAFLD is not yet found in any of the world’s non-communicable disease (NCDs) control programmes. The epidemic of cirrhosis which is predicted in the next 15 to 20 years is going to be an absolute tsunami-like disaster and worst of it is that the world is still not prepared for it.”
The strong link between diabetes and NAFLD is now established, points out Prof. Dassanayake. “Today Diabetes organizations world over, recommend the screening of all diabetics for NAFDL.” The physician also explains that almost all people who develop NAFDL will end up with diabetes and if it’s diagnosed early, lifestyle modifications such as healthy eating and reducing weight can reverse the condition. “Coffee is often encouraged among those with NAFDL,” he says.
A silent killer, NAFLD is mostly asymptomatic (showing no symptoms. “While a few may experience a dull pain on the right side of the stomach below the rib cage, most will not be aware until it has progressed to cirrhosis or worse, liver failure marked by swelling of legs and stomach and vomiting of blood, hence it is very sinister,” the physician warns.
Several blood tests and new tools such as the Fibro Scan can diagnose NAFLD. “If you catch it early of its onset, it can be reversed by losing 10% of the body weight. While management of NAFLD with drugs is minimal, lifestyle modification is what physicians encourage. However, if it has progressed to cirrhosis, as it happens in 10% of all people with NAFLD, there is no alternative other than a liver transplant which is a costly affair,” says Prof. Dassanayake.
Annually around 3,000 patients die of cirrhosis here at home and only about 10 transplants can be performed locally, says the physician. “This is due to lack of resources and the difficulty in finding suitable non-fatty liver donors. Only a few can afford to get a transplant overseas and the situation of a large majority is very grim. Sadly without a transplant, there is absolutely no hope for these patients.”
Debunking myths such as ‘long term diabetes drugs could cause fatty liver’ and that ‘fatty liver is harmless’ , Prof. Dassanayake reiterates that the condition is a red flag and urges people to eat healthy and watch their weight. “If you have a fatty liver at 25, you are likely to develop diabetes by 35 and suffer a heart attack by 45, such is the gravity of the condition. The good news is that unless you have a very nasty gene which triggers it, NAFLD is a preventable condition.”
Encouraging people to revert to the traditional Sri Lankan diet with moderate rice consumption, Prof. Dassanayake also calls for enhanced health literacy. “Unlike the good old days, where Sri Lankans were physically active, today many spend sedentary lives, hence they need to be conscious of their daily rice intake and also be conscious of the BMI value (Body Mass Index which articulates the ideal weight against height).
Institute of Hospitality Sri Lanka
The 32nd Annual General Meeting (AGM) of the UK-based Institute of Hospitality’s Sri Lanka Chapter was held recently at the Ramada Hotel Colombo,.The event provided an evening of camaraderie , reflection of the past and present achievements,setting new benchmarks for the future
The AGM had the presence of two distinguished guests, the Chief Guest Opposition Leader Sajith Premadasa, and the Guest of Honour British High Commissioner to Sri Lanka, Andrew Patrick. Their inspiring speeches were lauded by all hoteliers who were present at the occasion
A special thanks was extended to Robert Richardson, CEO of the Institute of Hospitality UK, along with his team, sponsors, committee members, and all attendees for making the event memorable.
Dr. Harsha Jayasingh, Past President of the Institute of Hospitality (UK) Sri Lanka Chapter, emphasised the Institute’s longstanding history and the strength of its Sri Lankan branch. “The Institute of Hospitality (IH) UK has a history of 86 years, and we are proud to be the Sri Lanka Branch. IH Sri Lanka is much stronger now with many members from all areas of the hospitality industry,” he stated.
Dr. Jayasingh highlighted the significant role of tourism in Sri Lanka’s economy,. He said tourism it is the third-largest source of revenue for the country. “Tourism accounts for about 13.3% of total foreign exchange earnings and employs 450,000 people directly and indirectly. The hospitality industry in this island of pearl holds tremendous potential for economic growth, job creations, and cultural exchange,” he added.
He also pointed out more women should be attracted to the industry and advocated for the use of technology in hospitality sector to attract the younger generation.
The newly appointed Chairman Ramesh Dassanayake spoke about the challenges faced by the industry, including the reluctance of youth to join the sector. . Dassanayake expressed concerns over the migration of staff between hotels and the overall ‘brain drain’ in the sector. ” We must maintain high standards in the hotel We must try to attract tourists to Sri Lanka, we must have with many facilities Hence, hotel schools and other professional institutions involved in skills development mustincrease their intakes,” he pointed out.
Chief Guest Sajith Premadasa emphasised the importance of eco tourism and said “We need to have an environmental policy related to tourism in place,” . .
The 32nd AGM of the Institute of Hospitality UK, Sri Lanka Chapter, was a testament to the strength and potential of Sri Lanka’s hospitality industry. The insights and commitments shared during the event set a new benchmark for the future.(ZC)
Pix by Thushara Attapathu
Life style
He recognizes human identity beyond boundaries of gender, race, nationality and religion.
Visit of Sri Gurudev to Sri Lanka
Humanitarian, spiritual leader and Global Ambassador of Peace Gurudev Sri Sri Ravi Shankar (Sri Gurudev) was in Sri Lanka on a three day tour on the invitation of the Prime Minister of Sri Lanka Dinesh Gunewardene. Gurudev who inspired a wave of volunteerism and service to moot one of the largest volunteer-based organisations in the world – The Art of Living – visited the various projects under the aegis of the foundation and launched twelve vocational and technical centers around the island. He was accompanied by thousands of followers from Sri Lanka and around the world.
Gurudev who visited Sri Lanka for the sixth time also had a first day cover launched in honour of his visit. He is a strong proponent of spreading happiness, using the unique Sudarshan Kriya, yoga, meditation and practical wisdom to unite people, empower individuals and transform communities. His programmes provide techniques and tools to live a deeper, more joyous life, while his non-profit organisations recognize the human identity beyond the boundaries of gender, race, nationality and religion.
The Art of Living which has more than 30,000 teachers and over one million volunteers across 180 countries has touched in excess of five hundred million people around the world. CNN called it “Life Changing” and The Washington Post headlined it, “Fresh air to millions”.
In Trincomalee, Gurudev met with war victims and had a heartwarming engagement with the children from the children’s homes run by the Foundation. He also visited the Koneswara Temple in Trincomalee and graced the Kumbhabhishekam at Seetha ecogPnize the human identity beyond the boundaries of gender, race, nationality and religion. Amman temple at Nuwara Eliya. He held discussions with the trustees on the progress of the foundation’s social service projects, while also holding a special event – Ekamuthuwa – attended by a large number of dignitaries and his devotees from around the world.
His time with the Prime Minister was spent discussing the prospects of unity in diversity and uniting Sri Lanka by adding happiness into the formula of living. In addition he had discussions with the Speaker of the Parliament of Sri Lanka Mahinda Yapa Abeywardena, prominent business stewards and civil society leaders.
by Zanita Careem
Envison your dream wedding day come to life at the Epitome Hotel, a prestigious city hotel in Kurunegala offering an unrivalled luxury rendors experience for weddings.
The venue is designed to embody opulence and luxury from all quarters for a spectacular wedding in kurunegala,Thier ballroom is the largest banquet facility in Sri Lanka It can be divided into six luxurious pillarless wedding halls on the ground floor and 25pax smaller banquet halls.
It can be easily named as a five star heaven in the heart of the city contributing to a myriad of immense experiences tailored to inspire and delight wedding experiences.
From opulent décor set up to exquisite table decor, lavish food, every detail is meticulously curated to spark your imagination and ignite creativity for a perfect wedding. The previous prestigious wedding shows season one and season two attracted large crowds
were unique events which gave the wedding vendors and potential clients had an opportunity to connect and interact with each other. Beyond being a showcase it was a chance for the wedding vendors to unite and contribute to the vibrancy of the wedding industry. The wedding show covered all area of the bridal industry providing a comprehensive variety of bridal supplies from Sri lanka and became the most popular bridal exhibitions in Kurunegala.This bridal exhibitions allowed brides and grooms to experience first hand the products and services available from suppliers in Sri Lanka
These wedding shows held at The Epitome created a benchmark and gave an opportunity for vendors to create connections to the utmost satisfaction said Harshan Lakshita Executive Director. of the magnificent Hotel
Our wedding shows featured experts and professionals in every field‘ It covered all areas of the bridal industry provided a comprehensive variety of bridal supplies from Sri lanka and became most popular bridal exhibition in this region.We are always open to everyone to join us at our wedding shows in the future. It is an opportunity to discover the incredible talent within our local wedding and bridal vendors to make meaningful relationships and plan thier special day at our breathtaking hotel The Epitome said General Manager Kavinda Caldera
The Epitome Hotel’s bridal show which will be held end of June will buzz with great ideas,advice and inspiration for all those who plan thier dream wedding
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The Hotel Epitome’s Wedding Season 3 will marked excellence, celebration and inspiration for those in the wedding industry. The exhibition halls will resonate with ideas on exquisite bridal wear to decor, florists , photography etc and showshowcase the rich tapestry of talent within the local wedding industry. .
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