5 minute read
PUBLIC POLICY
// GOVERNORS' VANTAGE POINT SPREADING AWARENESS of
Nonalcoholic Fatty Liver Disease By Nahum Méndez-Sánchez, MD, MSc, PhD, FACG
PREVENTING LIVER DISEASES IN MEXICO: A PRIORITY
One of the most satisfying aspects of my work in recent years is the opportunity to participate in different campaigns about the prevention of liver diseases. In my country, and specifically in my hometown, Mexico City, I organize and lead several long walks and run races in favor of a healthy liver. These events help to warn the general population about the effects of NAFLD, especially because Mexico has a serious problem of obesity and diabetes which currently are the main risk factors to developing NAFLD and, ultimately, cirrhosis. We must take into account that 50% of patients with diabetes have steatosis and 100% of patients with obesity and diabetes have steatosis. In fact, liver cirrhosis is the fourth cause of death in Mexico. Moreover, our research team investigated the current etiologies of cirrhosis in Mexico and we conclude that NAFLD, together with alcohol, will soon become one of the most frequent causes of liver cirrhosis.
A CHANCE TO DO MORE
Nevertheless, my activities at my place of work in Médica Sur Clinic & Foundation were limited to Mexico City and I felt that I could do more. So, I was excited last year when I received an invitation to participate in a TV show quite famous in all the country, called “Hoy” (which means “Today”), that has been on the air since 1994. I took the opportunity to spread awareness on national TV about NAFLD. In that very moment, it was something special since I diagnosed, just few days earlier, a patient with cirrhosis, and unfortunately the etiology was NASH.
The day of the interview finally came. I arrived early at the studio where the members of the staff kindly received me. Immediately they prepared
Nahum Méndez-Sánchez, MD, MSc, PhD, FACG ACG Governor for Mexico, Médica Sur Clinic & Foundation, Mexico City
me for the interview. At eleven a.m. we were on-air. The presenters introduced me to the public and after some introductions, questions began. The first one was about the definition of fatty liver. I tried to explain it clearly, emphasizing that from 5% of accumulation of fat in the liver we can call it fatty liver; it results from the different causes such as diabetes, obesity, and metabolic syndrome; and explaining also that triglycerides are synthesized in the liver from excess carbohydrates that are then esterified to storage for future energy needs. Surprisingly, the presenters did not know that triglycerides come from carbohydrates.
The second question was about the effects of alcohol on the liver. Of course, I explained that it is the main cause of fatty liver and there are other causes such as viral hepatitis and less-common hepatic autoimmune diseases, but again, given the high prevalence of metabolic risk factors such as obesity, metabolic syndrome, and type 2 diabetes, the prevalence of NAFLD will be higher.
Following the interview, we talked about diagnostic methods of NAFLD. Since Mexico has a huge public health program, I focused on non-invasive tests that most of the population can afford. First, emphasizing the importance of assessing metabolic risk, for example, if a patient has an increased body mass index. Second, the importance of liver function tests, and third, evidence that hepatic ultrasounds can give. Moreover, we talked about the complications of NAFLD and its progression from fibrosis and cirrhosis to hepatocellular carcinoma.
Finally, prevention was the last topic we discussed, and I basically explained that the best strategy is lifestyle interventions, of which diet and exercise are primary prevention by avoiding not just food with high concentrations of fats, but also those with carbohydrates. About weight loss, I repeatedly explained the importance to achieve at least a 10% loss of body weight. Finally, I said to the public that a medical assessment is also important and to consider going to a gastroenterologist or hepatologist if their physician told them the diagnosis of NAFLD.
I would like to say that the interview was a great experience. The influence of media in health is always important; now with the social media is easier to reach a lot of people, but I cannot deny that TV still has a lot of impact on the public. In fact, I believe that in Mexico the impact of TV is higher than in the United States, and the opportunity to use that tool in order to talk about a health problem that is not enough covered, even by the national health system propaganda.
For me, experiences like this are an example of the passion I feel for my specialty, also represented in being a member of ACG that at the same time encourages me to continue my labor, and that is why I am glad to share this with all of you.
I am sure that there are more stories like this or even better examples of the work of my colleagues in Mexico. I welcome all gastroenterologists in my country, and also those in the international regions, to share with our colleagues in other countries the
1 2
3
stories of the great work that an ACG member can do for people. Finally, I am proud of my involvement with ACG and congratulate the College for their continuous work improving people’s health.
ABOUT DR. MÉNDEZ-SÁNCHEZ
A member of the ACG since 2005, Dr. MéndezSánchez considers it an honor to serve as ACG Governor for Mexico. During his last year in this role, one of his goals is to encourage Mexican gastroenterologists to join ACG and/or to participate in the College’s academic activities. He was pleased when one of his youngest colleagues, Dr. Luis R. Valdovinos, applied and was selected for the ACG International GI Training Grant and trained at the Mayo Clinic.
NEWLY ELECTED AND APPOINTED ACG GOVERNORS
The following individuals were newly elected or appointed to terms on the ACG Board of Governors beginning October 2019:
Mohammad Al-Haddad, MD, MSC, FACG (Indiana) Wilson R. Catapani, MD, FACG (Brazil) Silvio W. de Melo Jr., MD, FACG (Oregon) Nalini M. Guda, MD, FACG (Wisconsin) Ronald K. Hsu, MD, FACG (Northern California) Baharak Moshiree, MD, FACG (North Carolina) Vonda G. Reeves, MD, MBA, FACG (Mississippi) Sapna V. Thomas, MD, FACG (Northern Ohio)
Learn More about the ACG Board of Governors & Connect with Your Governor:
